Should HPV vaccination be mandatory for young girls? And, more pointedly, is it appropriate for the governor of Texas to bypass the legislature by using an executive order to mandate the vaccine in Texas?
Very interesting discussions on this issue over at DB’s Medical Rants. And in Dinosaur Musings. And on NPR. And in the letters section of the New York Times.
My thinking on this issue is colored by what I have come to know about Merck’s funding of the group called Women in Government (WIG), whose members have introduced most of the HPV legislation around the country. As you may recall, I wrote in December about the financial relationship between Digene, Merck and WIG. The Baltimore Sun broke the story in January, and then the AP picked it up, as did Fox News, Forbes and others.
In their reporting on the Texas mandate, the NY Times pretty much glossed over the flow of lobbying dollars from Merck into Texas. Merck declined to tell the Times how much they actually donated to Women in Government, which, by the way, carries a non-profit status.
Since then, Merck has been mysteriously removed from list of Business Council members at Women in Government. (Don’t worry – the old cached pages are still around).
“Members also play an integral role in planning for future growth, have the ability to attend our regional conferences, and support the financial stability of the organization.”
to this:
“Business Council members support the overall mission of Women In Government.
Fascinating.
Much of the opposition to mandatory HPV vaccination is coming from the usual anti-vaccine groups and the religious right. That’s unfortunate, because it is distracting the media from seeing the real story, which is the unprecendented influence of Big Pharma in legislating healthcare. And the use of Pharma-funded consumer “advocacy” groups to push Pharma’s agenda when the healthcare community does not respond fast enough for the shareholders. The push for mandatory HPV vaccination is not coming from any organized medical lobby that I have seen – it is coming from Merck.
Right now, because the HPV vaccine does more good than harm, the healthcare community and the media seem to be willing to let Merck slide on this one. But I believe it is a very slippery slope upon which we are allowing them to ride. They still need to get better at covering their tracks, but their recent absence from the WIG website proves they are fast learners in this regard. If they get any better, then a day will come when we will no longer know from where the influences are coming. And if the product being pushed is not the HPV vaccine but another Vioxx, I don’t want to imagine the outcome…
I will state again that I believe the HPV vaccine to be a good thing. And so far, I have trusted the CDC and the professional organizations who have recommended for use of this vaccine. I have even begun giving my patients the vaccine.
But in lobbying for making Gardasil mandatory less than one year since its FDA approval, I think Merck has gone too far in trying to assure the market for their vaccine. And when I see them covering up their relationship with the WIG and declining to say how much money they have given this group which is lobbying all over America for mandatory HPV vaccination, I find myself wondering what else they are hiding.
And that’s not a good way to feel about a company whose vaccine you are administering to your patients.
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Update: The American Academy of Family Physicians and the Texas Medical Association have both issued statments against mandatory HPV vaccination.
Ever since the ads started running on TV, I’ve been disappointed that I’m too old to get the vaccine. You bring up some interesting thoughts and back stories on the issue. Now I want to read more about it.
Interestingly both this subject and the afternoon nap were covered in one of my daily newspapers this morning (Daily Mail).
If I had a daughter young enough to be vaccinated, I think I’d go for it. As you know, they are now vaccinating all pre-pubescent girls in the UK unless their parents object.
As for the siestas, I think I’ll start this afternoon.
I find that I both agree and disagree in principle. This on the clinical value of the vaccine (as opposed to the political shenanigans of Merck, which sickens me.)
Flea brings up the point (but only because he beat me to it) of unintended consequences: the possible future over-treating of abnormal paps; what about boosters? What about other completely unforseen adverse effects? (not to be considered a genuflection to the anti-vax crazies.)
I am proud of my status as a “late adopter” in general, and I don’t think that is an inappropriate position at this time.
As a fellow practitioner, what pisses me off is Merck’s apparent new avenue of approach in bypassing the direct marketing of drugs to providers which is illegal
and, instead of persuading we practitioners to utilize the vaccine on its own merit, essentially “forcing” us to use/prescribe via mandatory law. In other words, no matter what I may feel about this vaccine, the state governments will essentially give me no choice.
A quick note about the real world and my recent run-in with a Merck rep. I have been quite honest with all drug reps that when it comes to a new med, I will usually wait at least 2 years before feeling comfortable enough to ensure the safety of same on my patients. I’ve practiced for 17 years and ahve seen some interesting meds come and go secondary to adverse issues. Anyway, upon telling this one Merck rep the same info for the umpteenth time, she responded that “it concerned her that I would want to see my patients get cancer as oppose to giving them a vaccine that would prevent it”.
Needless to say, she no longer is seen by me. I believe I was quite diplomatic in having ensured her throat was ripped out.
That having been said, we in medicine are stuck in a buyer/consumer/practitioner beware conundrum….the stats that Merck is feeding us regarding the reality behind the science/progression/true death rates are misleading…and an article I recently read showed that only about 100 children of age 9 were part of the initial Merck study AND only followed for 18 months. I did attempt to discuss that part with aforementioned rep but really didn’t get far (this was before said throat ripping).
Informative page you have, It surely beneficial to learn more on this subject. One should learn as much as possible to be able to put it into a good use. Here is another page that is about hpv vaccine http://www.genetal-worts-information.com/Hpv-Vaccine.php
HPV is a possible indicator of cancer,not the cause of cancer.What’s wrong with pap smear tests,they have proven to be very effective in preventing cervical cancer.Merck is trying to create a market for its vaccine and is not concerned with the well being of its citizens.Profits lossed on Vioxx need to be made up for somewhere else.I find this type of manipulation disgusting.
the should NOT be mandatory.. ever since i got the first of three shots ive been ill and that was about six and a half weeks ago. i have been in and out of hospitals, seeing different specibualists and having every test you could think of done. every test has come back negative, doctors cannot find anything wrong with me. and this all started the day after my first shot. i am finally just getting out of bed and attempting to get my life back. i no it will take awhile. i would advise everyone to not get this vaccine!!!
speaking just on ethical terms i would not want my daughter to be forced to have this vaccine, you only need the vaccine if you are having sex and i think it is rude and over generalization for the govt to think every girl will be having sex as a teenager and young adult-yes i know teenagers still do have sex but i think it should be up to the parent
as well as im not completly against vaccines some are very nessasary and valid but this vaccine has had serious side effects in some people i have heard it hurts like crap, has made many girls sick, and since it has not been out for a while to see natural effects over time i would not want to put something in my body nor my family’s that i did not know would do