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HPV Vaccine- Should I use it and will my insurance pay?
Dec 26, 2010

Does anyone know what this means for those of us who are (WAY)over 26, as relates to having insurance pay for it? I assume that would be considered "off label"--- Would most insurances pay for it, if it hasn't yet technically been demonstrated to be useful for people over the age of 26? My insurance pays for most vaccinations without a copay, but I expect this might be a reason why they'd not pay for it. Anyone with any insight about this sort of thing?

Response from Mr. Vergel

I doubt that you can get your insurance to pay since you are older than the age range on the label. Besides, Merck keeps telling us that it will not work for most of us since we have already been exposed to the most cancer producing genotypes. Unfortunately, HPV genotype tests are only available for research purposes (I wish we could have access to it)

A study showed that the HPV vaccine may work for some young gay men

Promising results in young MSM

I think the total cost for the 3 shots is close to $400. You can get it at your doctor's office. I would love to have access to genotype testing to find out if I really would be wasting my money if I were to decide to get the shots.

Jeff Taylor, one of my HIV activist friends, says that even for the boys 9-26 of age for whom it's indicated, the Advisory Committee on Immunization Practices (ACIP) still won't put it on the list of recommended vaccinations--meaning that public payers (and therefore private payers) won't cover it. They did carve out an "optional" recommendation for MSM, but how many parents are going to insist that their sons are gay to their provider so they can get the vaccine, and then fight with the insurance companies for coverage?

Regarding those over 27, the ACTG is planning a trial in HIV+ MSMs over 27 to measure its effect--which will be useful for the rest of us. Stay tuned, and sign up with an ACTG site near you.....

Nelson



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