Sales of Merck’s HPV vaccine, Gardasil, declined by a third this year, and three years after the FDA approved the drug an estimated three out of four women remain unvaccinated — despite millions spent on advertising and lobbying for government mandates. A recent marketing study offers a reason. Michelle Steward, assistant professor of marketing at Wake Forest University, and several colleagues conducted an experiment with women, ages 18 to 30, and found that they were more likely to consider being vaccinated for HPV after participating in a survey than as a result of commercial advertising or a government mandate. “The educational cues in the survey are the least coercive and appear to prompt more thinking about the risks of not being vaccinated than laws, which may produce a negative backlash or advertisements, of which consumers might be skeptical,” said Steward. “The results would suggest that Merck’s money may be best spent engaging people through a survey on relevant health topics to get the consumer to think about their own risks. There’s nothing to suggest that there would be any difference in males’ reactions. If Merck gains FDA approval to market Gardasil for boys, the advantages of surveys versus mandates or advertising would remain the same. “Determining how best to move consumers from hearing about a drug or vaccination to actually using the product should rival R&D in importance to a firm,” Steward said. The study, “The Influence of Different Types of Cues-to-Action on Vaccination Behavior: An Exploratory Study,” will be published in the spring edition of the Journal of Marketing Theory and Practice.