Texas has today decided to
require that all school girls age 11 and 12 receive Merck's human
papillomavirus (HPV) vaccine known as gardasil in an effect to prevent cervical cancer induced by
The decision does not come from the state lawmakers.
It is Republican Gov. Rick Perry who issued an
executive order directing the state's Health Human Services Commission (HHSC) to
get ready to administer the HPV vaccine in girls at noted ages before they
enter sixth grade.
The order, effective September 2008, also directs HHSC and
the Department of State Health Services (DSHS) to "make the vaccine
immediately available to eligible young females through the Texas Vaccines for
Children program for young women ages 9 to 18, and through Medicaid for women
ages 19 to 21," says the statement of the governor's office on its
HPV is a common sexually transmitted disease.
The overwhelming majority of men and women
are expected to contract the virus in their life.
It does not cause any harm except in rare
cases in which cervical cancer may develop because of the infection. In 2006,
there were 1,169 new cases and nearly 400 deaths from cervical cancer in
Texas, according to a
statement issued by the Governor’s office.
This is compared to 11,000 new cases and 3,300 deaths from the disease per
The governor's order comes as a surprise as Mr. Perry is recognized
as a conservative Christian who opposes abortion and stem-cell research using
His political base is
said to count on the religious right.
media has early predicted that it would be impossible for
Texas to pass any bill to force girls to
receive the HPV vaccine as many lawmakers are considered conservative enough to
reject such legislation.
Is Perry’s order politically motivated?
No one knows.
But, USA Today has reported today that Perry has several ties to Merck,
the maker of the HPV vaccine, and Women in Government, a not-for-profit
organization comprised of state woman regulators, which some watchdog has claimed
is too cozy with Merck.
Media has reported that Women in Government is quite active
in promoting the Merck's vaccine, which analysts say is positioned to make
Merck more than billion dollars a year.
According to USA Today, Mike Toomey, Perry's former chief of staff,
serves as one of the drug company's three lobbyists in
Texas. Perry's current chief of staff's
mother-in-law, Texas Republican state Rep. Dianne White Delisi, is a head of
Women in Government.
“Perry also received $6,000 from Merck's political action
committee during his re-election campaign,” USA Today says.
Conservative and right groups have made it clear that they
oppose any bill that requires young girls to receive the HPV vaccine to prevent
cervical cancer as they are concerned that such a mandatory requirement could
be equivalent to giving a free license for young girls to have premarital sex,
which is prohibited in many conservative families.
They also say such a requirement would
interfere with the family's right to raising their girls in their own way.
But Mr. Perry likens HPV infection to polio although HPV
is transmitted via sex contact whereas polio infects people without requiring
people to have any contact.
say HPV is behaviorally avoidable and a state mandate is not warranted. But Perry
says the cervical cancer vaccine is no different from the one that protects
children against polio.
vaccine provides us with an incredible opportunity to effectively target and
prevent cervical cancer,” says Perry. “Requiring young girls to get vaccinated
before they come into contact with HPV is responsible health and fiscal policy
that has the potential to significantly reduce cases of cervical cancer and
mitigate future medical costs.”
Mr. Perry says it makes sense to use the vaccine to prevent
cervical cancer which would otherwise cause a large burden on medical
But does this mandatory inoculation
of the HPV vaccine really save medical costs?
On average, a 5-year treatment for a case of cervical caner would
cost $11,000, early studies show.
5-year span, about 5800 new cases of the disease are expected to be diagnosed in
means the medical cost for five years is 63.8 millions or 12.8 million a year.
In Texas, there are about 6.31 millions people now under age
18, meaning the number of girls who are required to receive the HPV vaccine
each year is about 0.35 million.
total number of girls to receive the vaccine is 1.76 million, meaning that
Merck can rake in 630 million dollars in five years or 126 million dollars in
the vaccine sales in
alone with Mr. Perry's order.
for the first year would double the price tag as girls both at age 11 and 12 will
receive the vaccine.
The calculation is
based on the price of the vaccine at $360 per girl.
It seems that this state mandatory vaccination can save
about 700 women’s lives a year in
at a cost of 126 million dollars a year spent on the preventive vaccine. These
700 women would otherwise need 7.7 million dollars for treatment of their cervical
Perry’s order can save some women’s lives, but it does not
To comfort those who are concerned, the order allows parents
to opt out of inoculations by filing an affidavit objecting to the vaccine on
religious or philosophical reasons. In addition, the governor's executive order
directs DSHS to ease the opt-out process by providing exemption request forms
Still, conservative groups say the HPV vaccine requirement
interferes with parents' right to making medical decisions for their children.