June 22, 2009
Tom Blackwell, National Post
Health Canada says it is cracking down on the growing number of TV ads that tout the benefits of vaccines for everything from hepatitis to travellers’ diarrhea, yet say little about the products’ risks and other shortcomings.
Responding to outside complaints, the department has persuaded some manufacturers to change “unbalanced” commercials, issued letters urging the industry to include both negative and positive information in ads and begun developing new vaccine marketing guidelines.
The action highlights, however, the fact that vaccine advertising falls into a legal grey area with little regulation – in contrast to the tight restrictions placed on consumer ads for prescription drugs.
Health Canada still has no plans to make vaccines subject to similarly stringent rules, but the measures it is taking are welcome and overdue, said the head of a marketing review agency.
“There are gaps in the system and this is one that a truck could drive through,” said Ray Chepesiuk, commissioner of the Pharmaceutical Advertising Advisory Board. “We consider [vaccines] to be serious medicine that have some risks – safety information the public should be aware of…. You can’t say all good things and ignore the bad things.”
Consumer advertising for vaccines used to be unheard of, Mr. Chepesiuk said. But the past couple of years has seen a flurry of ads for vaccines designed to prevent diseases ranging from meningitis to human papillomavirus (HPV) and E. coli-caused diarrhea.
In fact, vaccines are one of the fastest growing sectors in the pharmaceutical industry, and direct-to-consumer advertising is on the rise with it, the market-research company Kalorma Information noted in a report this month.
Many vaccines – especially those for common childhood illness – are provided at taxpayers’ expense by public-health authorities. If individuals want a vaccine not available through a government immunization program, however, they often need to obtain a prescription.
Direct-to-consumer advertising is all but barred for most prescription drugs in Canada. Ads can either mention the name of the medicine and not what it is used for, or they can talk about a disease and not refer to the drug. Many experts fear that unbridled advertising would prompt more consumers to seek out specific medications from doctors, potentially leading to inappropriate use and inflated costs for drug plans. Others argue that advertising only broadens the public’s knowledge. Regardless, vaccine ads face few restrictions. Under the Food and Drug Act, the products are covered by neither the restrictive advertising regulations for prescription medication, nor the looser rules for non-prescription drugs.
They are subject, though, to generic directives in the act against misleading advertising of drugs, Health Canada says, giving the regulator at least some leverage.
“The lack of safety information in ads may lead to an erroneous overall impression left with the viewer about the safety of the advertised vaccines,” said Stephane Shank, a spokesman for the department.
He refused to name the companies approached by Health Canada but said they are now modifying their commercials accordingly.
One pharmaceutical firm, GlaxoSmithKline, which makes the hepatitis vaccine Twinrix, said in an emailed statement the company believes Canadians benefit from “educational campaigns” that raise awareness about diseases, but stressed that it adheres to all rules governing advertising.
Vaccines are considered an overwhelmingly beneficial public-health tool and relatively safe, but do have side effects. Most are minor, such as muscle soreness and low fever, though some vaccines have been linked to a slightly increased risk of acquiring Guillain-Barré syndrome, a usually temporary paralysis.
Some ads for Gardasil, the HPV vaccine, feature women who look to be university-aged, though the product is usually targeted at young girls who are not yet sexually active and so could not have acquired the virus, said Barbara Mintzes, a leading drug-marketing expert at the University of British Columbia. “It doesn’t really make sense … to rely on manufacturers to advertise vaccines to the public,” she argued.
Sanofi Pasteur has generated controversy with its commercials for Menactra, a vaccine that protects against strains of bacterial meningitis not always covered in the meningococcal shots provided free by most provincial governments. One TV ad warns about the “rare but potentially devastating disease” that can “quickly lead to permanent disability or death.”
Critics question whether the product is really needed, since relatively few children become infected by those strains. Sanofi has argued the bacteria do sometimes prove fatal in Canada and that it makes sense to protect against the bugs.
Alan Cassells, a drug-policy researcher at the University of Victoria, said even government advertising for immunization can be misleadingly one-sided. He cited ads for British Columbia’s flu-shot campaign that depict the virus as a monster, albeit somewhat light-heartedly.
“That kind of fear-mongering I find distasteful,” Mr. Cassells said. “You should get a flu shot based on science and whether it’s good for you, not because you’re being scared by monsters on the sides of buses.”
Comment From Leslie
Nice. We are beginning to crack the glass ceiling on accepting advertising without reservations and doubt. My father told me a long time ago – “never believe everything that is advertised. Probably the most valuable piece of information I have ever received. Once you look at advertising with a shadow of doubt – all sorts of new awareness opens up.