Drugmaker's HPV Vaccine Push Raises Questions

Mandating vaccines for school children is a common U.S. practice. But a lobbying campaign by drugmaker Merck appears to have backfired when it comes to the HPV vaccine, which is given to girls to guard against cervical cancer.

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And a public health controversy in Texas has led lawmakers there to take steps to overturn an executive order by the governor. That order required schoolgirls to get the HPV vaccine that protects against cervical cancer. The company that makes the vaccine, Merck, has backed off from a campaign urging states to adopt school requirements.

The backlash against the vaccine was spurred by parents and organizers who worry that it promotes sexual promiscuity and hasn't been proven safe. NPR's Brenda Wilson reports that most public health experts don't think the HPV vaccine should be mandatory for schoolchildren yet.

BRENDA WILSON: Most public health experts are not against requiring schoolchildren to be immunized. But they were troubled by Merck's campaign to make the HPV vaccine mandatory. Larry Gostin is an expert in public health law and Georgetown University.

Dr. LARRY GOSTIN (Public Health, Georgetown University): I have no problem, generally, with mandatory vaccinations. But this, what seems to me to be a steamroller effort, makes me very uncomfortable because it's being pushed so hard by the company itself, which stands to make a lot of money. And it's just too early.

WILSON: In the wake of the aggressive lobbying campaign by Merck, more than half of the states are considering laws requiring young girls to be vaccinated, or schools to inform parents about the vaccine. Some like Maryland, Indiana and Michigan are slowing down the process and setting up taskforces to study the vaccine instead.

Dr. Neal Halsey, a pediatrician and an international health expert at Johns Hopkins Bloomberg School of Public Health, saw the backlash coming, knowing that many parents would object to giving children a vaccine to prevent a sexually transmitted disease.

Dr. NEAL HALSEY (Pediatrician, International Health Expert): One problem that many of the people are expressing who are concerned about the vaccine is something that is poorly understood by the general public. All of us think that our children are going to do exactly what we tell them, and that we will know before they become sexually active. The studies in places all over this country and elsewhere show that that just isn't the case.

WILSON: But the HPV vaccine will not be the first mandatory vaccine for children to fight a sexually transmitted infection. States already require children to be immunized against hepatitis B, which is transmitted through sex. Halsey says a number of things need to be in place before states start mandating a new vaccine.

Dr. HALSEY: We haven't yet had the vaccine out there very long. We haven't established the programs to deliver vaccines effectively to adolescents. We need to make sure there's an adequate supply, which so far it looks like that's the case.

WILSON: A true public health approach, he says, would be more deliberative and educate the public, assess costs - it is an expensive vaccine - and assure that the financial structures were in place to pay for it. Georgetown University's Gostin says there's another reason to wait before moving to mandate the HPV vaccine.

Dr. GOSTIN: I wouldn't want to be in the position of - God forbid - two, three, four, five years down the road, we found out that it wasn't as effective as we thought, that there were adverse or safety risks involved, and we had rushed to make it mandatory. That would be a very sad day indeed.

WILSON: Hundreds of thousands who have gotten the vaccine already reported minor side effects, such as fainting and soreness. Nothing, according to government health officials, that was unexpected.

Brenda Wilson, NPR News.

MONTAGNE: And this is MORNING EDITION from NPR News.

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