When the human papillomavirus (HPV) vaccine Gardasil arrived on the market in 2006, its producer Merck hailed it as an end to the spread of HPV and related cervical cancer and genital warts. Young women between the ages of 9 and 26 just needed three shots of the vaccine, Merck explained, and they'd be free of the most virulent strains of HPV for life.
The New York Times reports that fewer and fewer young women are completing the required three vaccinations.
A recent study in the journal Cancer looked at insurance records of 271,976 American girls and women who received received the first dose of Gardasil between 2006 and 2009. In 2006, 50% of young women finished up the remaining two doses. But by 2009, less than 22% of those who started vaccine doses saw them to completion.
The Times' Nicholas Bakalar relates:
Getting one shot is not enough, according to the senior author, Dr. Abbey B. Berenson, a professor at the University of Texas Medical Branch. “All the data is based on three injections,” she said. “Getting one shot does not protect, based on the data we have now.”
Berenson says that receiving one or two of the shots could give young women a false sense of protection against HPV.
Another study out last fall looked at nearly 10,000 young women across the Baltimore area. SmartPlanet's Janet Fang reported:
Only 27% started the vaccination process, and only 31% of them completed all 3 doses.
Where did things go wrong? Why would vaccine that showed such promise not get used? In addition to the hassle of multiple doses, some blame misconceptions about the vaccine's risk spread through the internet. Other's look to social conservatives' fears that HPV vaccines equate with sanctioning pre-maritial sex. Matthew Herper of Forbes has another theory:
A big part of the answer is politics. Drug safety, vaccines, antibiotics and reproductive medicine—all have become proxies for the culture war, often tripping up public health in the process.
Berenson, the study's senior author, points out that Gardasil's aggressive marketing campaign in 2006 glossed over the importance of getting all three shots.
In the financial markets, however, Gardasil continues to succeed. Sales rose 33 percent in the last quarter to $284 million. This increase in sales largely comes from its introduction to the Japanese market, and an increase in the vaccination of males. Analysts say that with 470,000 cases of cervical cancer worldwide, causing 250,000 deaths annually, it's likely sales of the drug will continue to grow as it enters into new international markets.
I'll be curious to see Merck's response to Berenson's study. Does the pharma giant care if effective Gardasil usage in the U.S. is down when overall sales are up?
Photo: Steven Depolo/Flickr
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