1⃣GARDASIL is a great vaccine. So great, in fact, that a single dose offers solid protection against HPV cancers.
Yet in spite of the #WHO’s recommendation and substantial evidence for the efficacy of 1 dose, Merck promoted 2 doses at this year’s #IPVC. 2/12 
Colleague Cameron B. Haas explains: #Merck constrained its statistical models so 1 HPV dose could never outperform 2 doses.
But there’s no justification for this assumption: more jabs give more antibodies, but this doesn’t necessarily translate to better protection. 3/12
It’s worth noting #Merck manufactured insufficient quantities of overpriced HPV vaccine for years.
Folks from low-income countries have lacked access.
Cervical #cancer is preventable but not prevented — due in part to corporate-driven inequities. 4/12 https://www.cervicalcancerdeclaration.org/
2⃣MOLNUPIRAVIR (MOV). #Merck obtained emergency approval for MOV in December 2021 — just barely the first oral antiviral against COVID-19.
But MOV works by causing viral mutations, the raw material for new variants of concern. 5/12 
Weeks before the US #FDA decision on MOV, numerous scientists identified issues with Merck’s statistical analyses, the risks posed to individual patients, and the risks for viral evolution.
Sally Otto and I explained the viral evolution risk here. 6/12 https://virological.org/t/mutagenic-antivirals-the-evolutionary-risk-of-low-doses/768
Unfortunately, MOV was recommended 13-10.
Merck’s case to the FDA repeatedly confused mutation and selection, arguing that all drugs impose selection.
But the problem is mutation: MOV potentiates rare but impactful ‘black swan’ variants. 7/12 https://www.youtube.com/watch?v=fR9FNSJT64M
Concerns about MOV’s risks have sadly been validated.
For example, work by Theo Sanderson and colleagues shows elevated — but sublethal — mutations in viral genomes, consistent with MOV, in regions where it’s used. 8/12 https://www.medrxiv.org/content/10.1101/2023.01.26.23284998v2
Updates on MOV mutations continue to be provided by Ryan Hisner on Twitter.
Further, as he explains, the drug 1) doesn’t work and 2) could be harmful.
The FDA panel argued MOV should be reconsidered after other drugs became available.
That time has come. 9/12
3⃣MEDICARE. Last week, #Merck sued the US government over a new law that will allow Medicare to negotiate certain drug prices — a common practice worldwide.
Failure to negotiate is one reason a vial of insulin costs $300 in the US but $30 in Canada. 10/12 https://www.nytimes.com/2023/06/06/business/merck-medicare-drug-prices.html
One of #Merck’s reasons for suing is likely its cancer drug Keytruda, upon which it relies to maintain yearly profits of US$14.5 billion.
Among other complaints, Merck’s lawyers suggest the company’s ‘free-speech rights’ will be violated. 11/12
In summary, the for-profit health industry urgently needs reform to address
1⃣inordinate profits on good drugs developed from public research
2⃣bad drugs
3⃣price gouging
Such practices have arguably done more than any media influencer to stoke public distrust in science. 12/12
