When public health experts learned about the arrival of Gardasil, the first vaccine approved by the US Food and Drug Administration to protect against cancer, many of them enthusiastically endorsed it. Since then, however, the vaccine has been dogged by political controversy. Now a new study, the first to provide details concerning adoption rates of the vaccine, reveals that in certain communities early uptake of the vaccine has fallen below expectations. Epidemiologist Sherri Sheinfeld- Gorin of Columbia University and her colleagues found that doctors in small private practices vaccinated fewer women than they had originally anticipated. The vaccine works by creating immunity to several aggressive strains of the human papilloma virus ( HPV).