Eventually, men, women, girls and boys should be universally vaccinated against the STD human papillomavirus (HPV), regardless of their individual risk factors, two doctors argue in a new article.

In June, the Food and Drug Administration approved Merck & Co., Inc.'s HPV vaccine Gardasil for girls and women ages 9-26. A month ago, a government advisory panel recommended routine vaccination of girls ages 11-12; and girls and women 13-26 who have not been vaccinated, have had an abnormal Pap smear, genital warts or other specified conditions.

About half of sexually active adults contract HPV at some point. HPV is usually harmless, though it can lead to cell abnormalities in the cervical lining that can progress to cancer. It can also cause genital warts and penile cancer. Gardasil protects against four types of HPV that can lead to cervical cancer and genital warts.

"We need to move toward a paradigm where this is a universal vaccine," said co-author Dr. Bradley Monk, a University of California-Irvine associate professor in gynecologic oncology. Because males can transmit HPV to their sexual partners, it is sensible to vaccinate boys, he said.

Some groups oppose the idea of vaccination as a requirement for school admission, saying parents should decide whether children receive an STD vaccine.

Monk dismissed the argument that an STD vaccine could encourage promiscuity. "Just because you wear a seat belt, does that mean you drive recklessly? Or just because you give your son a tetanus shot, does that mean he is going to go out and step on a rusty nail? Of course not," he said. "To have a vaccine that prevents cancer and not use it would be one of the greatest tragedies."

The full commentary, "Will Widespread Human Papillomavirus Prophylactic Vaccination Change Sexual Practices of Adolescent and Young Adult Women in America?" will be published in the Aug. 1 issue of Obstetrics & Gynecology (2006;108(2)).

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