title: Pharmaceutical companies' role in state vaccination policymaking: the case of human papillomavirus vaccination.
abstract: OBJECTIVE
  We sought to investigate roles that Merck & Co Inc played in state human papillomavirus (HPV) immunization policymaking, to elicit key stakeholders' perceptions of the appropriateness of these activities, and to explore implications for relationships between health policymakers and industry.
  
  
  METHODS
  We used a series of state case studies combining data from key informant interviews with analysis of media reports and archival materials. We interviewed 73 key informants in 6 states that were actively engaged in HPV vaccine policy deliberations.
  
  
  RESULTS
  Merck promoted school-entry mandate legislation by serving as an information resource, lobbying legislators, drafting legislation, mobilizing female legislators and physician organizations, conducting consumer marketing campaigns, and filling gaps in access to the vaccine. Legislators relied heavily on Merck for scientific information. Most stakeholders found lobbying by vaccine manufacturers acceptable in principle, but perceived that Merck had acted too aggressively and nontransparently in this case.
  
  
  CONCLUSIONS
  Although policymakers acknowledge the utility of manufacturers' involvement in vaccination policymaking, industry lobbying that is overly aggressive, not fully transparent, or not divorced from financial contributions to lawmakers risks undermining the prospects for legislation to foster uptake of new vaccines.
authors.affiliation: Harvard School of Public Health, Boston, MA, USA. mmello@hsph.harvard.edu
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mello
authors.forename: Sara
authors.initials: S
authors.lastname: Abiola
authors.forename: James
authors.initials: J
authors.lastname: Colgrove
mesh_terms: D004345:Drug Industry / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D008119:Lobbying; D008389:Marketing of Health Services / Q000458:organization & administration; D053918:Papillomavirus Vaccines; D011050:Policy Making; D011057:Politics; D014481:United States; D014611:Vaccination / Q000331:legislation & jurisprudence*
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines