When is the HPV Vaccine Effective? What about disclosure?

[ShyGuy1672]

Quick question: I'm three months into the Gardasil-9 Vaccine. I had my first injection of the three dose schedule on 9 Oct and second dose on 11 Dec. Knowing that my third dose will be in March, my question is whether the vaccine is effective and working in my body now or if it doesn't become effective until the third dosing?

Back Story: I've been in a 1.5 year relationship with my partner. About a year into it, she revealed that she'd had HPV/Genital Warts in College and just found a wart.

It had been two years since she'd had an outbreak, so thought her body had cleared it, so never told me about it in our STI/Safe Sex talks.

During the first year, before the new outbreak, we had unprotected sex. We traveled a lot, so were mostly long distance during that period, probably spending 3-4 month combined together.

We've learned a lot about HPV and our relationship since then and understand we have no way of knowing if it was a reoccurrence of her old condition or potentially a reinfection from me or another partner. We also understand that because of the unprotected sex, there is a strong likelihood that even if I didn't carry it previously, I have it now.

I shared the history with my doctor and that I've never experience genital warts myself. He performed a genital exam and found no evidence of warts at that time and I've seen no outbreak since.

When I asked about getting the vaccine off-label (since I'm over 26), he said there is a chance I haven't been infected, so there would be no harm in it.

So that's where we are today. My partner and I have practiced very safe sex since she found the first wart (we realize this isn't 100% effective for skin-skin transmission) and I'm two doses into the regime.

What I'd like to know is whether my body now has the antibodies to protect me from exposure (on the small % chance that I haven't already been exposed), which would mean the third injection is really about extending the efficacy of the vaccine, not adding immediate protection.

My partner and I would like to move forward and make decisions on how we're going to live our lives going forward. While I'm still going to get the third dose in three months, the question boils down to whether we can start making those decisions today or if we're still waiting.

Lastly then, and I've gotten different feedback on this one elsewhere, if my partner and I break-up and I find myself in a new relationship, what do people think about disclosure? I have never had an outbreak and assume that will continue to be the case, either because I was previously exposed and asymptomatic or because I had the vaccine. Do I tell a potential future partner in the STI discussion, "I've never had any genital warts and I've been vaccinated against the most common strains, but I was with someone that had it (like 75% of adults in the US at some point in their life) and we did have unprotected sex. But even if we'd had protected sex every time, it's not 100% effective because HPV is spread through skin-skin contact. And there is no male test for it, so I'll never know if I'm a carrier or not."

Disclosure to me is about providing relevant information for a partner to make an informed choice about the risks they are potentially exposing themselves to in a new partner. Because of the way HPV works (potentially being dormant for years after exposure and in such a high % of the population) and given that there is no way to know if I'm a carrier (assuming I continue to not have symptoms), is it actually relevant information?

Is it like disclosing, "I was once in a hospital and sat next to someone with Tuberculosis who was breathing. Even though I've never had a symptom, I may have been exposed." This is not relevant disclosure in my opinion.

Thanks in advance to the community and staff for any thoughts!

[Heather]

Welcome to the boards. Sorry you've gone through something topsy-turvy like this, but it sounds like you've handled it really well.

I really just don't think we could possibly say or predict what level of protection the vaccine gave you per the number of injections. Three is the complete dose, so I do think you'll want to be realistic and figure that to have the full effectiveness of the vaccine, you probably needed all the injections. But ultimately, I think these are questions you really want to ask an epidemiologist. If anyone is able to answer this kind of question that specifically, that's the kind of person who could.

In terms of how or what to disclose, I think a shorter version of what you suggested you might say sounds perfect: you know you have been exposed, you were exposed before being vaccinated but have been vaccinated, and to your knowledge (though honestly, people with a penis won't usually see outbreaks, so) you haven't ever had genital warts, a symptom of some strains of genital HPV. I don't think you need to explain this to a partner like you were a healthcare provider, since a) you're not, and b) dropping big sex ed on a partner who isn't asking for it can feel pretty patronizing, you know? They can research HPV if they want and find these things out like you did, if they haven't already, or they can ask questions of you if that's something they want to do.