Drugmaker Assists In Pushing for Mandate For HPV Vaccination

But they are stopping short of pressing for the mandate that Merck wants state lawmakers to impose. Some of the groups say they are not ready to endorse a mandate so soon after the vaccine gained approval from the FDA.

"A cancer vaccine is a relatively new concept," said Wendy Selig, the American Cancer Society's vice president for legislative affairs. "We have not reviewed all the policies regarding school mandates."

Some state-level health groups are promoting the mandate, including the Virginia chapter of the American Academy of Pediatrics and the Virginia Council on the Status of Women. But several lawmakers, including Howell, said Merck is doing most of the legwork. Howell added that it is useful to have the resources of a large company to provide research and meet with lawmakers. She said she is convinced of the public health benefit of mandating the vaccine.

That confluence of interests is commonly part of the legislative equation. In the late 1990s, drugmakers teamed with advocates for the mentally ill to encourage states to buy a new generation of antipsychotic drugs. The push netted hundreds of millions in profits for the manufacturers, but it was also promoted by the advocates as sound public policy. New psychiatric medications have been credited not only with improving the lives of the mentally ill, but also with saving states millions of dollars in unnecessary hospital stays.

In the case of mandating the HPV vaccine, there are good political reasons for nonprofit health groups to stay out of the debate, which has engaged critics who believe requiring a vaccine against a sexually transmitted disease would undermine parental authority and also encourage promiscuity. In Maryland, a proposed mandate was withdrawn after such objections were raised. Sen. Delores G. Kelley (D-Baltimore County) said her office received numerous complaints that the vaccine would increase the already high number of vaccinations children must receive. Another lawmaker has submitted legislation that would set up a task force to study the matter for two years.

In Texas, Gov. Rick Perry (R) was criticized last week for issuing an executive order that made his state the first to mandate the vaccine for sixth-grade girls. Perry has also been accused of being influenced by his former chief of staff, Mike Toomey, who is now a lobbyist for Merck.

Merck, best known for such blockbuster drugs as Singulair for the treatment of asthma and Zocor, a cholesterol-lowering medication, has a powerful financial incentive to push for the mandate sooner rather than later. A rival drugmaker, GlaxoSmithKline, is pushing its own HPV vaccine through the approval process. Mandating the vaccine quickly would help Merck corner the market before then -- helping to explain the intensity of the company's marketing and lobbying campaign toward consumers, physicians and politicians.

"We're certainly very proud of our efforts," said McGlynn. "We spent over 10 years developing Gardasil. We think this is a very important advance in women's health."

Staff writers Ovetta Wiggins and Nikita Stewart contributed to this report.