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.

FILED UNDER: Campaign 2012, US Politics,
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Chad S says:

    Jmo, but I would be more concerned that the company that would have administered it pay off one of his former COSs to make it happen.




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  2. Jay Tea says:

    Once again, New Hampshire gets it right. Gay marriage, seat belt laws, income taxes, sales taxes, legislative pay…

    Oh, lord, it’s hard to be humble
    When you’re perfect in every way…

    And note that it was here in New Hampshire that Perry had to fess up…

    J.




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  3. Trumwill says:

    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.

    Regardless of the merits of a mandate, it’s important that they get the vaccine before they become sexually active. In other words, when they’re not sexually active. Like when they’re 11.

    Should we act based on the assumption that they will not become sexually active, or that when they’re ready to, they will wait and get the shots first?




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  4. Laurie says:

    I don’t care about this issue enough to study it in depth or even read the whole post. I just object to dumb arguments.

    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.

    I can’t imagine any state mandating this vaccine without a provision like this:

    Texas allows parents to opt out of inoculations by filing an affidavit objecting to the vaccine on religious or philosophical reasons.

    This sounds like an easy process to me. From a public health standpoint maybe a “mandate” provides the best wide spread access while “forcing” no parent to comply. Maybe it is a dumb or unnecessary mandate and just a sweet deal for Merck.




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  5. WR says:

    And to prove your case, you quote a columnist who equates vaccinating young girls with slavery. Oh, yeah, that’s convincing.




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  6. OzarkHillbilly says:

    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.

    Doug, somehow or other you have forgotten the fact that 99.9% of 11 yr old girls grow up to be 16 yr old girls who have hormones pumping thru their veins who then grow up to be 22 yr old women who have hormones pumping thru their veins having sex with 22 yr old men who have had hormones pumping thru their veins for 8 yrs….. And by the time they become “at risk for getting this disease,” it is too late for a significant percentage of them?

    At what point do we recognize that reality no longer fits into an 18th century view of “rights”? (whatever that might mean) Look, religious conservatives can rail against pre-marital sex as much as they want, but that train has already left the station and their children know it. (just ask Bristol Palin)

    I am all about parental rights. I do not think a 14 yr old girl should have an abortion without a parents knowledge of it (Had that argument w/ many of my lefty friends) but an immunization is NOT an abortion. When teenage girls (and boys) are barred from having sex (not just legally, but actually...) we can talk about “parental rights”…

    Until then, let us talk about what is best for the children.




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  7. Doug, I don’t know why you keep saying stuff like this: “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.”

    Why don’t you scroll up further in your own entry and read this quotation from the Governor?–“I signed an executive order that allowed for an opt-out . . .”

    The conflict-of-interest issue remains, but given that there was an opt-out, the vaccinations were a lot less of an intrusion than you are presenting them as.

    A lot of girls’ first time is not consensual, and waiting even a few more years for vaccinations would have 1) increased the probability of side effects, and 2) negated the benefits of having them well before the girls became sexually active.

    Does this mean they were a good idea? Maybe. Maybe not. But they certainly were not “forced.”




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  8. Hey Norm says:

    Look…the base will forgive him this because their aversion to regulation ends at other peoples bodies. The so-called Republicans love regulating other people. Abortion, birth control, preventing equal rights for gays, the list goes on. Perry is just another one of them. No different. No surprises. Just abject hypocrisy.




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  9. bbay says:

    In an ever changing background of new information… The key here is that the Gov Perry’s response leaves room for reformation; and welcomes a new collection of ideas….

    I admire that in a leader…

    To say you were wrong, and to move to better solution…
    That’s the kind of leadership we need to heal America…




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  10. Janis Gore says:

    Maybe we should acknowledge that he’s a two-faced prick with a penchant for crony capitalism.

    Then we can discuss his bad points.




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  11. Hey Norm says:

    Yes bbay…
    Like changing his mind on states rights a couple times, or on being “called” to run.
    One man’s “open to knew ideas” is anothers flip-flopper.




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  12. ddennis says:

    @bbay:

    Okay, on principle, I agree. My issue is that Perry and Republicans like him are ever trying to get the rest of us to do what THEY think is right for everyone and are willing to use the force of government to do so. When it comes to what Democrats, Libertarians or Other political philosophies want, though, it’s Socialism. It’s their hypocrisy and dissonant duality that I find repulsive.




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  13. Yet another disillusioned pawn says:

    @Hey Norm: No, the left and the right are completely different. The left imposes on your rights because it is good for society. The right imposes when it is good for YOU. Entirely different.




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  14. Trumwill says:

    @Hey Norm: More like, they forgiven him because he reversed his position. They’re at least consistent in that they don’t like it when a Republican is doing it. There are a lot of examples of great Republican inconsistency and of favoring government intrusion of our lives despite saying they don’t, but this doesn’t appear to be one of them. For better or worse, they’re on the side of personal freedom here. (Not sure I agree with them, though.)




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  15. Hey Norm says:

    Trumwill…I don’t see how a mandate by executive order is On the side of personal freedom. But I respect your views, so I must be missing something.




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  16. Trumwill says:

    Norm,

    I was referring to the fact that the conservatives hated this and Perry is distancing himself from it. They’re not forgiving him because he’s intruding on young women’s bodies. They’re forgiving him because he renounces this intrusion. So in that sense, they’re actually being consistent with the rhetoric about keeping the government out of our lives. Am I making sense?




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  17. jan says:

    The deal about Gardarsil is that there have been 35 million doses given. Out of that amount, there have been 1,498 serious complications, equating to a .0000428 chance that a person could have a serious reaction to the drug.

    Perry cites his major concerns for giving an executive order was 1) to prevent cervical cancer in woman 2) to reduce the $360 cost of the vaccine by finding a way to have insurance companies cover it. Insurance companies would only cover it if it was mandated, not a voluntary requirement. So, Perry attempted to have it become a school-related package that would be covered by insurance with a simple co-pay. His EO, though, was resoundingly defeated in the legislature, being veto-proof. So, Perry then recinded his original order. And, that was the end of it.




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  18. Tea Parties are for Little Girls (formerly Hey Norm) says:

    @ trumwill…
    got it.




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  19. Rob in CT says:

    Wait… what, exactly, did Perry do wrong? There was an opt-out.




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  20. jan says:

    @Rob in CT:

    Bingo! The problem was that he initiated an EO in the first place, and people thought that was too aggressive of an act. BTW, I don’t like this vaccine myself (ever with the low probability of any adverse reaction from happening), and would have opted out of it for my daughter. But, I can see Perry’s reasoning behind it, even though I disagree with it.




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  21. Rob in CT says:

    I think I’d get my daughter vaccinated, though I’ll probably do some more research between now and when it’s relevant (she’s 18months old, so I’ve got some time). At first blush, a .00428% chance of a serious reaction is worth it for the reduction in risk of cervical cancer.

    Basically it seems to me that Perry took a stab at a public health problem and got smacked down for it, largely because SoCons were worried about girls having sex.

    I do prefer the NH approach, at least with this particular vaccine. There are some cases, though, where it makes sense to simply mandate it, because “opting out” can screw up herd immunity.




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  22. WR says:

    @jan: What is it that you dislike about this vaccine? I realize it keeps girls from getting the death penalty for having sex, but is there something beyond that for you?




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  23. tyndon clusters says:

    Bill Maher had THE classic take on this controversy back in 2007:

    “Christian parent groups and churches nationwide are fighting (the vaccine). Bridget Maher — no relation, and none planned — of the Family Research Council says giving girls the vaccine is bad, because the girls “may see it as a license to engage in premarital sex.

    ” It’s like being against a cure for blindness because it’ll encourage masturbation”

    These people don’t really want to see a cure for anything, except homosexuality.

    Can conservatives be any more moronic than they already are?




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