HPV vaccination reduces oncogenic HPV16/18 prevalence from 16% to <1% in Denmark

Original Article ↗ Hacker News Discussion ↗

Impact in Denmark and Data Infrastructure

  • Commenters highlight Denmark’s dramatic drop in cervical cancer incidence (from >40/100k to <10/100k, and ~3/100k in women 20–29), now below WHO’s “elimination” threshold.
  • The main “success” is seen as the ability to measure impact at population scale via national registries and digital systems; debate over whether e‑Boks (digital mail) itself is critical or just convenient.
  • High trust in public health and strong childhood vaccination programs are cited as key cultural/contextual factors.

HPV Types, Vaccines, and Possible Type Replacement

  • HPV16/18 prevalence in vaccinated Danish women has fallen from ~15–17% to <1%.
  • Concern: non‑vaccine high‑risk (HR) types remain common (~1/3 of women) and appear more frequent in vaccinated than unvaccinated groups in this study.
  • Some see this as potential “type replacement” and want broader-valent vaccines; others downplay it or call some non‑16/18 strains mostly a “nuisance.”
  • Gardasil 9 (9‑valent) is now standard in many places, but questions remain about coverage of other HR types.

Vaccinating Boys and Adult Men

  • Strong argument that focusing HPV messaging only on girls/cervical cancer is a public‑health failure, since HPV also drives throat, anal, and penile cancers and genital warts in men.
  • Many report age and sex-based access barriers: coverage often stops at 26, some must pay €300–€1,000+ out of pocket; others report full coverage in their 30s–40s.
  • Debate over benefit in older adults: some say vaccine is “useless” after exposure; others correct this, noting multiple strains and partial protection, but also that efficacy and cost‑effectiveness drop with age and prior infection.

Sexual Behavior, Morality, and Prevention Strategy

  • One side advocates abstinence/early lifelong monogamy as primary STI control; others respond that such advice is unrealistic, often harmful, and analogous to “just eat less” for obesity.
  • Broad agreement that education, condoms, and vaccination are more practical than moral prescriptions.

Safety, Misinformation, and Censorship

  • A flagged anti‑HPV article is dissected: critics say it cherry‑picked data, hid control groups, and overstated risks, while still exposing some real communication gaps (e.g., adjuvant “placebo,” handling of already‑infected individuals).
  • Some call celebrity anti‑vax “quackery” that should be criminal; others warn that criminalizing “misinformation” invites abuse and a de‑facto “ministry of truth.”
  • Denmark’s approach—openly listing serious but rare adverse events while emphasizing large cancer‑risk reductions—is praised.

Individual Risk, Cost, and Uncertainties

  • Multiple anecdotes: people struggling to obtain HPV vaccination as adult men, or only learning of its relevance after HPV‑related cancers.
  • Technical debate over:
    • How much vaccination helps once infected;
    • Differences in efficacy between women vs men and young vs older;
    • Reliance on surrogate endpoints (HPV DNA prevalence) vs long‑term cancer outcomes.
  • Some commenters inject extreme skepticism (questioning HPV–cancer causality, PCR validity), but others counter that such positions ignore a large body of converging evidence.