Vaccines are wonderful gifts from God to the human race. I recall my parents telling me stories of dealing with whooping cough and of knowing kids with polio complete with stories of the "iron lung". I am amazed at the recollections of my colleagues who diagnosed Haemophilus influenzae meningitis numerous times a year during their training. I have never seen a case of it because I began my training several years after an effective vaccine was introduced.
There is now a vaccine on the market called Gardasil which protects against human papillomavirus (HPV), a leading cause of cervical cancer, and suddenly I find myself questioning moral and ethical decisions related to this vaccine. I do not have an issue with the vaccine per se since its use may be lifesaving for some women. The issue I have stems from Merck pharmaceuticals (the manufacturer) and its advertising methods and lobbying efforts. This vaccine was being advertised in numerous magazines (including some full page ads) and on television before I had been detailed about the vaccine by Merck. I received telephone calls from parents requesting the vaccine before I had even considered using the vaccine. Then I heard of Merck lobbying state governments in Virginia and Texas into mandating Gardasil use for school aged girls, and I had still never been detailed by the company. The doctors who would be administering the vaccine were skipped over, and the vaccine was directly marketed to consumers and the government.
The vaccine is recommended for girls and women ages 9 to 26. This means I am going to have to counsel pre-teen girls that they are getting a vaccine which protects against a virus that is transmitted through sexual intercourse. Did Merck consider this while they were lobbying the governors of Texas and Virginia to mandate this vaccine's use? Did they consider the parents who might just not be ready to open that discussion with their pre-teen daughters?
Ultimately I believe Gardasil is a good thing. Unfortunately its manufacturers crossed the fine line between altruism in medicine and profit. Thankfully, the company has finally detailed me on the use of Gardasil and given me the opportunity to voice my concerns. They assure me the lobbying efforts have stopped, but trust has been compromised between me and my colleagues and the company which provides the vaccine. When push comes to shove, I will and must put the concerns and needs of my patients and their families above the financial interests of pharmaceutical companies.