State vaccination proponents are calling attention to a virus often linked to cervical, anal, vulvar, vaginal, penile and oropharyngeal cancers.
The human papillomavirus, known as HPV, is the most common sexually transmitted infection.
It usually goes away on its own within two years without causing health problems. The cases that don't dissipate can lead to cancer, according to the Centers for Disease Control and Prevention.
A vaccine to prevent people from contracting HPV is available but underused in Indiana, proponents say.
"Indiana is 40th in the country for HPV vaccines, which is abysmal," said Lisa Robertson, executive director of the Indiana Immunization Coalition.
The state ranks high in other vaccinations, but not HPV, which was approved in 2006 for girls young women and 2011 for boys and young men.
"We do a phenomenal job vaccinating our adolescents, but not with this vaccine," Robertson said. "Thirty-three percent of our girls are getting the HPV shot and about 16 percent of our boys."
The top reason is a lack of education among health care providers and parents.
"I don't think a lot of parents know the vaccine is available, especially that it's available for young men," she said.
The coalition is making a push to guide providers on how to talk about the vaccine, which is most effective when administered to 11- and 12-year-olds but can be given into the 20s, Robertson said.
"This is cancer prevention," she said.
Health care providers may avoid discussing sexual health with parents of children who have not even reached their teens, but talking to them before their first sexual contact is key, she said.
"Once they're exposed, they're exposed," she said. "This is about preventing cancer in your children 20 years from now. It's a precaution."
HPV is spread via skin-to-skin contact, not necessarily through intercourse, she said.
HPV is a virus.
"There are very few symptoms, the most common being genital warts for men and women," she said.
About 80 percent of the population have been infected with HPV at some point in their lives, according to the CDC. About 79 million Americans currently are infected with HPV, and about 14 million become newly infected each year.
Women are often screened during their Pap test, but there is not good test for men, Robertson said.
The coalition is working closely with guidance from the Indiana University School of Medicine Center for HPV Research, and in collaboration with the Indiana State Department of Health, to develop strategies to assist physicians in presenting the vaccine to parents of adolescents in a way that is effective for acceptance, said Cindy Brown, project manager for an HPV vaccine public health outreach campaign in Indiana.
"It's a hard one for a lot of the doctors to talk about," she said. "Parents think, "My 11-, 12-year-old doesn't need this vaccine. They're not sexually active.' Kids are coming in for their physical. Their getting their vaccines, but they're not getting this."
The vaccine is not required by the school systems in Indiana. Studies have shown the vaccine is not linked to any serious physical or behavioral side effects, she said.
Not everyone is convinced.
Valparaiso resident Jim O'Kelly, of the Anti-Vaccination League of America, and founder of the "No Shots, No School: Not True" campaign, said all vaccines, including the vaccine for HPV, are frauds.
"This whole vaccination thing is an entire fraud," he said. "There's no virus that causes HPV. This is something I've uncovered over the years."
O'Kelly, 72, said his daughter was injured by a vaccine in 1969. She died 10 years ago.
O'Kelly said anti-vaccination efforts are the strongest in years, thanks to the Internet.
"If you look for facts in this thing, it'll crumble away really fast," he said. "People are screaming for truth and information, and they're not getting it."