If you've got kids above the age of 11, you may have heard something about the vaccine against HPV at the doctors office. However, you are more likely to have heard about the controversy surrounding it in the lay press, because the HPV vaccine is unique in its occupation of the intersections of health, sexuality, public policy and drug company marketing.

The human papillomavirus (HPV) family of viruses cause a variety of human illnesses. Some varieties cause the common and benign hand and foot warts that many are familiar with. More importantly, several “species” of these viruses are sexually transmitted and can cause cervical cancer in women, and genital warts in both sexes. Even though most women who contract the virus do not develop illness, nearly a quarter of a million women die each year worldwide from cervical cancer, and HPV is now recognized as the causative agent in the majority of cases. HPV is the most prevalent sexually transmitted disease on the planet. Cervical cancer is the second commonest cause of cancer deaths in women. This is a very big deal.

There are currently two vaccines on the market – Gardasil and Cervarix - both shown to be very effective against the two virus strains most implicated in cervical cancer. And both vaccines have been demonstrated to be extremely safe. Both are made by mega-pharmaceutical companies; Gardasil by Merck, Cervarix by GlaxoSmithKline.

So we have a common and potentially lethal disease that has a safe, effective and readily available preventive vaccine – what's the fuss about?

Unquestionably, the biggest deal is the fact that we are talking about a sexually transmitted disease. There is a notion among some that vaccinating adolescents encourages early and irresponsible sexual activity. Sadly, abundant epidemiological data suggest that teens need no such encouragement: 62% of 12 graders are sexually active, as are 33% of 9^th graders. Good data has also shown that fear of cancer is NOT a deterrent to sexual activity. Pregnancy yes, STD's yes – but HPV, based on its hit or miss nature and long time frame from infection to clinical disease, does not get this age groups attention.

“Well, its not like measles or something – you can't avoid that – sexually transmitted stuff is preventable through abstinence”. Well, yes and no. If you NEVER become sexually active, you are in safe territory. But read this sentence twice: 14% of women age 18-25 with ONE lifetime sexual partner STILL have HPV. I think you can figure out how this can be true. More depressing news: 12% of 9-12th grade girls report being forced into sexual activities, as do 9% of boys.

“Well, OK, but we are a very strong Christian family and we have taught the importance of purity to our children and I just don't think that this applies to our situation.” First of all, good for you for prioritizing abstinence education. It can be a difference maker. I wish it were enough. But please read the above paragraph again. Next ponder this sobering statistic: adolescents who label themselves as “evangelicals” actually have a slightly HIGHER rate of teen sexuality and a higher percentage of multiple (>3) partners – the prevalence is 13.7% - than those that are “non-evangelicals.” We can quibble till sunrise about the validity of some of the surveys behind these numbers – but we cannot hide from the fact that Americas teens are highly sexualized and are at greater risk than many realize.