A shot in the dark: Are we ready for STD vaccines?

Vaccines in the pipeline are delving into new terrain: sexually transmitted diseases. The target audience of young teens poses unique challenges.

By Susan J. Landers, AMNews staff. Nov. 3, 2003.

David I. Bernstein, MD, envisions a future in which a physician would turn to a mom accompanying her daughter for a routine office visit and say, "Oh, she's 13, it's time for these vaccines." The teen would roll up her sleeve, and the doctor would administer a vaccine against human papillomavirus. And maybe another to ward off herpes simplex.

But Dr. Bernstein, professor of pediatrics and director of the division of infectious diseases at Cincinnati Children's Hospital, is also the father of teenage daughters. "I keep thinking, wait, these are my girls we're talking about." He, like most parents, can't imagine that his children will be having sex someday, perhaps sooner than he would want.

Dr. Bernstein's hopes and fears cut to the heart of the debate over many of the vaccines now in the pipeline. They offer the promise of protection from sexually transmitted diseases, but the fact that the target audience is young teens or even preteens might prevent these vaccines from being widely accepted for a number of reasons.

Researchers are working on vaccines that protect against not only HPV and herpes but also chlamydiosis, cytomegalovirus infection, gonorrhea, hepatitis C and HIV. Any single one of these vaccines, if brought to market, could save millions of health care dollars, not to mention the personal toll of disease and death.

Chlamydial infections can cause sterility in women, genital herpes poses a life-threatening risk to newborns, and untreated gonorrhea can cause infections in other parts of the body. Prenatal cytomegalovirus infection is a leading cause of death, mental retardation and deafness. HIV continues to ravage the world's population. A safe and effective HPV vaccine, which many believe will be on the market within the next three to five years, could put an end to the majority of cervical cancers.