At 27, I am too old to protect myself from cancer.

I was 21 when the Gardasil vaccine was widely released in 2008, amidst controversy over its microsecond of testing; it had only been approved by the FDA two years earlier*. At the time, I was married and like anyone who marries at 19 for all of the wrong reasons, I assumed I’d never be single again.

Couple this fact with my lack of health insurance and some of the more unnerving reports of the vaccine effects and I didn’t find it worth the cost or risk. Don’t misunderstand me. I am by no means an anti-vaccer. I plan to pump my children full of life saving hormones the second they enter the world. There is a reason we’ve eradicated diseases like polio and, until recently, measles. I wasn’t against vaccinating for HPV, but rather doing so with a formula concocted in some dude’s garage last week. I assumed that by the time had children, there would have been more tests verifying the safety of the vaccine, but for me, it wasn’t necessary, cuz happily ever after and all that jazz.

Then… I got divorced. At 23, with my divorce finalized and now with health insurance through my dad, Gardasil was once again on the table. It still scared me, though. I mean, this was only 2011. It had been widely distributed for only three years. How many times have we watched public service announcements about some miracle drug causing irreparable harm or even death? So, once again, I passed on the vaccine. I was in grad school and working two jobs. I wasn’t getting laid any time soon. In time, when I actually had the energy and desire to date, I could reconsider. Even when my health insurance was about to lapse, I still wasn’t comfortable getting the Gardasil shot. No. I wasn’t sexually active. I’d really only even kissed my ex-husband. I could private pay and get the shot later… or so I thought.

Things have been going really well with Jake, y’all. Like, he’s the bees’ knees and all that other nauseating sentiment. There have been fucking Eskimo kisses. It’s disgustingly cute and unquestionably white. I think I’m really falling for him and I’m getting a lot better at this making out thing, particularly since I’ve stopped apologizing for my lack of skill. At this point, he’s got to find the awkwardness endearing, because there’s absolutely no ignoring it. As patient and sweet as Jake has been over my lack of experience, though, he’s had a far more typical sexual history. I don’t want to know how many people he’s been with, and I’ve told him as much, but he’s admitted that he wasn’t always the poster boy for safe sex. In short, he’s been exposed to HPV, which according to the CDC most men and women will have at some point in their lives.* As there’s no way to test for this like other STI’s, it appears it would be time for me to schedule that private pay vaccine course for Gardasil. Sure, it’s expensive, but I’m willing to pay for my sexual health… if someone will let me.

shut up and take my money

After my conversation with Jake, I began to look into getting the vaccine. I discovered that, had I received the shot when I had insurance, it would’ve been Gardasil-4. This year, they’re switching to Gardasil-9, which includes protection from five more types of cervical cancer. Score! I can be even better protected for my money! I soon realized, however, that not only does the FDA only recommend vaccination up to age 26, under the assumption that most have already been exposed by this age, but many doctors will not approve the shot for “off label use” in anyone older. That’s right. Because it’s assumed that everyone over 25 has had more than four sexual partners, anyone who hasn’t is just too old to protect themselves from cancer.* Thank you, Food and Drug Administration. That is an awesome reward for my self-restraint and concern for my own sexual health.

Despite the many discouraging stories I found online, I decided to see if my general practitioner might make an exception, based on my personal circumstances.

Me: “… and I was wondering if Dr. Davidson might be willing to give the HPV vaccine to a 27-year-old. I know that the FDA only recommends it up to age 26, but I can pay for it out of pocket.”
Receptionist: “Well, I’ll have to discuss it with him and call you back.”
::calls back::
Receptionist: “You are over age. The FDA only recommends the vaccine up to age 26.”
Me: 
::Didn’t I just…?::
“I understand, but I’ve only had sex with one person five years ago, in a monogamous relationship. I’ve had less sex than most 24-year-olds. I’m trying to find out if the doctor will let me private pay for the vaccine as my own personal choice.”

The back and forth went on for an unreasonable length of time, before the receptionist finally told me that the doctor might give me the vaccine, but I’d have to pay for an office visit first. Having no health insurance, this was going to be $80 for a possible no, but I made the appointment with the PA anyway, for one hour later. I was so nervous and terrified that I’d be denied, that I arrived 30 minutes early and feared my blood pressure alone would disqualify me. I tapped me foot and read story after story of women being told no by doctors, on my phone, unable to find any with different results. This didn’t help the nerves, bee tea double ewe. Finally, my name was called, 15 minutes earlier than my actual appointment, but it felt like an eternity.

I’m lucky, y’all. As I sat, near tears over my own procrastination, I explained to the nurse why I wanted the Gardasil vaccine and why I felt I was still a good candidate. Though she gave me some information that I knew was incorrect, from having just read the entire CDC website, (the vaccine does so protect from genital warts, and quite effectively at that, as confirmed by the PA*) she also gave me some wonderful news: my doctor’s PA loves Gardasil and encourages anyone who wants to get vaccinated to do so. In no time at all, she arrived to tell me so herself. She agreed that I had little chance of previous exposure and while she couldn’t legally guarantee effectiveness, she saw no reason why Gardasil would not benefit me just as much as a 24-year-old in the same situation. If I was willing to private pay, I could receive the Gardasil vaccine. The consensus all over the Internet seems to be the same. Gardasil is effective as a vaccine against HPV for anyone with little sexual exposure, as HPV is primarily an STI and an extraordinarily common one at that. Having only slept with my ex-husband and having received normal results on all my gal exams, it’s unlikely I’ve been exposed. Yet, the FDA refuses to approve the use of Gardasil in the 26+ sexually inexperienced. Once again:

I thank my stars that I found a PA who is more considerate of individual circumstances, because she agrees that at 27, I still have every right to protect myself from cancer. Am I still afraid of the Gardasil vaccine? A little. I’m more afraid of cervical cancer and genital warts, though, so I had my first shot on Wednesday and I’m not dead yet. In fact, as frustrated as I am with the FDA, I’m also pretty irritated with the fear mongering anti-vaccers who keep insisting Gardasil would have killed me five years ago. I feel fine. Most people who take this vaccine feel fine. The one in a million outliers really aren’t a sound reason for me to risk cancer, which has a much higher likelihood of killing me.

So, fuck the FDA for telling me that statistically I should’ve put out more by now and fuck the granola-eating helicopter parents who insist that one of the best decisions I could’ve made for my sexual health would end me. Thank you, though, to the medical professionals who are willing to consider each patient’s story, because in no time at all, I’ll be protected. Speaking of which, there is one caveat that I hadn’t really discussed with Jake when I was doing my research.

::text message::
Me: So, the good news is, they’ve ordered the INSANELY expensive shot. The bad news is, no matter how well things go for us, I’m not having sex with anyone for like 7 months.
Jake: Good things come to those who wait. Lol.

He’s just… keen.

Citations

https://en.wikipedia.org/wiki/Gardasil

http://www.cdc.gov/std/HPV/STDFact-HPV.htm#a7

http://www.theatlantic.com/health/archive/2012/06/left-out-why-is-it-so-hard-for-older-women-to-get-the-hpv-vaccine/258611/

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5 thoughts on “At 27, I am too old to protect myself from cancer.

    • That’s pretty much the case, unless you can find a doctor to give you the vaccine over age. Insurance won’t pay for it, regardless.

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