Should adolescent girls be required to get a vaccine for a potentially lethal sexually transmitted disease? State governments around the country will soon have to decide. Merck has developed a vaccine for human papillomavirus, the leading cause of cervical cancer. The vaccine, which may receive FDA approval as early as this month, could potentially save about 2,500 lives a year in the United States. There is just one hitch. "In order to get the vaccine to the most people before they are exposed to HPV, we want to give it to them before their sexual debut," says medical epidemiologist Lauri Markowitz of the Centers for Disease Control.
The idea of routinely vaccinating girls between the ages of 11 and 12 against a sexually transmitted disease has some proabstinence groups up in arms. To Hal Wallace, head of the Physicians Consortium, such a program would send a message "that you just take this shot and you can be as sexually promiscuous as you want." Markowitz disagrees, pointing to a recent CDC report that vaccinating adolescents is unlikely to alter their sexual choices. "It doesn't look like fear of sexually transmitted diseases prevents people from being sexually active, so removing that fear is not going to affect people," she says.
Although Merck's vaccine will be marketed only for cervical cancer, preliminary evidence suggests it may also be effective against penile, anal, and vulvar cancers and even certain cancers of the head and neck. The vaccine could also significantly reduce the time and money spent on detecting and treating precancers, Markowitz says. All the same, the proabstinence Family Research Council states it "would oppose any measures to legally require vaccination." Alan Kaye, chairman of the National Cervical Cancer Coalition, is gearing up to fight on the other side. "How could we deny our children and grandchildren a win against cancer?" he asks. "Why would we?"
