Six years ago, I quit my job and embarked on a six-month tour of Asia. Knowing I would face mosquitoes, funky water, and suspicious street food, I consulted a travel doctor to find out what medications and vaccinations I needed. Some vaccines she deemed mandatory—typhoid, tetanus booster, hepatitis A—and some, like hepatitis B, she strongly recommended. You can contract the hepatitis B virus when the blood of an infected person enters your body; unprotected sex and intravenous drug use are common routes of transmission. I was not planning to do any of these on my trip, but I got the vaccine anyway. Chronic hepatitis B infection can cause liver cancer and cirrhosis, neither of which sounded very pleasant.
Nowadays, children are routinely given the hepatitis B vaccine as infants (it became widely available in 1982). This is not surprising, except that the introduction of a very similar vaccine—the one to protect against human papillomavirus (HPV)—has caused a political and social uproar. The controversy is perplexing, given the similarities between the two viruses. Just as hepatitis B causes liver cancer, HPV causes cervical cancer. Both viruses require intimate contact for transmission, and HPV is even more prevalent (see, HPV: Stirrups or Chastity?). If we already vaccinate against a virus like hepatitis B, why weren’t we prepared to do so for HPV?
“With hepatitis B, there was no mass marketing, so it was quietly discussed with parents and physicians in doctor’s offices,” said Lynn Hanson, a nurse practitioner and HPV researcher at UCSF’s Dysplasia Clinic.
“I think Merck [the maker of the HPV vaccine] sabotaged itself because it came out with such a strong, aggressive marketing campaign, so it became a hot topic in the news and was put on the political agenda.”
She also notes that GlaxoSmithKline has developed another HPV vaccine, which is expected to get FDA approval this year. It is no surprise, therefore, that Merck made a huge push to make their vaccine, Gardasil, mandatory before facing competition. Costing about $360 for a three shot series, the vaccine would have generated billions of dollars if required for every school-aged girl.
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