“One less”...what?: What analyzing stakeholder discourses of Gardasil can tell us about ethics, expectations, and the politics of new reproductive technologies

Gardasil, a vaccine that prevents some strains of the human papillomavirus (HPV) that cause some anogenital cancers, was approved by the FDA as a “cervical cancer vaccine” in June 2006. It was quickly and unanimously endorsed for girls and young women by the CDC's Advisory Committee on Immunization Practices, and its implementation – primarily, whether to make vaccination mandatory for young adolescent girls – is now being decided by state legislators. Emerging scientific and public discourses consider ethical issues surrounding vaccine policy, such as individual rights versus community responsibility; implications regarding gender, adolescent sexuality, and parental control; and perhaps most importantly, the influence of aggressive marketing and advocacy funding practices by Gardasil's patent-holder, Merck & Co., Inc. Among the urgent topics obscured in these debates is effectiveness of health education, consumer expectation of benefit, and the risks to individual and community health (including broader vaccine behavior) if over-zealous but unsophisticated public consumption of HPV vaccines does not reduce further cervical cancer morbidity and mortality in the United States, where disproportionate rates of cervical disease and death are primarily attributable to healthcare disparities including low rates of preventive screening among marginalized populations. The author will probe these issues by analyzing discursive materials both supporting and opposing HPV vaccine mandation from the scientific and public spheres, including: policy statements by professional organizations and scientific research; news features, editorials, letters to the editor, and blogs; and advocacy and marketing materials. She will highlight gaps in the literature and areas for future research.