Women in Government, Merck's Trojan Horse: Part Three in a Series on the Politics and PR of Cervical Cancer

In this article, we'll analyze the push for mandated HPV vaccination of adolescent girls that is taking place at the state level throughout the U.S., and the non-profit organization, Women in Government (WIG). WIG has been Merck's non-profit front and direct channel to state-level legislators who are the key to enacting mandates.

The Push for Mandates, and the Pushback

As reported previously, Merck laid the PR and "education" groundwork for Gardasil well before FDA approval was granted in June 2006. But even with FDA approval and the strong recommendation of the Advisory Committee of Immunization Practices at the federal level, mandatory vaccination was not a given since the power to enact such requirements lies in the hands of state legislators. Merck was working behind the scenes on that front as well, and moved quickly to persuade policymakers with the authority to mandate vaccination for 11 to 12 year old girls. Within a few months of FDA approval, almost twenty states had legislation pending that would mandate vaccination against HPV. Merck must have felt like they had won the lottery when within a month, the Centers for Disease Control (CDC)'s Advisory Committee of Immunization Practices (ACIP) recommended that 11 and 12 year olds be targeted for routine vaccination, and all women 12-26 years old be encouraged to be vaccinated. Merck and Gardasil were on a roll, thanks in large part to Women in Government.

According to their website, "Women in Government is a national 501(c)(3), non-profit, bi-partisan organization of women state legislators providing leadership opportunities, networking, expert forums, and educational resources to address and resolve complex public policy issues." The campaigns that they feature on their home page deal with kidney health, Medicare preventive services, higher education policy, and the "Challenge to Eliminate Cervical Cancer," which was publicly launched in 2004.

On February 2, 2007, Texas Governor Rick Perry, against the wishes of his conservative base and to the surprise of critics, signed an executive order mandating HPV vaccination for girls entering seventh grade. Then, unfortunately for Perry and Merck, details of his many connections with both Merck and Women in Government became public. Ellen Goodman of the Boston Globe noted, "It turned out that Perry's former chief of staff is now a lobbyist for Merck. Did that look bad? Whoa, Nellie. Did it look bad that Merck had funded an organization of women legislators backing similar bills? Whoa, Merck." USA Today reported that Perry's current chief of staff's mother-in-law, Texas Republican State Representative Dianne White Delisi, is a state director for Women in Government. Perry's wife, Anita, a nurse by training, addressed a WIG summit on cervical cancer in Atlanta in November 2005. Perry also received $6,000 from Merck's political action committee during his re-election campaign.

Merck announced on February 20, 2007 that it would no longer lobby directly for vaccine mandates at the state level. The New York Times quoted Dr. Richard M. Haupt, executive director for medical affairs in Merck's vaccine division as saying, "Our goal is to prevent cervical cancer. Our goal is to reach as many females as possible. Right now, school requirements and Merck's involvement in that are being viewed as a distraction to that goal." Dr. Haupt did say, however, that Merck would continue providing health officials and legislators with education about the vaccine and would continue lobbying for more financing for vaccines in general. When asked how much Merck had spent on its Gardasil lobbying efforts, Haupt declined to name a figure.

Women in Government: Picking Up the Slack for Merck

So who is this group receiving Merck funding and pushing for vaccine mandates across the country? As noted above, Women in Government had identified cervical cancer as a focus of their work as early as 2004. Available on the WIG web site is a legislative policy toolkit. It provides legislators with sample legislation written by their colleagues in other states, maps showing states with cervical cancer related bills pending or laws enacted, WIG's fact sheets on HPV and cervical cancer, and a letter from WIG President Susan Crosby. While not focused solely on introducing and enacting HPV vaccine mandates, they are a main component of the WIG campaign and something by which they measure success. According to a map that WIG provides on their site, as of June, 2007, twenty-three states and the District of Columbia have introduced HPV vaccine mandate legislation, in addition to Virginia, which has already enacted legislation.