Rick Perry: Selling Sixth-Grade Girls' Health to the Highest Bidder?

 In 2007, Governor Rick Perry shocked both public health officials and his conservative base when he signed an executive order mandating that female students in Texas be vaccinated against human papillomavirus (HPV) before entering the sixth grade. The order referred to Gardasil, a vaccine that had been approved by the FDA only a few months earlier after having been found to prevent infection with four strains of HPV, including two strains that account for 70 percent of cervical cancer and two that account for 90 percent of genital warts.  The FDA approved the three-shot regimen for young women ages nine to 26 and the Centers for Disease Control and Prevention (CDC) recommended that this become part of the routine vaccinations of girls at ages 11 or 12 because “it is important for girls to get HPV vaccine before their first sexual contact – because they won’t have been exposed to human papillomavirus.”

Public health advocates argued that because HPV is so easily spread through sexual contact, universal or near-universal vaccinations would be the only the way to eradicate the disease.  They pointed out that, although cervical cancer can be prevented through early detection using Pap Smears and other medical tests, approximately 10,000 women in the United State do become infected each year.  As a result of these arguments, a number of states considered legislation and rules similar to Perry’s order which would make the vaccine a requirement for school attendance.  (It’s worth noting that many public health advocates stopped short of supporting these types of mandates because of the fear that such requirements and the steep price of the vaccine –- about $390 for the series -– would be too much of a burden on the Vaccines for Children program, “a federally-funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay.”)

On the flip side, social conservatives and proponents of abstinence-only-until-marriage programs argued that vaccinating young girls against a sexually transmitted disease was morally questionable and dangerous.  They suggested that such a vaccine would give young women a false sense of security and lead to promiscuity.  They also took issue with the young age at which vaccine was recommended and complained that at the very least this would cause parents to have to have uncomfortable and age-inappropriate conversations with their daughters. Ultimately, they said that this was a parental issue in which the state should not become involved. 

When it came to issues around sexual and reproductive health, Governor Perry sided with these factions far more often that with public health experts. So, people on both sides of the debate were surprised when Governor Perry bypassed his state legislature and issued the executive order which not only required all female students to be vaccinated but also “directed state health authorities to make the vaccine available free to girls 9 to 18 who are uninsured or whose insurance does not cover vaccines,” and ordered Medicaid to offer Gardasil to women ages 19 to 21.

At the time Perry argued that “the HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer,” and that it was no different than the vaccine for polio.  According to one blog he had this to say to his critics: 

“I understand the concern some of my great and dear friends have about requiring this vaccine, which is why parents can opt out if they so choose…I refuse to look a young woman in the eye who suffers from this form of cancer and tell her that we could have stopped it, but we didn’t. Others may focus on the cause of this cancer. I will stay focused on the cure.”

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