HPV Vaccine Mandate the Tip of Big Money Insider Interests

As first highlighted on the Ocean State Current in early June, the state Dept. of Health, through its authority to mandate vaccines for Rhode Island public and private school students, unilaterally declared that all seventh graders must be vaccinated for the sexually transmitted human papillomavirus (HPV).  In part owing to the RI Center for Freedom & Prosperity’s recent statement on the mandate, the issue has now been getting some attention.

“Sadly, the governmental process in our state and in Washington, D.C., has become so corrupted by special interest considerations, that many Rhode Islanders no longer automatically trust what our government tells us. In the case of this HPV vaccine mandate, there is major national controversy over the effectiveness and safety of this vaccine,” Mike Stenhouse, CEO for the Center, tells the Current. “What arrogance, for an unelected bureaucratic agency to arbitrarily declare this vaccine safe, and then impose such an oppressive mandate that infringes on the parental rights of Ocean State families without due public discourse or legislative oversight.”

One lingering question is:  Why would Rhode Island government move to make it only one of two states to issue this mandate and be the only state to do so through the bureaucracy, not with the deliberation of elected officials?

The philosophical part of the answer may be that people in Rhode Island government have a very low threshold for actions they believe they can take without the explicit consent of Rhode Islanders.  A greater sense of representative democracy in other states may make the barrier higher for taking such actions, so government agents are restrained in the mandates on which they’re willing to expend effort.

However easy it is for state employees to impose their will on their neighbors, though, what’s the motivation for this particular change?

The first step in an investigation might note that the federal Centers for Disease Control and Prevention (CDC) has a Vaccines for Children Program that finances vaccines for children from low income families.  HPV is on the list of covered diseases, and providers can charge an “administrative fee” for giving the vaccines.

A search of USASpending.gov helps to quantify the money involved — through the VFC program or otherwise.  So far in fiscal year 2015 (which ends in two months, on September 30, 2015), the CDC has given $18.4 million to the Rhode Island Dept. of Health, $933,308 of it for Immunization Cooperative Agreements.  Such funds can be used for implementing immunization programs, including providing “information and education” and ensuring “compliance with compulsory school immunization laws.”  Activities such as the upcoming “community meetings about HPV vaccination” would likely be covered, although it isn’t clear whether they are included in the FY15 total, yet.

(Note that, although HPV is not listed in a parenthetical note about included diseases for Immunization Cooperative Agreements, it is on the CDC’s list of those that are “vaccine-preventable.”  The Current has requested clarification about whether agreement funds are available for HPV.)

On the expenditure side of the ledger, according to RIOpenGov.org, the Dept. of Health annually purchases millions of dollars in pharmaceuticals from Merck Sharp & Dohme Corp., the manufacturer of Gardasil, the HPV vaccine.  In fiscal year 2014 (which ended July 31, 2014) the amount increased from $4.1 million the previous year to $6.0 million.  In FY15, it held at $5.6 million.

Given this level of business with the state, it isn’t surprising that Merck Sharp & Dohme maintains relationships with as many as four lobbyists annually.  In 2015, according to the state’s Lobby Tracker, the company has $15,000 retainer agreements with R. Kelly Sheridan and Elizabeth Suever, both of the lobbying firm Roberts Carroll Feldstein & Peirce.  It also has two annual agreements, for $594 monthly ($7,128 annually) each, with Matthew Paul Badalucco, for lobbying the legislative and executive branches of government, respectively, and an annual agreement with Michael Goldstein of $167 monthly ($2,000 annually) for lobbying the executive branch.

These amounts are estimates that lobbyists report when they register at the beginning of the year.  The regular reports provided to the Secretary of State’s office report payments specifically for lobbying activities.  Discrepancies in the totals could mean that the company did not end up paying the lobbyist or paid him or her for activities that didn’t technically fall under the state’s definition of lobbying.  In the two years leading up to the Dept. of Health’s January 2014 decision to mandate the HPV vaccine, Badalucco received $14,154 to lobby the executive branch, followed by only $3,558 over the next six months.  His monthly payments specifically for lobbying resumed (at $600 each) in January 2015.

Of Merck’s slate of lobbyists, only the two from Roberts Carroll Feldstein & Peirce are listed as contributors to local politicians.  Sheridan and Suever have given a combined $94,506 in political donations since 2002 — to legislators as well as executive branch candidates and officials.

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