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More Gardasil Politics

As a follow up to my lengthy post on Gardasil the other day, this morning USA Today editorializes that it's "premature" for states to mandate HPV vaccinations, and on the same page Governor Rick Perry defends his decision:

As governor of Texas, I will do everything in my power to protect public health. The executive order I signed last Friday will help stop the spread of human papillomavirus (HPV) and prevent cervical cancer in young women.

Some are focused on the cause of this cancer, but I remain focused on the cure. And if I err, I will always err on the side of protecting life. [snip]

If we could stop lung cancer, would some shy away claiming it might encourage tobacco use? This is a rare opportunity to act, and as a pro-life governor, I will always take the side of protecting life.

It's clear throughout the op-ed, and in the last paragraph in particular, that Perry is trying to counter the claim of some conservatives that since HPV is transmitted through sexual intercourse, mandatory vaccines will somehow encourage promiscuity. Personally, I find that argument unpersuasive.

To the extent I have objections about this policy, they lie with the fact that Rick Perry has made a unilateral decision mandating that 11 and 12 year old girls are injected with an eight month old vaccine - and his defense that "as a pro-life governor, I will always take the side of protecting life" makes me more unsettled by his action, not less.

Take Perry's last question, for example. Say we did have a brand spanking new, eight month old vaccine that prevented future occurrences of lung cancer. Would Perry mandate it for all children, given that he always takes "the side of protecting life?" What about a drug that prevented heart disease? Or better yet, one that reduced obesity, thereby preventing future cases of heart disease and diabetes?

The question is, who gets to make these decisions and are they being made in a careful and methodical way?

Perry gives us a clear answer in today's op-ed when he writes:

Though some might argue that we should wait several years before requiring the vaccine, I believe such a delay unnecessarily risks the lives of young women.

Really? Unless the current crop of 11 and 12 year olds scheduled to receive it next year are going to become sexually active, is anyone really going to be put at risk by waiting, and why would the governor be so dismissive as to call a delay to debate the merits of the vaccine "unnecessary?"

Remember, this is an eight month old vaccine. Yes, it's been approved by the FDA and put on the "recommended immunization schedule" for 2007, but there are doctors who believe it's way to early to mandate the vaccine, one of whom emailed me the other day to say this:

Gardasil will not do away with yearly Pap tests for women. It will not meaningfully reduce healthcare costs, in my estimate. Cervix cancer is readily prevented by straightforward treatment of early Pap abnormalities which may over years evolve into cancer if left untreated.

Gardasil's long term safety is unknown, yet we see a stampede to immunize middle school girls with it. Do you remember the swine flu crisis? Those immunizations caused an outbreak of Guillan-Barre syndrome, a debilitating neurologic disorder. There never was a swine flu epidemic in the non-immunized!

Merck will profit from Gardasil, but womens' health will not.

This may be a minority view, but it is certainly a view worth letting the public and the state legislature hear in the course of coming to grips with the decision of the state mandating that 11 and 12 year old girls are injected with a drug that's been on the market less than a year.

Governor Perry wrote today, "a full debate will take place as our health agency adopts implementation rules before the order takes effect in 19 months." He's got it exactly backwards. The debate should take place before the decision is made, not after. Furthermore, the decision should come from the legislative branch, not the executive, at which point the Governor could lend his support to the idea or oppose it. You'd think a conservative Republican governor would know how the system should work.