Lost in the Lobbying

Posted on Mar 1, 2007

By Ellen Goodman

BOSTON—Hasn’t anyone ever told drug companies to put a warning label on their lobbying? You know, the kind you find on every little prescription bottle? Caution: Too much lobbying may result in an overdose of suspicion. Push too hard and you may experience political acid reflux.

As it is, Merck seems to have rolled a million—or many millions—into a shoestring. And the real losers may be girls and women who need access to the vaccine against cervical cancer.

Let’s return to that magical moment when clinical trials proved that a new vaccine was nearly 100 percent effective in preventing two strains of the HPV virus that causes most cervical cancer. This is the second-leading cancer killer of women in the world. In America, about 9,700 women are diagnosed with it every year and 3,700 die.

In October 2005, Eliav Barr of Merck said exuberantly, “This is it. This is the Holy Grail.” Merck, barely recovering from its Vioxx troubles, was the first of two companies to develop a vaccine. There were hosannas all around. Or, well, almost all around.

The response from the abstinence-only crowd was less enthusiastic. Family Research Council’s Tony Perkins said that “it sends the wrong message.” After all, HPV had been almost as useful in the scare tactics of abstinence-only education as had HIV. There were fanciful charges that preventing cancer would encourage promiscuity.

But it was bad PR to be against cancer prevention. So the right-wing groups dropped back from opposing the vaccine itself to opposing mandatory school vaccination.

All of this might have just simmered along, but something happened on the way to gradual acceptance. After FDA approval, the folks at Merck saw Gardasil as their anti-Vioxx, the drug that would help them do well by doing good.

Let us say that the lobbying and advertising that ensued were not heavy-handed by drug company standards. Let us not say much about drug company standards.

Nineteen states introduced legislation to add Gardasil to the list of school vaccines. But the plans blew up when Rick Perry, the governor of Texas and a conservative darling, issued an executive order mandating vaccines. His order allowed parents to opt out on religious or philosophical grounds, the same all-purpose loophole that has worked with other vaccines.

But it turned out that Perry’s former chief of staff is now a lobbyist for Merck. Did that look bad? Whoa, Nellie. Did it look bad that Merck had funded an organization of women legislators backing similar bills? Whoa, Merck.

With a JetBlue-style fiasco on its hands, Merck suspended all flights, uh, lobbying and advertising. But now some very strange bedfellows are going to the mattresses against Gardasil.

There are the abstinence-only folks who believe that cancer prevention sends the “wrong message.” There are the routine opponents of all vaccines and the libertarian opponents of the “nanny state,” not to mention some doctors who thought the vaccine was being rushed and was too expensive. But behind this odd collection are legions who have come to regard Big Pharm with big suspicions.

I hold no brief for Merck. They won their setback the old-fashioned way: They earned it. There’s every reason to assume that Merck wanted its drug approved before the competitor from GlaxoSmithKline comes down the pike. At $400 for a three-shot regimen, there’s a lot of money at stake. 

Nor am I surprised to find that parents are queasy. It’s not easy for any parent to accept that their middle-schooler should get protection from a sexually transmitted disease, even with the risk of cancer. But the parents among these strange bedfellows may remember that the enemy of your enemy is not necessarily your friend.

What’s been lost in the debate about school-mandated vaccines is that this one is extraordinarily safe and effective against a lethal disease. Researchers tell us that most parents ask three questions about vaccines: Is it safe, does it work well and can it prevent something that will seriously harm my child? Gardasil passes those tests. School vaccines also pass the public health test of providing the widest possible coverage.

In the wake of this fiasco, the rush for school mandates has slowed to a crawl. It’s wise to keep one eye on the costs and another on alternative vaccines. It’s savvy to give parents a way to opt out.

But allow me to add one last label on this sorry tale of public relations and public health. This warning is for parents. Caution: Too much suspicion can be bad for your daughters’ health.

Ellen Goodman’s e-mail address is ellengoodman@globe.com.

© 2007, Washington Post Writers Group

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