Merck, Glaxo HPV vaccines held back by more than sex and money

Why are U.S. parents reluctant to vaccinate their children against the human papillomavirus (HPV), which can cause a variety of cancers? A new study in JAMA Pediatrics finds that sex and money each play a role. But a lack of easy-to-understand information about the shots--and often, the lack of a doctor's clear recommendation for them--are also helping to depress vaccination rates.

Merck's ($MRK) Gardasil and GlaxoSmithKline's ($GSK) Cervarix have both been on the market for years in the U.S., and at first they seemed like an easy sell; after all, HPV can trigger cervical cancer. But the vaccination rate still lags. According to the JAMA study's lead author, Dawn Holman, only about 54% of girls received at least one dose of an HPV vaccine in 2012, and only about one-third received the full course of three shots. That compares with about 85% of teens receiving the tetanus, diphtheria and whooping cough vaccine.

As Holman points out, HPV is a sexually transmitted virus, so parents' attitudes toward sex can determine whether their children are vaccinated. Because the vaccines must be administered before a teen becomes sexually active, some parents have even suggested that vaccinating girls against HPV would "encourage" them to have sex. Plus, the shots are costly, and they often aren't covered by insurance.

Merck and GSK identified these barriers early on. But now, the JAMA study illustrates other obstacles. Parents aren't getting easy-to-understand information about the shots. Doctors need more education, too, Holman said, so they can make their case to parents. The new study confirmed the findings of previous research showing that many pediatricians aren't recommending the shots to parents, but simply noting that they're available.

As a Merck spokeswoman tells Bloomberg, a doctors' recommendation goes a long way--it's critically important, in fact. "'Offering' the HPV vaccine is not the same as 'recommending' the HPV vaccine in the same manner as the other important adolescent vaccines," spokeswoman Pam Eisele told the news service. "A true vaccine recommendation is more accepted by parents."

So, it sounds as if Merck and GSK need to redouble their doc-education efforts, particularly Merck, which is developing a next-generation version of an HPV shot. The new vaccine would protect against 9 strains of HPV, including the four strains currently included in Gardasil. Meanwhile, the case for GSK's Cervarix may soon be easier to make; researchers are finding that a single dose could be effective at preventing HPV infection. That would make Cervarix less expensive--but also less lucrative for GSK.

- read the Bloomberg story

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