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Allison slid behind the wheel of her Toyota Highlander, strapped on a seat belt, and put the key in the ignition. Before starting the car, however, she paused to reflect on her recent encounter with Dr. Sarah Smith. Dr. Smith had delivered her and Steve’s twins—Ellie and Elijah—12 years ago, and since that time had served as their family’s physician and friend. She had scheduled her appointment with Dr. Smith because of a nasty sinus infection . . . but left with more than a prescription. Allison thumbed through the pamphlet she had taken on Gardasil, the vaccine developed by Merck over a decade ago. Gardasil was initially approved for young girls and women and later expanded to include boys and men. Dr. Smith suggested that Ellie and Elijah be vaccinated at their upcoming annual physicals. “The reason why I am recommending you consider this for the twins now is because we can integrate the inoculations alongside the other vaccinations required for public school attendance for kids entering the sixth grade,” Dr. Smith had stressed. She also pointed out that the latest version of this vaccine now includes protection against nine strains of the HPV virus, up from only four.