Non-food Things
Perry's vaccine order saves lives, but at high price
By Ben Wasserman - foodconsumer.org
Feb 2, 2007 - 3:45:17 PM

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 virus.

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 website.

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 year nationwide.

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 embryonic cells.   His political base is said to count on the religious right.   News 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.   Right groups 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.

“The HPV 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 expenditure.   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.   For a 5-year span, about 5800 new cases of the disease are expected to be diagnosed in Texas, which 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.   The 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 Texas alone with Mr. Perry's order.  

The cost 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 Texas 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 cancer.

Perry’s order can save some women’s lives, but it does not save money.

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 online.

Still, conservative groups say the HPV vaccine requirement interferes with parents' right to making medical decisions for their children.