Merck's human papillomavirus vaccine Gardasil should be given to both men and women, Bradley Monk, associate professor in gynecologic oncology at the University of California-Irvine, writes in a commentary published in the most recent issue of the journal Obstetrics & Gynecology, Reuters reports (Beasley, Reuters, 7/30). FDA last month approved Gardasil -- which is given in three injections over six months and will cost $360 -- for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that all girls ages 11 and 12 receive the vaccine (Kaiser Daily Women's Health Policy Report, 7/25). According to Merck, Gardasil in clinical trials has been shown to be 100% effective in preventing HPV infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, in women who do not already have the virus, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases. Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in Atlanta at a meeting of the American Society of Clinical Oncology (Kaiser Daily Women's Health Policy Report, 6/30). "We need to move toward a paradigm where this is a universal vaccine," Monk writes in the commentary, adding, "To have a vaccine that prevents cancer and not use it would be one of the greatest tragedies." Vaccinated boys and men would be protected from genital warts, and since men can transmit the virus to their sexual partners, all women and men should receive the vaccine, Monk says. He writes that vaccinating people with Gardasil does not promote sexual promiscuity, adding, "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" (Reuters, 7/30).