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The Vaccine Minefield

A vaccine for Human Papillomavirus (HPV), approved last year, has now sparked controversy in at least a half dozen states. HPV is by far the most common sexually transmitted virus in the U.S. (a recent study suggests as many as 25 percent of women under the age of 60 are infected). Symptoms are usually not serious but two rare strains of the virus can actually cause cervical cancer—the second most common form of cancer among American women.

That’s why the introduction of an HPV vaccine made waves last year. Approved by the FDA in June, it is the first vaccine that can avert a form of cancer. Public health officials hailed it, and even President Bush talked it up earlier this year.

But the vaccine’s manufacturer, Merck, quickly overreached in its effort to market it, pressuring state officials to mandate vaccination of sixth-grade girls. In February, Texas governor Rick Perry issued an executive order requiring vaccination, but when it was revealed that Perry’s former chief of staff is now a lobbyist for Merck, the company’s role in pushing for mandatory adoption became an issue across the country. In late February, Merck announced an end to its lobbying campaign.

The HPV vaccine stands to be a major boon to women’s health, but it is not an obvious candidate for mandatory use. Mandatory vaccination of children is generally used to prevent diseases that can spread easily in school—like chicken pox and mumps—and HPV does not quite qualify. Indeed, many parents are uneasy vaccinating their 11-year-old daughters against a sexually transmitted disease. Merck marched far too aggressively into that minefield, and by overplaying its hand has not only undermined its own vaccine, but may also have unwittingly contributed to a growing campaign to build doubts in parents’ minds about vaccines in general—a campaign with serious health implications.

That broader campaign has been building slowly for years, advanced especially by a few groups of parents of autistic children, who are persuaded (without concrete evidence) that chemicals in childhood vaccinations (especially small doses of mercury) cause autism. By planting baseless fears in the minds of parents, they have caused a real decline in the number of children being vaccinated, which could contribute to the resurgence of some diseases thought to be things of the past, like mumps. Public-health officials have come to realize over the past decade that vaccines are extremely sensitive territory. Apparently no one bothered to tell Merck.