Gardasil: To Be Mandatory or Not To Be Mandatory — That is the Question

Won’t anyone defend Merck’s campaign to mandate the vaccination of school girls with Gardasil?

Even fellow blogger and industry supporter Rich Myer over at World of DTC Marketing claims this issue “is a prime example of what’s wrong with pharma and adds to the public perception that pharma is only in it for the money” (see “A prime example of whats wrong with Pharma (Gardasil)“).

The brouhaha over Gardasil was heightened when Texas Republican governor Richard Perry signed an executive order requiring school girls to be vaccinated with Gardasil (see “Texas Gov. Orders Anti-Cancer Vaccine” and “Texas vaccine mandate draws GOP ire“).

You would think that vaccination against a form of cancer would be a no-brainer. Maybe I am too close to this. We lost a very dear friend to ovarian cancer. She was only thirty-something, had two small daughters, and was literally a saint (that’s how she was eulogized by the priest at her funeral).

I am on record saying how courageous I thought Merck was in bucking the religious right who claim that vaccination against HPV will promote promiscuity (see “Merck On a Roll“).

Aside from the promiscuity red herring, there are a few other issues with mandatory vaccination that critics raise, including:

• It’s too expensive (see World of DTC Marketing for a discussion of this issue).
• It’s not covered by all insurance plans (neither was Viagra in the beginning, but you didn’t hear about male promiscuity).
• The risks are unknown.
• Merck is engaging in “Astroturf” grass-roots support efforts through an organization called Women in Government, mostly composed of state legislators and pharma companies.
• Collusion of the governor with Merck lobbyists

I am not going to comment on all these issues except for the risk issue. I flatly dismiss the promiscuity argument and refuse to even discuss it. You can read The Pharma Blogosphere tomorrow for a synopsis of all the blog chatter on the other issues.

Risk and Lobbying
Ever since Vioxx was removed form the market, drug risk has been a hot topic and lightening rod for criticizing the drug industry. But let’s not forget that the main problem in the Vioxx case was the fact that Merck had a campaign to hide the risks it knew about and “dodge” the issue.

We now hear the mantra that “all drugs have risks” and this is certainly true. Patients need to know the risks as well as the benefits and be able to make an informed decision. The problem is when their trust is shattered by industry cover-ups. Hopefully, this won’t happen with Gardasil.

If you are my age, you remember being lined up for polio shots in school. There was no choice — I am not even sure parents could have opted out of the vaccinations on religious grounds as they can in the case of Gardasil vaccination in Texas. And there was never any discussion of risk then.

Unfortunately, I don’t think anyone has enough knowledge of what the risks are with Gardasil and the polio vaccination experience may serve as a warning.

So, maybe it’s not a good idea on the grounds of unknown risk to force mandatory vaccinations at this time. Merck, therefore, should back off from lobbying states to make it mandatory.

That’s my opinion. What’s yours?