Rick Perry Issues Mea Culpa On Mandatory HPV Vaccine Program
Rick Perry has walked back his support for mandatory HPV vaccination but the broader issue still remains.
One of the few items in Rick Perry’s record that has upset conservatives of all stripes, especially social conservatives, is his decision in 2007 to issue an Executive Order requiring that all 11 year old girls in Texas Public Schools be required to be vaccinated with Gardasil, the newly developed vaccine for Human papillomavirus (HPV), the virus which has been tied to cervical cancer, which results in approximately 4,000 deaths per year nationwide. At the time, several socially conservative groups objected to the mandate, many on the ground that inoculating young girls against a sexually transmitted disease would encourage sexual promiscuity. However there were also those who objected to forced vaccination for a disease that is not, on its face, a public health threat. Perry’s Executive Order was overruled by the Texas Legislature less than a year after he signed it, a measure which Perry allowed to become law rather than exercising a veto, and the issue sort of died away.
Until yesterday in New Hampshire, that is, when Perry faced a question about his decision during his first real campaign stop:
His third question from the crowd was about an issue that his critics have touched on — his 2007 mandate for girls to get vaccinated against the cervical cancer-causing HPV virus.
“I signed an executive order that allowed for an opt-out, but the fact of the matter is I didn’t do my research well enough to understand that we needed to have a substantial conversation with our citizenry,” he said. “I hate cancer. Let me tell you, as a son who has a mother and father who are both cancer survivors.”
Perry said he’d invested government resources in cancer cures, adding, “I hate cancer. And this HPV, we were seeing young ladies die at the early age. What we should have done was a program that frankly should have allowed them to opt in, or some type of program like that, but here’s what I learned — when you get too far out in front of the parade they will let you know. And that’s exactly what our legislature did…
Based on Ed Morrissey’s post on the issue, it seems that Perry’s walk back, along with his decision to allow the repeal to go into effect in 2007, it would appear that the concerns of social conservatives are likely to be satisfied by Perry’s response. However, that still leaves the broader question of whether Perry’s Executive Order or similar action on the part of a legislature, was appropriate in the first place. When Perry’s comments were first announced this morning, it resulted in extended debate on the issue of mandatory vaccinations between Jazz Shaw and myself on Twitter, along with others later in the day, and that’s inspired a more lengthy treatment of the issue here.
As a preliminary matter, I will say that there are clearly cases where mandatory vaccination is appropriate. When one is dealing with an easily communicable disease with a high mortality rate, vaccination is the best method available to either eradicate the virus, or bring it under some form of manageable control. Smallpox is the classic example of such a disease, but the argument also applies to childhood disease such as measles and Whooping Cough, both of which are highly communicable and pose a serious health risk to children and the general population. For that reason, requiring vaccination against these types of diseases for public school attendance makes sense because one doesn’t want an infected chil in an environment where they could easily transmit the disease to others.
It doesn’t seem to me that this same argument applies in the case of HPV. Like Hepatitis B, HPV is not easily communicable. You can’t get it by sitting next to an infected person on the subway. It’s not transmitted through the air. Although it’s theoretically possible, there are no documented cases of someone being infected simply by skin-to-skin contact. The one known, and most common, method for transmitting the virus. you have engage in sexual activity. If you’re targeting people who might be at risk for getting this disease, you’d be better off concentrating on a segment of the population that is actually engaging in the behavior that puts them at risk, not eleven year old girls.
Moreover, the mandatory nature of the vaccine is a direct intrusion on the right of parents to raise their children as they see fit. Yes, there are extreme examples where a parent who refuses to provide their child with life-saving medical care could be subject to having that decision overruled by the state, but that’s not the situation we’re dealing with here. If the Texas law had contained a provision allowing parents to opt-out of the vaccination requirement, then this aspect of the law would be lessened. However, as Perry concedes, no such opt-out existed, and that was one of the primary objections that Texas citizens had to Perry’s Executive Order.
An excellent contrast with the approach that Perry took in 2007 can be found in what New Hampshire did around the same time:
“Education is something that we do — in the schools and, most importantly, in our communities and in the pediatrician’s office,” said Greg Moore, a spokesman for the New Hampshire Department of Health and Human Services. “How do we do it? Old-fashioned legwork. We make sure the right people have the right information. We have people who go out at the regional and local level, sit down and talk to health-care providers and ask, ‘What can we do for you?’ Cervical cancer is a huge issue for us, and now we have this tremendous opportunity to educate and protect women even more.”
The New Hampshire approach encourages residents to take more responsibility for their lives. With the government acting as partner — instead of some antebellum massa — parents are encouraged to make choices that are in the best interest of their children. And guess what? They usually do.
So far this month, about 3,300 doses of the HPV vaccine have been made available to girls in New Hampshire. State health officials say they are receiving feedback and determining where demand is greatest and how soon to order more vaccine. “We are at the beginning of the process, but from the anecdotal evidence, there appears to be a great demand from parents,” Moore said.
All child vaccinations in New Hampshire are voluntary. The state doesn’t kick girls out of school because they didn’t get a vaccine. It understands that parents can become overwhelmed and need encouragement — not just threats and kicks in the butt. And as a result, the state has one of the highest rates of child immunization in the nation.
“We know that there are parents who have expressed concern about children and childhood vaccines,” Moore said. “Our program was designed with an emphasis on education and addressing whatever concerns parents might have.”
Doesn’t this seem like a better way to do things than relying on a mandatory program, imposed by Executive Order, that serves only to stir up resentment from parents who are at the same time concerned about the well-being of their children and wary of the heavy hand of government?
Without question, cervical cancer is a horrible disease, and the vaccine against the HPV virus, the first vaccine against cancer ever created, is a tremendous medical breakthrough. If I had daughters, I would most likely make sure they got the vaccine, after studying the issue to my satisfaction. Nonetheless, there are legitimate issues of medical privacy and individual liberty involved here, and dangerous precedents that could be set if Perry’s example were followed. Cervical cancer is fundamentally different from other public health threats such as typhoid or influenza in that it takes far more than casual contact for the disease to spread. Moreover, based just on annual death figured cervical cancer (roughly 4,000 deaths per year) is far less of a public health threat than influenza (roughly 36,000 deaths per year). Is the next step going to be that we require everyone to get the flu vaccine whether they want to or not. It may well be wise for parents to vaccinate their daughters against HPV at a young age, that doesn’t mean it’s the business of government to force them do it.
Update: Jazz Shaw takes a contrary view in his post over at Hot Air, I recommend you take a look at it.