'Round the Sphere: Mandatory Gardasil Vaccination Politics Make Strange Bedfellows

Are you for or against mandatory vaccination of school girls with Gardasil? Are you afraid to be against it and thus painted as a right-wing religious conservative!

There have been several posts within the Pharma Blogosphere today on this issue.

First up is PharmaGossip's post "Merck - Gardasil: fatal side effects?," which suggests a hint of doubt about the veracity or scientific merit of a report from "US public interest group" Judicial Watch regarding the release of documents that link Gardasil to as many as 11 deaths since its approval in the market. I only note that Jack Friday does not identify this group as a "conservative, non-partisan educational foundation."

Compared to Jack Friday, Ed Silverman over at Pharmalot is a flaming liberal -- at least when measured by his slant on this story. In his post, "Gardasil: Conservative Group Trumpets Side Effects", Ed starts right off questioning the mission of Judicial Watch by use of the phrase "bills itself as a conservative public interest group that 'advocates high standards of ethics and morality in our nation’s public life,'"

"This is, essentially, another front in the battle against Gardasil. By issuing such press releases, Judicial Watch not only caters to its core constituency - social conservatives who worry the HPV vaccine will be seen as a green light to premarital sex among teenagers - but also plays on the concerns of parents who are undecided whether to vaccine adolescent girls (Gardasil isn’t yet approved for teenage boys) and question mandated vaccination."

Ed thus categorizes opinions about mandatory vaccination as a battle front with religious conservatives on one side and everyone else on the other.

May I dare say that it is not as black and white as that?

In my post to Pharma Marketing Blog, "Gardasil: Is the Risk of Being "One Less" Worth It?," I see the evidence presented by Judicial Watch as a test case of the new pharmaceutical industry "balance benefits vs. risks" mantra.

After all, even Big Pharma CEOs like Lilly's Sidney Taurel are calling for better systems to "quickly identify both the true benefits and the full extent of risks associated with medicines in widespread use."

Presumably, physicians in consultation with patients represent the best way to determine whether a drug or vaccine is right for a particular patient based upon known risks vs. expected benefits. If Gardasil vaccination is mandatory, that kind of conversation with the physician is not an option. This goes against every liberal notion of "patient empowerment."

Therefore, I propose "patient empowerment" as the liberal battle cry and battle front against mandatory Gardasil vaccination!

BTW, I argued this point with the former blogger in charge at NRx before he left for journalism school. As of this writing, the current author of NRx has not written about this issue, but has instead posted important information about how easy it is to read gibberish and a YouTube video that is no longer available! Just so you know where the priorities are.

Jim Edwards Continues to Beat the Mandatory Gardasil Vaccination Dead Horse

Jim Edwards over at BrandweekNRX makes a fantastically inaccurate claim that the Centers for Disease Control (CDC) is taking his side on mandatory Gardasil vaccinations:

"Not that I want to rehash this debate, but it’s nice to know that the CDC took my position and not my opponents’," says Jim (see "Claim: Merck Will Lose $130 Million a Year on Gardasil by Stopping Its Controversial Lobbying").

Jim, if you didn't want a rehash, why'd you start it?

You are not accurately portraying the facts when you say that CDC is taking your position and not your opponents'. Since you link to my comments here (see "Holy War in Pharma Blogosphere Over Gardasil!") as one of your opponents, I'll have to respond.

Your position --- and correct me if I am wrong -- is that Gardasil vaccination should be MANDATED by the states. That is, it should be required of all girls of a certain age before they can enroll in grade school.

The CDC merely is making the vaccine available to eligible girls, it is not MANDATING anything. Your readers should read the Merck press release you link to, which says, in part:

"Eligible adolescents may [my emphasis] receive recommended vaccines through VFC once the CDC contracts for the purchase of the vaccine, a process that is now complete."

Note that the word "may" is not equivalent to "must".

CDC's VFC program helps families by providing free vaccines to doctors who serve eligible children and is administered at the national level by the CDC through the National Immunization Program. CDC contracts with vaccine manufacturers to buy vaccines at reduced rates.

This is very much different than a mandatory program.

The CDC stance, in fact, is closer to my position than yours; namely, the Gardasil vaccine should be made available to all girls who desire to have it, and at a price they can afford, but vaccinations should not be required by state mandate.

P.S. I think Jim threw down this gauntlet knowing full-well that I would respond and thus raise BrandweekNRX to the number 1 position on The Pharma Blogosphere Topics List, beating out Peter Rost!

'Round the Sphere: Rost Retires, Edwards Wages holy War, Byrd Flies, and Other Tidbits

It's been an interesting week in The Pharma Blogosphere!

I Won't Have Rost to Kick Around Anymore
First, Peter Rost (Question Authority) retires his blog in order to focus on his new movie (see "Rost Hit By PhRMA's PPA Bus: Shuts Down Blog"). He's dead to me now and I have removed the Question Authority blog from The Pharma Blogosphere list.

Holy Cow, Holy War!
Jim Edwards is getting me really mad! First, he claims I am pro-cancer. Now he says I am anti-science! Dude, I have an MS and MPhil degree from Columbia University in Biochemistry and majored in Chemistry at Franklin and Marshall College (phi Beta Kappa) and am a member of the New York Academy of Sciences! But Edwards seems to think I am just another hick from Pennsylvania, a God-fearing, bible-totting border state! Like I said, meet me at Christ Church at dawn (see "Holy War in Pharma Blogosphere Over Gardasil!")

Parents Don't Know Shit!
Meanwhile, Drug Wonks has a guest blogger (TV personality JOHN STOSSEL) who blames the media (how original for Drug Wonks and how "biting the hand that feeds him" for Stossel) for scaring parents about vaccinations (see "Scaring Ourselves Stupid"). Another attempt to paint opposition to MANDATORY vaccination as "anti-science." And however much Stossel's "heart goes out to parents struggling to help their autistic children," his brain is gone out to lunch. And I thought the conservatives believed that parents' rights rule!

Byrd in a Cage?
Has eDrugSearch Blog and Web site been shut down, hijacked, or subverted? See "eDrug Search Hijacked by Sleazy Link Farm".

I don't know about you, but I am getting concerned about recent troubles experienced by "insiders," "whistle blowers," and "anti-establishment" proponents in The Pharma Blogosphere. Are we all vulnerable?

What Else Is Going On?
Blogosphere Survey: The First Ever Pharma Blogger Survey has ended! There were a gross of responses -- 144, that is. From wikipedia I learned that 144 is the twelfth Fibonacci number, and the largest one to also be a square, as the square of 12. I also learned that 144 is the measurement, in cubits, of the wall of New Jerusalem shown by the seventh angel (Holy Bible, Revelation 21:17). Holy War Batman!

So when do I reveal the results? I may reveal a few results here from time to time as teasers, but I will make a full report available at the upcoming "Healthcare Blogging Summit 2007 (Spring)" in Las Vegas, where I will be participating in the panel "Navigating the Blogosphere."

CL Psych Blog: CL Psych Blog was rated as one of the TOP FIVE blogs in The Pharma Blogosphere in terms of readability, credibility, and usefulness. Not the highest in rank in any of those categories mind you, but right up there! Consequently, I have made it a point to check it out often.

This week CL Pysch liked what I had to say about Cymbalta, off-label promotion, and disease mongering (see "Cymbalta for GAD: Pimp That Thang"). To find out why CL Psych is talking about "Pimp[ing] That Thang," you'll have to read my original post ("eGAD! How I Learned to Stop Worrying and Love Cymbalta!").

[SHOULDN'T I BE DOING SOME REAL WORK?]

OnThePharm: Still on vacation! More than a week ago, OnThePharm announced it was back from a week's vacation. Doesn't seem to make a difference -- no posts were made since then!

Eye On FDA: Mark Senak over at Eye On FDA weighed in on Gardasil and mandatory vaccinations in the post "State Status on HPV Mandates." Mark, who will be my podcast guest next Tuesday (see "Keeping an Eye on the FDA"), points out that some states are considering legislation to BAN mandatory vaccination (now THAT's anti-science!). He also belittled Washington state's proposal to include $25,000 for an awareness campaign on the subject of HPV. He thinks this is "measly." Au contraire, mon ami! Look what Merck got for $6,000! A great worldwide PR campaign that the majority of people responding to my poll think will BENEFIT Gardasil sales! (See "Does Merck Need a Vaccine for Bad PR?")

Pharma Giles: Pharma Giles examines Pharma CEO lookalikes (see "Lookalikes..."). He insults me, however, when he characterizes The Simpsons as a "children's television cartoon." Obviously, this Brit or Aussie blogger (I forget which) is not too familiar with US culture. Although that might be a plus in his favor, he really ought to get with it. As I keep telling my wife, The Simpsons is the longest running TV show in American history and I doubt if many kids watch it or can even understand its humor and political commentary! BTW, "Montgomerie (sic)" Burns is NOT the boss of a "nuclear reprocessing plant" -- it's a nuclear POWER plant! Jeez!

OK, that's it. I really got to do some work!

Holy War in Pharma Blogosphere Over Gardasil!

Jim Edwards of BrandweekNRX won't let up in his holy war against other bloggers in this space who disagree with him over the issue of mandatory HPV vaccination.

According to Jim, if you are against mandatory vaccination, you are pro-cancer and worse -- you are "anti-science"!

"This is a debate between those who believe science can cure disease," say Jim, "and those who believe religion (or 'abstinence,' which is the current buzzword to describe religious solutions to STDs) can cure disease." (See "JAMA Survey makes Gardasil Debate Even More Confusing".)

Them's fighting words, Jim! And it's hogwash!

Of course, I am dismayed to find myself on the same side of this issue as perhaps the religious right is, but Jim seems to have lost all his journalistic sense if he thinks ergo I agree with the religious right on the power of religion vs. science!

How dare you make that assumption! Meet me at dawn in the grave yard behind Christ Church in Phila, if you dare. I'll bring the pistols!

P.S. I think all the "bad" PR over mandatory vaccination is helping Gardasil sales (see "Does Merck Need a Vaccine for Bad PR?"). What do you think?

Will the Controversy Over Mandatory Vaccination Help or Hurt Gardasil Sales?
	It will definitely help
	It might help
	I don't know
	It could hurt
	It definitely will hurt

This Week in the Blogosphere: Gardasil

The following is a sampling of Gardasil sightings in the pharma blogosphere.

Pharma Marketing Blog: In the post "Gardasil: To Be Mandatory or Not To Be Mandatory -- That is the Question," blogger John Mack points out that the Gardasil controversy raised several issues: promiscuity, parents' rights, drug risk vs. benefit, even disease mongering through lobbying. Mack concludes that "maybe it's not a good idea on the grounds of unknown risk to force mandatory vaccinations at this time. Merck, therefore, should back off from lobbying states to make it mandatory." What do you think -- take the Pharma Marketing Blog Poll.

BrandweekNRX: Jim Edwards obviously agrees with Pharmaceutical Executive Magazine that Gardasil is "Brand of the Year." See the post "Gardasil: Brand of the Year? Journalists like Jim could never express their opinions like this in the articles they write for their publications. We know they HAVE opinions, but without the blogs we'd have to infer what they are by reading between the lines. There isn't anything between the lines in blogs -- at least there shouldn't be. Except perhaps in corporate hack blogs. By this standard, BrandweekNRX certainly isn't a hack job! But what about Jim's articles in Brandweek? In his blog, Jim focuses his criticism on the promiscuity issue and puts himself squarely against the religious right. Now that I know his opinion of a major issue for the religious right, can I trust that his reporting on this topic in that publication will be "journalistic" (ie, balanced)? Again, I have to ask: will journalists change blogging or will blogging change journalism?

Pharmalot: This is another journalist blog. It's somewhat more difficult to read where Ed Silverman -- Phamalot's author -- stands on the issue of mandatory vaccination against HPV. I've read his post on the subject -- "The Lone Vaccine State: A Row in Texas" -- and cannot tell if he is for or agin' the Texas mandate that he writes about. Ed does cover all the issues and concludes "the overriding public policy concern here is finding the best way to promote good public health. Unfortunately, any number of state lawmakers may also benefit from industry support as they debate and promote the vaccine issue. That kind of bonus doesn't spawn confidence that the right thing is being done for the right reason. But there's no vaccine for that." From this, I conclude that Ed would vote that Merck should press on for mandatory vaccinations but not through aggressive lobbying (and politician payola).

World of DTC Marketing: In the recent post "A prime example of whats wrong with Pharma (Gardasil)," Rich Myer accuses Merck of putting "profits ahead of good medicine." He's ticked off about the price, lack of insurance coverage, and difficulty that physicians seem to having stocking the vaccine. He makes some good points. But Rich, you got to give the "We try never to forget that medicine is for the people" quote a rest! Seriously dude!

eDrug Search: I love the headline ("Mandatory Gardasil in Texas: Perry’s motives are a bit Merck-y"). I'll have to use "Merck-y" next timeI'm critical of Merck. Anyway, Cary is focused on the ties that Governor Perry has with Merck, which he picked up from News Hounds ("They eat their own - TX Governor Rick Perry under fire from just about everyone for mandatory vaccinations"): "Two of Perry’s former chiefs of staff currently work for Merck, and the mother of one of them is involved in lobbying for this … Has Perry just caved in for Merck? … His former c-o-s is being paid $250,000 by Merck to lobby for this, a Texas state legislator (Diane White Delisi) is pushing for it and working with Merck, and her daughter-in-law is the current chief of staff." Cary could have mentioned that Perry received a $6,000 political donation from Merck when he was running for office. Not that's there's anything wrong with that!

PharmaGossip: Nada about the current brouhaha over mandatory vaccination. Maybe the Insider will have an opinion later. It's always a good idea not to be too far ahead of the pack. You might just say something you regret. But Insider protects his identity very well, so I'm sure he doesn't give a crap about regrets.

Drug Injury Watch: Gardasil is not yet among the Rx products being tracked on this lawyer's(Tom Lamb) blog. Keep an eye out though for future lawsuits -- even class action lawsuits. I wonder if Merck has pit some money aside to deal with that possibility? What do you think Tom?

Drug Wonks: I was hoping that these guys would take up the issue of Gardasil and drug risk-benefit analysis. That would be right up their alley. Haven't seen it though.

That's all for now!