Merck developed a clever scheme for marketing HPV vaccine: it would lobby for laws that would add the vaccine to state Medicaid entitlements, require it be covered by private insurers and mandate the vaccine to attend school. I know of two different approaches at the state level.
In 2007 in Texas, Governor Perry simply issued an executive order that all Texas schoolgirls entering sixth grade must receive the vaccine. This was the first state mandate for this vaccine. Merck had provided Perry financial support. The Texas Medical Association was against the mandate. After several months, the Texas legislature overturned Perry’s order.
Merck provided money to the organization “Women in Government”, a national association of female state legislators. Women in Government, in conjunction with Merck, developed a massive campaign to encourage use of the vaccine and support state vaccine mandates. At first glance, it looked like a “win win” strategy for legislators: using state funds to prevent cervical cancer, in children.
At least a dozen state legislatures considered instituting HPV mandates. But in the end, only Virginia and Washington D.C. passed HPV mandates for middle school girls.
However, vaccinations have not been popular. “Opt out” provisions have been used by the majority of families. Only 17% of Virginia’s eligible sixth graders had begun the 3 shot series, and only 23% of eligible sixth graders in the District had done likewise, at the start of this school year.
On January 21, the Virginia House of Delegates passed a bill to eliminate the HPV requirement. It may not pass the Senate, and may not be enacted. Still, the bill gives notice that legislators are rethinking their hubris: citizens do not want decisons about their children’s sexual health to be made by the state. Especially given the conflicts of interest.