AUSTIN – Gov. Rick Perry – usually a hero to social conservatives – surprised many of them Friday by making Texas the first state to mandate a vaccine for sixth-grade girls to prevent a sexually transmitted infection that leads to most kinds of cervical cancer.
In his executive order, Mr. Perry said girls must receive the human papillomavirus vaccine before school starts in September 2008. While noting that parents may opt out of the vaccine for conscience or religious reasons, he said it "provides us with an incredible opportunity to effectively target and prevent cervical cancer."
The move was applauded by many women's groups but harshly denounced by social conservatives for its intrusion into parents' control over their kids' health. Some also alleged that Merck – the pharmaceutical company with the only vaccine on the market – was responsible for the initiative.
"Follow the money. It leads to Merck," said Cathie Adams, president of the conservative Texas Eagle Forum.
Merck had provided a relatively small amount of money to Mr. Perry's campaign fund – $5,000 in 2006 – and has paid three lobbyists up to $250,000 this year. One of the lobbyists, Mike Toomey, was formerly Mr. Perry's chief of staff.
But press secretary Robert Black said the governor has not talked to anyone from Merck or to Mr. Toomey about the initiative.
"He came to the conclusion it was the right thing to do. You don't have opportunities like this where you can certainly prevent a cancer. It's never happened before, so it would be irresponsible to walk away from it," Mr. Black said.
He said the governor certainly discussed it with first lady Anita Perry, who is a nurse and a robust spokeswoman for women's health issues.
"Health issues in general are certainly a topic around the governor's house, and they were before he was governor," Mr. Black said.
HPV is one of the most common sexually transmitted infections. The vaccine can prevent certain strains of the virus that cause 70 percent of cervical cancer cases. Last year, the Food and Drug Administration approved the vaccine and the Centers for Disease Control recommended its use.
It is unclear whether the vaccine would be effective on women who have already been exposed to HPV and therefore is mostly recommended for those who are not yet sexually active. It is also still being tested to see if it can prevent cancers and disease in males.
The CDC states that tests on the vaccine included 11,000 females, ages 9 to 26, worldwide and that no serious side effects were reported.
Texas has the second highest number of women with cervical cancer in the nation. Last year, 1,169 new cases were reported and almost 400 Texas women died from it.
The vaccine is administered in three doses and generally costs about $360, which is covered by most insurance companies. Under the governor's order, it would also be available to eligible youngsters through the Texas Vaccines for Children Program.
Sen. Leticia Van de Putte, D-San Antonio, and Rep. Jessica Farrar, D-Houston, hailed the decision as a "bold step towards eradicating cervical cancer and saving lives."
The two lawmakers have authored legislation to add the HPV vaccine to the state health department's list of required immunizations for sixth-grade girls to be admitted into school. They said they would continue to push so that the directive can become part of state law.
And Kathy Miller, president of the Texas Freedom Network, which does frequent battle with social conservatives, handed out rare praise for Mr. Perry.
"Today's decision by the governor is not just a positive step forward in efforts to promote women's health. It is also an important acknowledgment that health and science should not be held hostage by ideology," Ms. Miller said.
But Ms. Adams said she and other conservatives were saddened by the action.
"This replaces the parent with the state," she said. "You're not only turning parents' rights upside-down, but you're also subjecting children to an experimental vaccine."
Ms. Adams said that the vaccine, which has been tested for four years, is too new.
"We don't know when that 12-year-old girl, when she's expecting a baby [years later] and there's a birth defect, we don't know if those are related," she said.
The usurping of parental authority and inadequate testing are her two greatest concerns, but she also said, "There is a moral issue" about sending a message to young girls that the state expects that they will have sex.
"It gives young girls false hope and protection when the research does not support that," Ms. Adams said.
Mr. Black said the governor believes the CDC when it put the vaccine on its immunization list.
He pointed out that parents can decide not to immunize their daughters if they have concerns. But, he added, vaccines that prevent cancer don't come along very often.
"From the governor's perspective, it didn't take a whole lot of convincing," he said.
And while many of his usual base of social conservatives might take issue with his mandate, Mr. Black said, "The governor has never shied away from doing what he believes is right."
A look at the cervical cancer vaccine:
HOW IT WORKS: The vaccine blocks infection by four common strains of human papillomavirus or HPV, which can cause cervical cancer many years after infection. HPV, which eventually infects over half of sexually active people, also causes genital warts.
CANCER CASES: On average, there are 9,710 new cases of cervical cancer and 3,700 deaths in the U.S. each year. Worldwide, cervical cancer is the No. 2 cancer in women, causing over 470,000 new cases and 233,000 deaths a year.
IN TEXAS: The state ranks second in the U.S. in the number of women with the disease. In 2006, there were 1,169 new cases and nearly 400 deaths from cervical cancer in the state.
WHO AND HOW: Medical groups recommend routine vaccination for girls ages 11 and 12, and say it can be given to girls as young as 9 and up to 18. It is approved for women up to age 26. The vaccine is administered in three doses over six months.
SOURCES: Associated Press, governor's office
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