New recommendations, same old policies. Getting HPV vaccine at 27-45?

October 18, 2018 12:56 PM

You've probably heard about the very recent changes to the CDC's HPV vaccine recommendations, now stating that people 27-45 should get the HPV vaccine as well. My insurance company (Highmark) has not changed its coverage, though, which is frustrating since I'd get the vaccine today if it were covered. They didn't seem to have any plans to change their policy, either. Has anyone here received the vaccine when they were over 26? Did you have to pay out of pocket? Any advice would be appreciated.
posted by Seeking Direction to Health & Fitness (11 answers total)

I just saw that and totally want it, too! I’ve always been one year too old until now. I’ll be watching answers here closely.

As a data point, United Health Insurance doesn’t cover it above 26 either (with no plans to change).
posted by Weeping_angel at 1:00 PM on October 18, 2018 [2 favorites]

The change is litterally weeks old. Insurance companies generally work on yearly formularies, trying again when your policy roles overb islikely your best bet.

Your public health department may be starting to plan a drive to vaccinate it's worth calling them , but give it at least another month or two. These things move slow.
posted by AlexiaSky at 1:02 PM on October 18, 2018 [5 favorites]

CDC's Advisory Committee on Immunization (ACIP), which advises CDC on vaccine recommendations, has not voted to recommend the vaccine for older ages," explains CDC press officer Kristen Nordlund in an email, adding that the ACIP meets later this month (October 24 and 25) and will be discussing this topic. In fact, anyone interested can tune into the webcast.

In other words, the bureaucratic changes around this aren't finished yet. It's my understanding that insurance companies follow the ACIP recommendations in determining which vaccines to cover.
posted by ThePinkSuperhero at 1:18 PM on October 18, 2018 [7 favorites]

I did! I started the series at age 43 and finished it a few weeks after I turned 44. This was before the extended age range was approved, so I did pay out of pocket. I also had trouble finding someone to do it. I tried Planned Parenthood, and they wouldn't even discuss it, which makes me really angry. I ended up getting it from a clinic that specializes in gay and trans health. I'm really happy I got the vaccine, and if you can afford it, I would strongly suggest you just pay for it.

I had zero side effects except for the usual slightly sore arm you can get after any shot. Keep in mind that the vaccine has been approved for up to age 45 in Australia for years, and they're on track to eliminate cervical cancer.
posted by Violet Hour at 3:34 PM on October 18, 2018 [3 favorites]

Weird, I just came here to suggest going to Planned Parenthood. That's where I got the series when I was 23, but maybe I had a better experience with it because I was in the recommended age range at the time, or maybe things have changed. Anyway, I would still suggest giving them a call in your area to see what they say. Otherwise, yeah, a local clinic might be the way to go, and you might check around to see who's updated their guidelines yet.
posted by limeonaire at 4:00 PM on October 18, 2018

I got it when I was 30(?) ish, but had to pay out of pocket. I also got my Hep-B vaccine at the same time. My doctor recommended them and it seemed like a good idea to me. It was also reasonably convenient for me (the doctor was close to my work and my workplace has flexible work hours).

I'm in Australia, and the Gardisal was frigging expensive. I wouldn't rush, unless you have a lifestyle that is likely to expose you to HPV. If there's a chance your insurance may pick up the bill in the near future, I'd wait and see.
posted by kjs4 at 8:32 PM on October 18, 2018

I got Gardasil when I was 28, I think. I just went to my regular OB/GYN. I had to pay out of pocket. It seems like a miracle of science to me--I would recommend it to anyone. (I used to know a man who had gotten it! Mad respect.)
posted by heatvision at 3:31 AM on October 19, 2018

Response by poster: Thanks, everyone! I guess I'll stay on the lookout for announcements from my local health department. Fingers crossed that Highmark updates its policies.

If it makes any difference, I'm a 27-year-old (cis, heterosexual) male. So technically the vaccine hasn't been "recommended" for me since I was 21 (since I don't fall into a "high-risk" category)...and the HPV vaccine wasn't recommended for men at all back when I was a teenager. I still think it's worthwhile.
posted by Seeking Direction at 6:05 AM on October 19, 2018

I'm a late-30s cis male, and I've been asking about the vaccine for years. As soon as I read about the new approval, I sent my doctor a request to get it, and they responded: "While the FDA has approved HPV for an extended population, they are not the only approval we need. Both the Center for Disease Control (CDC) and the Advisory Committee on Immunization Practices need to ratify use of the vaccine for the new age group. They have not done so at this time. "
posted by middlethird at 1:43 PM on October 19, 2018 [1 favorite]

Wouldn't that age group already be exposed? Isn't 27-45 too late? The CDC doesn't specify.
posted by onecircleaday at 3:59 PM on October 19, 2018

Wouldn't that age group already be exposed? Isn't 27-45 too late? The CDC doesn't specify

While most in that age group have already been exposed to HPV, it's highly unlikely that everyone has been exposed to **all nine strains** covered by the vaccine, so we still get protection.

And again, if your doctor won't do it, that just means you need a new doctor. I got it outside the age range before there was even FDA approval, I just had to call around until I found a clinic willing to do it. Start with LGBTQA+ health centers (seriously, just search "gay doctor + yourcity"); they're more likely to have been giving it to men before it was approved for them.
posted by Violet Hour at 8:12 PM on October 19, 2018 [1 favorite]