Although mandating human papillomavirus vaccinations would "certainly brighten Merck's future," it is "not so clear" whether it would be in the "best interest" of girls, Sigrid Fry-Revere, director of bioethics studies at the Cato Institute, writes in a New York Times opinion piece (Fry-Revere, New York Times, 3/25). Among women not already infected with the vaccine HPV types, Merck's HPV vaccine Gardasil in clinical trials has been shown to be 100% effective in preventing infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases. Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in Atlanta at a meeting of the American Society of Clinical Oncology. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26 (Kaiser Daily Women's Health Policy Report, 3/23). According to Fry-Revere, Merck has "greatly exaggerated both the threat" of cervical cancer and the ability of Gardasil to prevent it. Even without Gardasil, the risk of dying from cervical cancer caused by HPV is "extremely low" when "early detection methods are used," Fry-Revere writes. In addition, the vaccine might "lul[l] young women into a false sense of security," and not much is known about the length of immunity or potential long-term side effects, according to Fry-Revere. HPV vaccination mandates might "cause more harm than good," she writes, adding, "Under these circumstances, are we really prepared to spend millions of dollars administering this vaccine?" (New York Times, 3/25).

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