By Erik Ness
A Shot of Politics
Concerns about promiscuity, corporate power and parental rights are infusing the debate over cervical cancer vaccination
By Erik Ness
In June 2006, when the U.S. Food and Drug Administration (FDA) approved Gardasil, Merck’s vaccine against human papillomavirus (HPV), it looked like a historic moment in cancer prevention. One year later the potential is still there, but the political outlook is cloudy after a tumultuous season in state legislatures.
According to the national Centers for Disease Control and Prevention, some 20 million people are currently infected with HPV and about half of sexually active men and women acquire a genital HPV infection during their lifetime. Women are more susceptible: By age 50, at least 80 percent of women have had a genital infection by HPV.
Gardasil protects against four of the more than 30 sexually transmitted HPV variants—types 6, 11, 16 and 18. About 90 percent of genital warts are caused by 6 and 11. But 16 and 18, if not cleared by the body, set the stage for 70 percent of cervical cancer in the U.S., as well as cancer of the vulva, vagina, anus and penis. This year in the U.S., cervical cancer will be diagnosed in an estimated 11,100 women, while some 3,700 women will die of the disease. Associated health care costs run to $5 billion.
Soon after FDA approval of Gardasil, the federal Advisory Committee on Immunization Practices added HPV to its routine vaccination schedule for 11- and 12-year-old girls and recommended catch-up vaccines for females aged 13 to 26.
Merck timed an advertising campaign to the approval. At the same time, researchers at the University of Pennsylvania’s EPIC Center of Excellence in Cancer Communication Research tested the impact of the media spotlight on Gardasil. Study participants were asked to read descriptions of the vaccine’s purpose framed in one of three ways: as protection against cervical cancer; as protection against cervical cancer and sexually transmitted infections; or as protection against cervical cancer and sexually transmitted infections, which may or may not increase sexual promiscuity. Sixty-four percent of those who learned only about the vaccine’s cancer protection powers said they were “very likely” or “somewhat likely” to get vaccinated, compared with only 43 percent of women who learned that it also protects against sexually transmitted infections and 44 percent who learned that it also protects against sexually transmitted infections and may or may not increase promiscuity.