In June 2006 the US Food and Drug Administration is expected to approve a human papilloma virus (HPV) vaccine which is over 90% effective in preventing new infections and precancerous cervical lesions caused by the HPV types that it covers.1 2 The vaccine prevents cancer through preventing sexual transmission of HPV types that cause cervical cancer.3 This link to a sexually transmitted infection raises ethical concerns that must be resolved if the benefits of preventing cancer are to be realised.

The vaccine must be given before HPV infection is acquired. It is most likely to be recommended for 11-12 year olds, because by the ninth grade (age 14-15) 28% of girls in the US are sexually active. This has prompted some advocates of premarital abstinence to charge that HPV vaccination will condone or promote sexual promiscuity. However, its impact will probably be small because multiple factors are associated with initiation of sexual activity; fear of sexually transmitted infections is …