The United States has the most affluent and technologically advanced health care system in the developed world, yet it is also the most inequitable, with over 40 million of its own residents lacking access to this system of care—a fact which weighs heavily on our national conscience. Consequently, health care reform is again an urgent political issue, with the most recent reform package estimated to cost over 3 trillion dollars to institute. It is in this context that one of the newer technological advances, HPV (human papilloma virus) vaccination, must be evaluated. The rapid, deceptive, and pervasive promotion of HPV vaccine raises more questions than answers. Our understanding of HPV is evolving rapidly, but given what we do know, the vaccine makes little sense. Why are we vaccinating young women with an expensive, painful vaccine that has not been proven to prevent what it claims? Why are we advocating that all pre-adolescent young women be vaccinated against an uncommon virus that is known to be largely transient? Why has it been marketed when the long-term effects on the immune system of young girls and the oncogenic potential of other viruses are unknown? Are we perhaps creating more problems than we are preventing? And finally, is this an effective use of scarce medical resources and dollars? These are questions that should have been answered prior to FDA approval, but will need to be answered in the days ahead if we are to preserve a system of health care that is accessible to all of our citizens.