On Guard Against the Gardasil Juggernaut by George Delgado, M.D. No one likes the feeling that something has been shoved down his or her throat. Merck, the pharmaceutical giant is looking like a bully in how it thrust Gardasil, the first genital human papilloma virus (HPV) vaccine, on the US market. You might imagine genital HPV infection being like an iceberg. The small tip represents those infections that lead to cervical cancer. Below the water is the vast majority of the infections, those that do not transform into cervical cancer because they are cleared by the body. Gardasil has received some renewed uncomfortable publicity in the August 19, 2009 issue of The Journal of the American Medical Association, commonly known as JAMA. Two articles and an editorial explored the safety and the marketing of Gardasil.
According to the JAMA analysis by Sheila Rothman, PhD and David Rothman, PhD, Merck took to heart the difficult introduction of its hepatitis B vaccine about twenty years ago. With Gardasil, Merck was armed and formidable. It funded professional organizations like the American College of Obstetricians and Gynecologists, the American Society for Colposcopy and Cervical Pathology (ASCCP), the society of Gynecological Oncologists (SGO), and the American College Health Association (ACHA) so that they would produce educational and awareness initiatives. Rothman and Rothman especially highlighted the roles that ASCCP, SGO and ACHA played in the promotion of Gardasil. Through educational presentations, mostly directed at health professionals and public health announcement programs these professional organizations were essentially minions in supporting what became the Merck juggernaut that led to widespread coverage and acceptance of the new vaccine.
The other problem the authors describe is that Gardasil has been promoted as a vaccine to prevent cervical cancer. In its While safety is always a huge issue, I studies Merck only proved that it can believe that the bigger story with Gardasil prevent some of the precancerous changes that may lead to cervical cancer. Saying that was the unprecedented publicity campaign it prevents cervical cancer is a huge that won Merck an industry award for the assumption; especially since, at this point, pharmaceutical brand of the year for we do not know how long the vaccine “building a market out of thin air” according effects will last. We won’t know if it to the trade publication, Pharmaceutical prevents cervical cancer for at least another Executive twenty years because that’s how long it takes the disease to develop. Dr. Jennifer Roback Morse • 663 S. Rancho Santa Fe Road Suite 222 San Marcos CA 92078 www.jennifer-roback-morse.com • email:
[email protected] • 760/295-9278 ©2007 No part of this document may be reproduced or disseminated in any way without the expressed written consent of the Ruth Institute.
At between $360 and $1000 for the total cost of the three-shot series this is a huge and extremely costly public health experiment that we have undertaken under the heavy-handed influence of Merck, the advice of professional organizations who have breached public confidence by their blind acceptance of the Merck “educational” programs and the poor judgment exercised by public officials in recommending or mandating universal vaccination. Pap smears have cut cervical cancer by about 70% in our country and are only getting better. Abstinence before marriage and fidelity during marriage are the only fool-proof ways of preventing HPV infection. Hopefully, in the battle against cervical cancer, we will find a rational, complementary and proven role for the expensive Gardasil vaccine, perhaps in high risk women.
Dr. Jennifer Roback Morse • 663 S. Rancho Santa Fe Road Suite 222 San Marcos CA 92078 www.jennifer-roback-morse.com • email:
[email protected] • 760/295-9278 ©2007 No part of this document may be reproduced or disseminated in any way without the expressed written consent of the Ruth Institute.