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As the Center for Disease Control (CDC) announces that its the Merck vaccine Gardasil is now being used by one in four US girls ages 13 to 17, and more and more state governments and other programs are suddenly recommending the vaccine to girls as young as nine, it’s important to take a step back and ask ourselves how and why this vaccine has become so urgently popular.

Merck executives and marketing specialists say that it’s because Gardasil prevents certain strains of human papilloma virus (HPV) which can lead to cervical cancer—something every young woman simply needs to protect herself. Cervical cancer, admittedly, can be deadly. Worldwide, it is the second leading cause of cancer deaths among women, with 500,000 new cases developing each year.

What Merck marketing campaigns will not tell you is that almost 95 percent of cervical cancer deaths occur in developing countries, where pap smears are not standard medical practice for sexually active women. In countries like the United States, where women frequently get pap smears to detect the abnormal cells that could lead to cervical cancer, so that these cells can then be removed with techniques such as lasers, cryotherapy, and occasionally surgery, actual deaths from cervical cancer are considered rare. In the US, 3,600 women die every year from cervical cancer, and most of these women, according to Laurie Markowitz, head of the HPV working group at the CDC, do not get regular pap smears.

Of course, Merck is not marketing its HPV vaccine Gardasil to young women in countries in Africa, where the vaccine is generally too expensive for widespread (and yet no doubt effective) use; Merck is marketing it to Americans.

And Merck is marketing hard. It has aired hip, savvy-lifestyle-oriented ads for Gardasil before the film “Sex in the City,” on YouTube, and during ad breaks between “Law and Order” segments. offers free “sharing tools” to “get the message out” like e-cards, desktop wallpapers, event planners and even t-shirt iron-on designs. Girls who are given their first vaccine dose (3 are needed for the best protection against HPV and genital warts) can opt for a text messaging service letting them know when they’re due for their next dose. Perhaps not surprisingly, for these efforts Merck took home all of the 2008 Pharmaceutical Advertising and Marketing Excellence awards, and Pharmaceutical Executive Magazine named Gardasil its Brand of the Year.

As Merck has gotten the public energized about Gardasil, it’s also helped to launch exciting cervical cancer awareness campaigns around the country, by arranging unpublicized financing of scientific and patient groups who’ve helped to get the word out about the threat of cervical cancer. Because vaccines, unlike other drugs, can be mandated by governments, Merck has also been aggressively lobbying politicians and legislators around the country. Already, 41 states have passed or introduced cervical cancer legislation, and 24 are working on proposals to mandate the Merck vaccine for young teenage girls.

Continued in Part II.

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