Mandatory Vaccination with Merck's Gardasil Raises Eyebrows

Last week, Governor Rick Perry (R-Texas) decided on a bold move when he announced an Executive Order mandating the vaccination of girls with Merck's (MRK) new anti-HPV vaccine Gardasil.

A Controversial Good Cause
By itself, this news would be interesting. A governor so interested in public health, that he or she bypasses all other regulatory and legislative channels with an Executive Order would be newsworthy. But in this case, there is controversy.

Here is the background. Gardasil was approved last year in June, 2006 by the FDA as the first vaccine to prevent cervical cancer in women by building immunity to human papillomavirus - the most common sexually transmitted infection in the United States. The vaccine is given to young girls because it is most effective if administered prior to any HPV infection.

Planned Parenthood has advocated for widespread vaccination. According to the Washington Post coverage - "The most effective vaccination programs are either given to young children or are mandated for attending school," said Jeffrey Waldman, senior director for clinical affairs for Planned Parenthood Federation of America. Rarely does one expect to find Planned Parenthood and a conservative Republican governor of a southern state in bed together.

A Delicate Balance Between Lobbying and Public Affairs
But some people disagree with them. Their logic (or lack thereof, depending on your point of view) echoing back to the needle exchange/condom availability controversy in HIV/AIDS prevention, is based on the belief that the vaccine will encourage or condone sexual activity. But some of the outrage directed at the Governor, by such organizations as The John Birch Society are based on the fact that some perceive the move by the Governor not to be out of public health concern, but due to lobbying by the drug's manufacturer, Merck. In fact, apparently one of Merck's Texas lobbyists is in fact Governor Perry's former chief of staff.

Coverage of this issue in the media or the blogosphere generally takes note of the fact that Merck is actively lobbying in other states for mandatory coverage. Without getting into the merits of requiring the vaccination, the sudden emergence of this situation in Texas points to the need for a delicate balance between direct lobbying and public affairs efforts. In this case, it is important that parents have a full understanding of the complexities of the problem between HPV and cervical cancer, along with rates of sexual activity among teens. In that way, they understand the problem so that when the solution presents itself, by whatever mode, it has a higher level of acceptance.

Educating the Public
I'm not saying that Merck has failed to consider the balance between lobbying and public affairs in advocating for immunization. I have no insight into their public education efforts in Texas and have no other facts at hand. But judging by some of the coverage, it is possible to consider that the governor of Texas provided a solution to a problem before many were even aware of the problem. Educating the public after the fact is much harder.

While public health advocates may cheer, if people perceive big pharma is pushing solutions on them before they want them through intensive lobbying efforts and campaign contributions, the value of the geniuine public health contribution being made by a drug like Gardasil can be easily overshadowed by resentment. That does neither Merck or the pharma industry any good. It is essential that public relations communicate before lobbying activates.

By the way, anyone interested in contacting Governor Perry about this decision can do so through this link.

RELATED READING:
- The New FDA Drug Safety Initiative
- Merck Wants Out of Pfizer's Shadow
- Merck Putting Vioxx Behind It

MRK 1-yr chart

Comments

[M Opine]

The media seems to have jumped on the "religious nuts don't want sex vaccine" bandwagon but there is plenty of legitimate opposition to this drug.

Merck was the same company that brought us the Vioxx fiasco. Remember that?
What are the side effects of this drug? Does it have the potential to cause sterility? What other health effects is this going to have on young kids? Neurological damage? Seizures? (see link below)

The assumption seems to be that Gardasil is some type of magical cure with no ill effects.

If Merck is so eager to prevent cancer in women then why is it charging $500 for the vaccine? Why not make it free? Oh wait, the government and tax payers will pick up the tab for the bulk of the poor and insurance will cover the rest - now I get to pay even higher premiums!

Who's against this mandate?
www.drugnewswire.com/1.../

National Vaccine Information Center
Texas Doctors Association
Texas State Legislators
Most Texas Citizens

[xxx xxx]

I completely disagree with your opinion. The drug has been studied in thousands of people and has shown to be safe. It has sideeffect and they are clearly stated.

Maybe I am too much of a European but we talk here about cancer prevention. If someone doesn't want to vaccinate his child - so be it. But, if that child later develops cancer why should society pay for the treatment ? A taxidriver is paying a higher insurance premium compared to someone with less mileage per year. If someone deliberatly doesn't vaccinate then his health insurance premiums should go up because it is a higher risk.

US$ 500 to prevent cancer is actually cheap. If you drink one cappuccino a day for US$ 5 you spend that money in a little over 3 months - would you stop drinking coffee just because of that?

[M Opine]

Well the same argument can be made on the adverse effects. How much does it cost to treat arthritis? Seizures? Remember Vioxx, Phen-Phen and a slew of other drugs that ended up killing people.

According to the news article, the drug was tested in 2000 people. 2000 out of 6 billion on the planet = 0%

I don't drink coffee.

[prayforouryouth]

I wish people would THINK for themselves! We do not need the state controls on things like this. Do you really want the government telling you you MUST vaccinate your daughter against sexuually transmitted diseases? What if you are trying to teach chastity? Why would anyone want this garbage pumped into their daughter's body. Just teach your daughters! Talk to them! Demonstrate moral lifestyles by living one yourself!

[M R Bigginz]

Obviously you're not well informed on this subject matter. Sure, the government is pointing this program toward childern and teenagers, however once a women is inoculated it protects her from the HPV virus for a lifetime.

With studies showing that 50% of our population being infected, only a irresponsible, ignorant adult would not want this for their child. Abstinence, of course is best when a child/teenager, but our daughters eventually grow up into an adult. This infectious desease can be transmitted in such a stealth-like manner, without this protection (condoms don't work and men sometimes exhibt no symptoms) there is no way of assuring their saftey.




On Jun 08 08:45 AM prayforouryo uth wrote:

> I wish people would THINK for themselves! We do not need the state
> controls on things like this. Do you really want the government telling
> you you MUST vaccinate your daughter against sexuually transmitted
> diseases? What if you are trying to teach chastity? Why would anyone
> want this garbage pumped into their daughter's body. Just teach your
> daughters! Talk to them! Demonstrate moral lifestyles by living one
> yourself!