The CDC pledges To base all public health decisions on the highest quality scientific data." In the case of influenza vaccinations and their marketing, this is not so. Promotion of influenza vaccines is one of the most visible and aggressive public health policies today. Although proponents employ the rhetoric of science, the studies underlying the policy are often of low quality, and do not substantiate officials' claims. The vaccine might be less beneficial and less safe than has been claimed, and the threat of influenza appears overstated. Twenty years ago, in 1990, 32 million doses of influenza vaccine were available in the United States. Today [the number is] around 135 million doses. This enormous growth has not been fueled by popular demand but instead by a public health campaign. Drug companies have long known that to sell some products, you would have to first sell people on the disease. In the 1950s and 1960s, Merck launched an extensive campaign to lower the diagnostic threshold for hypertension, and in doing so enlarging the market for its diuretic drug, Diuril. Could influenza ... be yet one more case of disease mongering? Marketing influenza vaccines ... involves marketing influenza as a threat of great proportions. The CDC's website explains that "Flu seasons ... can be severe," citing a death toll of "3000 to a high of about 49000 people." However, a far less volatile and more reassuring picture of influenza seems likely if one considers that recorded deaths from influenza declined sharply over the middle of the 20th century ... all before the great expansion of vaccination campaigns in the 2000s. Yet across the country, mandatory influenza vaccination policies have cropped up ... precisely because not everyone wants the vaccination, and compulsion appears the only way to achieve high vaccination rates.