A Game of Gotcha! Over Gardasil

Sex, money, fear, political intrigue. No, it's not Hollywood, but the increasingly high-volume back-story--or backlash--to the Gardasil rollout.

Last week, Merck's efforts to lobby local governments to mandate vaccination against the human papillomavirus (HPV) came under intense scrutiny, highlighting the minefield drug companies face when their big marketing and public-affairs budgets are used to sway uptake of new, expensive--and, above all, controversial--products. The uproar over Merck's lobbying efforts caused the company to halt its campaign last week--saying that its public involvement was doing more harm than good.

Taken together--along with the touchy issues of teen sex, parental rights, privacy and personal freedom--"you've got the perfect witches' brew," said Caren Turner, president of Turner Government and Public Affairs. "In general, people are mistrustful of new medicines. And anything involving children is going to involve an extra dose of caution."

A bizarre-bedfellows alliance--parents, the religious right, libertarians, and even obscure anti-vaccine advocates--were quick to bandy about the company's contributions to the likes of Texas Gov. Rick Perry's campaign and female lawmakers group Women in Government as a Gotcha! to protest mandatory-vaccination bills pending in several states and jurisdictions. Their grudges against Gardisal ran the gamut from fears that the vaccine might encourage promiscuity to the lack of long-term safety data to the slippery slope of government intrusion in personal liberty, especially because HPV cannot be spread in a school setting.

Merck's public-affairs tactics, according to its executives, have largely been educational: reaching out to groups that had concerns about the vaccine and providing clinical trial data to policymakers. Its DTC approach featured young girls pledging to be "one less" cancer statistic as well as an unbranded HPV awareness campaign to help women "make the connection."

But it was proof of money changing hands--Merck's political action committee gave $5,000 to Perry, for instance--that gave opponents the smoking gun that made the drug giant blink.

Turner estimated that the controversy could have a five-year chilling effect on sales volume. "It could have been avoided," she said. "This is a nation that was formed with a spirit of independence and a don't-tread-on-me philosophy. Merck might have been a little more patient. When companies push too hard, it backfires."

All pharma companies have government-affairs team--the key is to act with discretion and to start slow, perhaps not going straight to compulsory vaccination. "As with any new innovation, the political environment is very significant in determining the steps a company should take to launch the product," said Jeffrey Sandman, CEO of Hyde Park Communications, a public affairs firm. "Certain key stakeholders need a little more hand-holding."

Still, he largely defended Merck's efforts. "This is a dramatic innovation that will help save a significant number of lives," said Sandman, whose wife is a gynecologist. "If you think it's a ultimately a good thing--and I believe, absolutely--then you have to ask, 'What's wrong with the lobbying campaign?'"