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Rick Perry And the Gardasil Decision

Now that Texas Governor Rick Perry has entered the race for the GOP presidential nomination his actions as governor are coming under close scrutiny.

One of the items being tossed about is his Executive Order requiring all girls in Texas to receive the vaccine to prevent infection by human pappillovirus (HPV) prior to entering sixth grade.

There are reasons to criticize the decision but they aren’t the ones being discussed.

Tom Bevan at RealClearPolitics has a good run down on the controversy, despite quoting a particularly vile anti-vaccine group. In a nutshell, in 2006 Merck received approval from the FDA for a vaccine that was effective against several strains of HPV that were known to create lesions that were known precursors to cervical cancer.

At the time, this looked like a silver bullet: a shot that would prevent cervical cancer. The decision initially appeared to be a no-brainer. By requiring the immunization of girls it seemed like that most of them would be immune to cervical cancer caused by exposure to HPV. By the time Governor Perry issued his Executive Order, the CDC’s Advisory Committee on Immunization Practices (ACIP) had recommended the vaccine for all females aged 9 to 26. In other words, Governor Perry was hardly breaking new ground here. He was following the guidance issued by the CDC in a minimalist manner, his order only covered upcoming 6th grade girls.

The criticism that Governor Perry somehow trammelled parental rights is nothing short of a calumny. The Executive Order specifically states:

Parents’ Rights.The Department of State Health Services will, in order to protect the right of parents to be the final authority on their children’s health care, modify the current process in order to allow parents to submit a request for a conscientious objection affidavit form via the Internet while maintaining privacy safeguards under current law.

Beyond this, currently all manner of vaccines against childhood diseases are given to children and considered mandatory. Why the HPV vaccine would be considered an affront to parental rights while the measles, mumps and rubella (MMR) vaccine would not is more than a little unclear. There was a concern by some that the vaccine would be the entry point to skankdom by leading girls to believe that by being immune from genital warts — and not herpes, syphillis, gonorrhea, AIDS, chlamydia, etc., — they would feel the overwhelming urge to engage in promiscuous and unprotected sex. How this line of reasoning works is a little more than I can grasp.

However, there were a lot of very good scientific reasons as to why Gardasil should not have been made mandatory. For instance,

1. The recommendation did not include males, though males can carry and transmit HPV. This oversight made the creation of “herd immunity” impossible. This, definitionally, means the vaccine could have only a limited effect in combatting HPV.

2. Not all strains of HPV linked to cancer were affected by the vaccine. While doing something is better than doing nothing… generally… no one knows what the impact will be of creating a better evolutionary environment for the others strains by eliminating competing versions of the virus.

3.Requiring people to receive a vaccine against diseases which they may very well never encounter is a very queasy ethical area. Unlike diseases like measles, whooping cough, etc., HPV is not spread through casual contact.

4. Clinical trials were conducted on women aged 16-26 leaving everyone to presume that Gardasil was safe and efficacious in 10 year-olds even though there was zero data pertaining to that age group.

The decision by Governor Perry to make Gardasil mandatory is a nothingburger. Clearly, Governor Perry erred in issuing his Executive Order, something he has admitted, and to his great credit, when he was challenged he relented rather than digging in. But his error was in acting on the recommendation of the federal agency charged with developing vaccine recommendations without proper staff work and building a political consensus to support that action.

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