I can only tell you about my experience, but here it is.

I live in Los Angeles and my doc is affiliated with UCLA (and is AWESOME, btw).

Got the first shot in early December. Hurts like a motherfucker for a couple hours, but I bet it hurts a lot less than a hysterectomy/chemotherapy.

Got the second shot just this morning. I'm a righty and this one hurt less, possibly because it was in my left arm (first one was in the right). Can't say if it's because it was the second shot, or the left arm, but for what it's worth.

Both shots were done at my doctor's office. My third shot is scheduled for early June, also at the doc's. It would never have occurred to me to get it at a drug store.

Don't know yet if my insurance covers it... the receptionist told me today that only Blue Shield (or maybe it was Blue Cross? I have one of them but can never remember which) covers it and she didn't think mine did. This struck me as odd because I haven't gotten a bill for the first one. She seemed to think I should pay upfront and seek reimbursement, which also struck me as odd, because since my PCP is in-network, billing usually goes directly to claims, and then they tell me if I owe anything.

Anyway, I didn't pay this morning but the receptionist told me I should call my insurer to ask if it's covered. I don't particularly want to, so I'll just wait and see if I get billed. And if I do, you can bet I'll be on the phone with them asking why they don't want to vaccinate people against cancer.

So there you go.

I know you ladies aren't here to dig up the research for me, but I think I may have gotten misinformation. I thought that once you were past a certain age or had already had sex, the shot was less effective? Is this not true?

I haven't gotten mine yet (and if it's sold out in the metro area I might have to wait awhile), but the idea is that girls should get it before they become sexually active, so they're shooting for anywhere between 9 and 13 I think. Then as a "catch up" strategy, women between that age range and roughly 26 are recommended to get it. Really, though, you can get it at any age and at any state of "deflowering." It only is ineffective if you have already been infected with the particular strains of HPV against which the vaccine protects. Even if you had another strain, you might theoretically still be able to get the vaccine, be protected from those strains of HPV, and thus from cervical cancer.

Anyway, to the OP: I see a gyno through my DC school's student clinic, and they told me they order the vaccine. Perhaps your doctor could order it specifically for you? All depends on what your preference is, I suppose.

No problem getting it in Salt Lake City, Utah. I had forgotten to ask for it (what with getting to know a new doctor) and then she recommended that I get it, so one of the nurses popped on over to the pharmacy and got it and by the time I was done with my exam and all dressed, they had it ready for me.

I only had a minor problem getting the first shot in december. My doctor's office hadn't gotten it in yet (they said that it was backordered), so I just had to go in a week later.

I'm pretty sure my insurance covers it, but I never bothered to ask.

I know my college has a stock of it too, but it's $120 a shot.

I know my college has a stock of it too, but it's $120 a shot.

That's dirt cheap. My doc's office charges $230 a pop.

Re: jrav
This is the addy for the CDC's Q&A on the vaccine:
http://www.cdc.gov/std/HPV/STDFact-HPV-vaccine.htm#hpvvac1

Under who should get it:
"The HPV vaccine is recommended for 11-12 year-old girls, and can be given to girls as young as 9. The vaccine is also recommended for 13-26 year-old girls/women who have not yet received or completed the vaccine series."

as for sexual activity:
" Females who are sexually active may also benefit from the vaccine. But they may get less benefit from the vaccine since they may have already acquired one or more HPV type(s) covered by the vaccine. Few young women are infected with all four of these HPV types. So they would still get protection from those types they have not acquired. Currently, there is no test available to tell if a girl/woman has had any or all of these four HPV types."

and finally over 26:
"The vaccine has been widely tested in 9-to-26 year-old girls/women. But research on the vaccine’s safety and efficacy has only recently begun with women older than 26 years of age. The FDA will consider licensing the vaccine for these women when there is research to show that it is safe and effective for them."

sorry for the long post...hope that was what you were looking for

I just finished my second shot in the series and this time, I asked the pharmacist for a needle so I could do it myself. Worked out great!

To get this second dose, though, I had to wait two weeks for them to order it (I live in Dallas).

I don't think pharmacists can give injections. I think you're going to have to have a nurse or MD.

Jebus, I miss one day on here-- computer problems-- and all hell breaks loose. I hope that they don't run out of the vaccine. I was watching CNN the other night, and they had a poll about whether this vaccine should be mandatory. In related news, when I saw the results (could have changed, I left to go do something or other) it was about 40% for it and 60% agaionst it.

wtf? Had this been any other cancer, there would be no debate! If I may quote my sister badly, "It's not about how you get it; it's about how much it kills you!"

Thanks to all. I appreciate the info.

Hi,
In most states, pharmacists are trained to give injections to adults for common vaccines and annual flu shots. The theory is that the pharmacist is the most accessible health care provider (no appointment to make, right in the neighborhood) and if shots are available at the local drug store more people will get vaccinated. It can vary from state to state, and I'm not sure how the HPV vaccine is being handled so if you need more information you can call any local phamacy (larger chains may have better implementation of these programs). Hope this clears up some confustion!

Good to know, PharmFatale. (awesome name, btw!)

I'm in the DC area, 23, been having sex for a good long while, but I still wanted to get the shot.
Sucks that it's sold out, but thank you for the reminder to call my dr.'s office about it!

If it's sold out, that means a lot of women are getting the shot, right?

~Oenophile, always seeing the silver lining.

that's weird, because when i asked my (new)gyno about this just this week she said it was only for "novices" by which I understood that she meant "virgins". was i misinformed?

In medical cost vs. benefit modeling (which strongly informs national medical public policy making and far too strongly informs the medical policies of HMOs), the most critical component is a value called "cost per life year gained."

If the cost per life year gained is under $50,000, that is generally considered a decent investment by US medical policy makers. If "cost per life year" gained is over $100,000, that is generally considered a wasteful medical policy because that money could surely be put to much better use elsewhere. Yes, this is cruel and heartless to some degree, but wide scale medical cost allocations do need to be made and, more relevantly, are continually made using these cost plus risk vs. benefit analyses. Think HMOs. Now consider why pap smears, blood tests and urine tests aren't recommended every month for everyone. Testing monthly could definitely save more than a few lives, and there is no measurable associated medical risk. But the cost would be astronomical versus the benefit over the entire US population when comparing these monthly tests to other therapies, procedures and medicines.

Now on to GARDASIL. By the time you pay doctors a small fee to inventory and deliver GARDASIL in three doses, you are talking about paying about $500 for this vaccine. And because even in the best case scenario GARDASIL can confer protection against only 70% of cervical cancer cases, GARDASIL cannot ever obsolete the HPV screening test that today is a major component of most US women's annually recommended pap smears. These tests screen for 36 nasty strains of HPV, while GARDASIL confers protection against just four strains of HPV.

Now let's consider GARDASIL's best case scenario at the moment -- about $500 per vaccine, 100% lifetime protection against all four HPV strains (we currently have no evidence for any protection over five years), and no risk of any medical complications for any subset of the population (Merck's GARADSIL studies were too small and short to make this determination for adults, these studies used potentially dangerous alum injections as their "placebo control" and GARDASIL was hardly even tested on little kids). Now, using these best case scenario assumptions for GARDASIL, let's compare the projected situation of a woman who gets a yearly HPV screening test starting at age 18 to a woman who gets a yearly HPV screening test starting at age 18 plus the three GARDASIL injections at age 11 to 12. Even if you include all of the potential medical cost savings from the projected reduction in genital wart and HPV dysplasia removal procedures and expensive cervical cancer procedures, medicines and therapies plus all of the indirect medical costs associated with all these ailments and net all of these savings against GARDASIL's costs, the best case numbers for these analyses come out to well over $200,000 per life year gained -- no matter how far the hopeful pro-GARDASIL assumptions that underpin these projections are tweaked in GARDASIL's favor.

Several studies have been done, and they have been published in several prestigious medical journals:

http://dx.doi.org/10.1001/jama.290.6.781
http://tinyurl.com/2ovy95
http://tinyurl.com/2tbuma

None of these studies even so much as consider a strategy of GARDASIL plus a regimen of annual HPV screenings starting at age 18 to be worth mentioning (except to note how ridiculously expensive this would be compared to other currently recommended life extending procedures, medicines and therapies) because the cost per life year gained is simply far too high. What these studies instead show is that a regimen of GARDASIL plus delayed (to age 22, 25 or 28) biennial or triennial HPV screening tests may -- depending on what hopeful assumptions about GARDASIL's long term efficacy and risks are used -- hopefully result in a modest cost per life year savings compared to annual HPV screening tests starting at age 18.

If you don't believe me about this, just ask any responsible OB-GYN or medical model expert. Now, why do I think all of this is problematic?

1) Nobody is coming clean (except to the small segment of the US population that understands medical modeling) that the push for widespread mandatory HPV vaccination is based on assuming that we can use the partial protection against cervical cancer that these vaccines hopefully confer for hopefully a long, long time period to back off from recommending annual HPV screening tests starting at age 18 -- in order to save money, not lives.

2) Even in the best case scenario, the net effect is to give billions in tax dollars to Merck so HMOs and PPOs can save billions on HPV screening tests in the future.

3) These studies don't consider any potential costs associated with any potential GARDASIL risks. Even the slightest direct or indirect medical costs associated with any potential GARDASIL risks increase the cost per life year gained TREMENDOUSLY and can even easily change the entire analysis to cost per life year lost. Remember that unlike most medicines and therapies, vaccines are administered to a huge number of otherwise healthy people -- and, at least in this case, 99.99% of whom would never contract cervical cancer even without its protection.

4) These studies don't take in account the fact that better and more regular HPV screening tests have reduced the US cervical cancer rate by about 25% a decade over the last three decades and that there is no reason to believe that this trend would not continue in the future, especially if we used a small portion of the money we are planning on spending on GARDASIL to promote free annual HPV screening tests for all low income uninsured US women.

5) The studies assume that any constant cervical cancer death rate (rather than the downward trending cervical cancer death rate we have today) that results in a reduced cost per life year gained equates to sound medical public policy.

As I said before, if any of you don't believe me about this, please simply ask your OB-GYN how the $500 cost of GARDASIL can be justified on a cost per life year gained basis if we don't delay the onset of HPV screening tests and back off from annual HPV screening tests to biennial or triennial HPV screening tests.

The recommendations are already in: http://tinyurl.com/33p9q6

The USPSTF strongly recommends ... beginning screening within 3 years of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 years ...

is it just me? i find it very curious that hpv is a sexually transmitted disease, yet is is women that the vaccine was designed for, and may eventually be forced to take... not that i'm against the vaccine in and of itself (though i do have some serious questions about them overall), but why aren't men being held more accountable? they are spreading it, after all...

a) there's no reliable way to test men for HPV. they're going to be spreaders for a while. they haven't tested the vaccine on dudes because it's not causing cervical cancer for them.

b) i live in northern VA. I pay $160 per shot. I have Blue Cross "CareFirst". My doc. makes me pay for each shot, which i then submit for payment. Blue Cross finally sent me a check for the first two shots this month. I'm 26. I asked about Gardasil as soon as it came out. My doctor informed me that the drug will probably be tested for older gals soon, but that while i'm in the age range, and have had no irregular paps, i should go for it. i did so.

c) when i went for the last of three shots last week, i was told the doctor's office was out of it. i was told to call back to see if they had any in a few days and come in then. the efficacy of the first two won't decline in the meantime, and the final shot should fix me up cancer-free.

d) cancer-free. well, at least that one cancer. one small step for a woman...