The Science and Politics of Vaccines Collide
Dr. Howard Forman reflects on heartening new evidence for the effectiveness of the HPV vaccine—and troubling signs of vaccine skepticism from the Trump administration.
This commentary was adapted from episode 172 of the Health & Veritas podcast. The views expressed are the author’s own. Subscribe for weekly doses of expert insight on health and the healthcare industry.
The Papanicolaou test, or Pap smear, was introduced in the 1940s. Its use over the eight decades since has saved many lives from cervical cancer. Our progress against this disease, which kills hundreds of thousands worldwide. accelerated with the introduction of the Human papilloma virus (HPV) vaccine in the United States in 2006. HPV has been known as the cause of most cervical cancer for at least 40 years, with increasing evidence and a growing understanding of its mechanisms of action.
We are now nearly 20 years out from the introduction of a vaccine—a vaccine that is preferably given to children when they are 11 or 12 years old—and we are just now seeing real epidemiological impact. The data keeps getting better. On a recent episode of the Health & Veritas podcast, we briefly touched on one such study. But I now have more, and more impactful, data to share.
A study from the National Cancer Institute (NCI) relates impressive evidence that one shot, rather than a series, is extraordinarily effective at preventing cervical cancer. This has both major domestic and global implications, because it dramatically improves the likelihood of reaching more people. This is a disease that more generally afflicts younger people, so the impact is enormous.
A few months ago, another study from Scotland showed 100% efficacy among women who had been vaccinated before the age of 14, either with one or more doses. This is an astonishing level of protection.
But at the same time that we are seeing this overwhelming evidence, we are also facing a vaccine-skeptical administration—and that might be a generous characterization of their views. Right now, all of these things are true:
- Robert F. Kennedy Jr., the health secretary, has been a major supporter of a lawsuit against Merck contesting the safety and effectiveness of the HPV vaccine Gardisil.
- Kennedy and Dr. Martin Makary, the FDA commissioner, are being pointedly less than emphatic about the public health need for the measles, mumps, and rubella (MMR) vaccination during a time of the largest domestic measles outbreak in more than 30 years.
- Makary and his staff are making noises about delaying approval of the Novavax COVID vaccine, at a time in the year when we would like vaccine-makers to be readying the newest antigens for inclusion in the fall booster. There have been many good questions for them from scientists and journalists, but no good response from Makary or the FDA—other than to indicate a new standard for approving an annual vaccine and potentially applying this standard to all COVID vaccines.
These three data points, backed by uncontested statements from these officials, raise far greater concerns than we had a few weeks ago. Our colleague Jason Schwartz summed it up well recently: “If there was a belief that FDA would be insulated from this larger climate of skepticism toward vaccines that the new administration and the secretary brings, those hopes were probably misplaced.”