The Texas HPV Vaccine Controversy

The biggest debate in Texas right now is over Governor Rick Perry's executive order mandating all girls entering the sixth grade to be immunized with the recently approved human papillomavirus (HPV) vaccine starting in September 2008. The order, signed on February 2, has sparked all sorts of controversy: the conservatives are furious, the liberals are speechless, and the independents are suspicious. Personally, I have mixed feelings about Perry's decision as well. At first, I was elated that Perry, a conservative Republican, was able to see past the absurd argument that the vaccine would increase sexual promiscuity. But, almost as soon as Perry's order was signed, it turned out to be too good to be true.

It seems Perry has some strange bedfellows at Merck, the maker of the HPV vaccine, Gardasil. First of all, Perry's former chief of staff, Mike Toomey, is now one of Merck's lobbyists in Texas. Second, it has been reported that Perry received $6,000 from Merck's political action committee during his 2006 re-election campaign. Lastly, his current chief of staff's mother-in-law, Texas state Rep. Dianne White Delisi (R), is the state director for the Merck funded advocacy group, Women in Government. Perry's suspicious dealings made me question not only his motive for by-passing the legislature, but also his reason for making it mandatory. Was this just a sneaky way to both please Merck and, at the same time, create public resistance to the vaccine? My guess is that he is not quite that sly, but unfortunately that is exactly what is happening.

The opposition to the vaccine now brewing in Texas will most likely end with a bill overriding the executive order as well as leaving a bad image of Gardasil in most people's minds. Already, members of the Texas legislature have filed four bills that would supersede the Governor's order. In addition, some members have written letters to the Governor asking him to rescind the order. One bill (HB 2326) goes as far as to amend the Health and Safety Code in order to spell out the exact vaccines that would be mandated, which seems contrary to the argument that vaccines shouldn't be mandated at all. This list, of course, purposely excludes the HPV vaccine.

But, so far, Perry stands firm in his decision and surprisingly sounds very progressive. The Washington Times quotes him as saying, "Providing the HPV vaccine doesn't promote sexual promiscuity any more than providing the hepatitis B vaccine promotes drug use." I think this is very well said, but I am still not completely convinced about the necessity to make the vaccine mandatory. Don't get me wrong; I think the vaccine is great and I will have it myself (when I can afford it), but my issue is with the government telling people what to do with their bodies. I just don't think that is the answer. I think education, availability, and affordability are the answers.

While I applaud Perry for trying to be progressive, as well as making it easy to opt-out by having a form online, I still feel like he went about it the wrong way. For one reason, it is pretty well known that if you tell people they have to do something, they will resist it. Also, the vaccine is still very expensive. Marilyn Keefe gives a great breakdown of the problems associated with the cost of the vaccine, as well as issues with insurance and government-funded healthcare. Additionally, having an opt-out form online is great, but only if you have a computer and internet access. Unfortunately, the whole situation is a big mess and it looks like the executive order really was too good to be true.

Although I don't have a clear answer as to how to resolve this issue, it needs to be resolved. I think that if a bill, similar to Perry's order, had been allowed to go through the regular legislative process it would have been better received and, at least, there could have been an opt-in option. But now, because of all of the negative attention surrounding Gardasil, it looks unlikely the girls and women of Texas will even get that. As I think about the future of vaccines, particularly an HIV vaccine, I worry that this same debate will happen again and again. That is why we need to figure this out. I see this HPV vaccine as just the beginning of vaccines that will be considered controversial just because they are spread through sexual contact. In reality, these types of vaccines should not be controversial at all; instead, they should be welcomed and appreciated.

Editor's note: Watch Stephen Colbert discuss Governor Perry's decision to make the HPV vaccine mandatory—"Bad Medicine" clip from Comedy Central's Colbert Report below.

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