On June 8, 2006, the Food and Drug Administration approved Merck & Co.'s vaccine Gardasil, which protects women from the human papillomavirus (HPV). Twenty-four states began entertaining initiatives that would make the vaccine mandatory for all fifth- and sixth-grade girls in public schools. However, as the vaccine gained traction in the media, the dominant issue frame put forth by Merck & Co. was undermined by several competing morality concerns raised by citizens in newspaper opinion pieces. Using an analysis of selected media coverage and a logit analysis modeling the influence of competing morality, economic, and public-health determinants on states' decision making, we investigate the ascent of issue salience surrounding the HPV vaccine, and the policy consideration process. The results from the analysis indicate that citizen-initiated opposition increased the salience of the topic and changed the issue framing in which the mandatory vaccine legislation was being considered. State policy consideration was influenced by a mix of morality and public-health determinants. Moreover, Merck's attempts to influence state policy failed to increase the likelihood of policy consideration.