WHEN LOBBYISTS for major drug companies embark on major pushes with politicians, the results are seldom laudable. Though there is reason to hope that a new Merck vaccine, Gardasil, will significantly reduce the incidence of cervical cancer, lawmakers nationwide moved with unseemly haste to require inoculations for all young girls. Their rush seems especially precipitous in light of a new study that has raised questions about how effective the vaccine ultimately will prove.
In drug trials, Gardasil has been shown to be safe and effective at halting the two strains of human papilloma virus that most commonly cause cervical cancer. Key to the vaccine's effectiveness is administering it before a woman is exposed to the virus, which is spread through sexual intercourse. This explains the valid interest in providing the vaccine to prepubescent girls despite the cost of more than $300 per vaccination.
It has mostly been religious conservatives who have railed against requiring Gardasil vaccinations for girls entering middle school. There's little merit to their argument that mandating the vaccine is an unconscionable intrusion on parental mores. HPV is a communicable disease with often fatal consequences. It should be stamped out if possible.
But just because critics of the vaccine argued their case on the wrong grounds does not mean they were wrong. Now, after all the early hoopla, it has become less clear that Gardasil will succeed in nearly eliminating HPV. A recent study in the New England Journal of Medicine indicated that blocking the two primary HPV strains might create an opportunity for other strains to flourish, so that the overall reduction in cancers would be relatively small. In addition, safety in the general population over time often differs from experimental safety -- as the Merck painkiller Vioxx tragically illustrated.