Merck and the Debate Over Mandatory HPV Vaccinations

The New York Times reports in Furor on Rush to Require Cervical Cancer Vaccine:

Racing to embrace a new vaccine, at least 20 states are considering mandatory inoculation of young girls against the sexually transmitted virus that causes cervical cancer.

But a roaring backlash has some health experts worried that the proponents, including the vaccine’s maker, Merck, have pushed too far too fast, potentially undermining eventual prospects for the broadest possible immunization.

Groups wary of drug industry motives find themselves on the same side of the anti-vaccination debate with unexpected political allies: religious and cultural conservatives who oppose mandatory use of the vaccine because they say it would encourage sexual activity by young girls.

Even some who support use of the vaccine question the rush and the vaccine’s high cost — about $400 for the three-shot course. “The decision to make this mandatory this early has created a significant controversy over things that have nothing to do with the vaccine,” said Dr. Joseph A. Bocchini, chairman of the committee on infectious diseases of the American Academy of Pediatrics. . . .

The rush for mandatory inoculation — most of the state proposals have been introduced since the beginning of the year — is unusual. It was only last June that federal regulators approved the vaccine, called Gardasil.

Even before the vaccine’s approval, though, Merck had begun laying the political foundation in state legislatures to promote widespread vaccination of young girls.

Gardasil and another vaccine under development by the drug maker GlaxoSmithKline are aimed at the human papilloma virus, or H.P.V., which is known to be the cause of cervical cancer. Analysts see a potential $5 billion a year market for H.P.V. vaccines, and some say that Merck is intent on inoculating as many girls as possible before the introduction of Glaxo’s product, which could become available this year. . . .

The controversy worries public health experts like Dr. Bocchini, who is also the chief of pediatric infectious diseases at the Louisiana State University Health Sciences Center. He is concerned that the outcry might make the public mistrustful of a vaccine that would otherwise be to its benefit.

“If the public had enough experience with the vaccine and had enough knowledge about H.P.V., the question about whether to get the vaccine or give it to their daughters wouldn’t be an issue,” Dr. Bocchini said.

The Washington Post reports today that, in response to the furor, Merck has promised to stop its campaign for state legislation requiring the vaccine:

Merck and Co., a New Jersey-based pharmaceutical maker, announced yesterday that it would stop its nationwide lobbying for states to require that young girls be immunized against a virus that causes cervical cancer.

Merck officials said the decision comes after public accusations that the company's profit motive, rather than public health, is guiding the debate over whether to require rising sixth-grade girls to receive Gardasil. The new vaccine protects against several strains of human papillomavirus that cause nearly 7,000 cases of cervical cancer annually.

Read Merck to Stop Pushing to Require Shots.  For more stories on the issue, see the round-up in today's Kaiser Daily Women's Health Policy Report.