Gov. Perry’s Pro-Choice Conversion

I am the father of two daughters and I am firmly pro-choice, so it is quite odd that I find Texas Gov. Rick Perry and other socially conservative Republicans on my side on the subject of mandatory Gardasil vaccinations.

Perry came late to this pro-choice position. Back in 2007, he signed an order mandating that Texas schoolgirls receive Gardasil, a vaccine that protects against human papillomavirus, before entering the sixth grade. According to research, the vaccine is more than 96 percent effective in preventing the transmission of the strains of HPV that cause most types of cervical cancer. The state legislature overturned Perry’s mandate, but the governor continued to stand by his position through 2010, saying that he saw the order as part of his pro-life platform. “This is a rare opportunity to act, and as a pro-life governor, I will always take the side of protecting life,” he wrote in an opinion piece in USA Today.

Since making his debut in the Republican presidential campaign field, however, Perry has toned down his support for mandatory HPV vaccination. He now says the executive order was a mistake.

Perry has been criticized over possible conflicts of interest surrounding the order. A former top Perry aide, Mike Toomey, acted as a lobbyist for Gardasil maker Merck & Co. in promoting mandatory HPV vaccination. In the most recent Republican presidential debate, Michele Bachmann also pointed to campaign contributions Perry had received from Merck.

Because the vaccine needs to be administered prior to infection with HPV, experts recommend that girls receive it before the start of sexual activity, if possible. The vaccine, therefore, has been targeted at 11- and 12-year-olds. In some conservative circles, early inoculation against a sexually transmitted disease is seen as condoning early sexual activity. This was not Perry’s goal, of course, nor is it anybody else’s – conservative or otherwise. Nobody wants children just reaching puberty to have sex, but the sad fact is that they sometimes do, and many will be infected with HPV before reaching adulthood.

So I see HPV vaccination as an important safety measure, just as I see thorough sex education, availability of condoms and other birth control, and frank discussions of abstinence and safe sex as important for sexual health and safety. If my daughters were still young enough to need my guidance on medical issues, I would certainly want them to be vaccinated.

But just because I would make this choice does not mean other parents would do so, or that the state should mandate that everyone follow my lead. There are plenty of good reasons why people who are just as concerned as I am about good health would not want their 11-year-old children to be vaccinated against HPV.

I accept that there is no reason to believe Gardasil, or the newer alternative, Cervarix, presents any health risks. I place little faith in claims by some people outside the medical community, based on anecdotal evidence, that the vaccine causes neurological problems. However, as with any new medical treatment, there is the possibility that unforeseen long-term consequences will materialize down the road.

It is perfectly reasonable for some parents to conclude, based on their knowledge of their own children, that early sexual activity is less of a risk than is the use of a new vaccine. Some might decide to wait and let their children make their own choices about being vaccinated. Others might conclude that, given the newness of the vaccine, condom use is a better way to prevent HPV infection. Why should my judgment, or a governor’s, be binding upon those parents and their kids?

Of course, many other vaccinations are required, and quite rightly, before young people enter a classroom. The difference is that these are generally for diseases that can be easily spread through ordinary contact or proximity, like measles and rubella. When significant numbers of students are not vaccinated for these diseases, simply attending school becomes a dangerous act. As a result, young people are deprived of the opportunity to receive a free, public education in a safe environment. HPV, on the other hand, cannot be transmitted through ordinary classroom activities. The state, therefore, has little immediate interest in students’ vaccination status.

At the time of Perry’s executive order, Gardasil was approved only for females, but in 2009, it was approved for males as well. While cancers caused by HPV are far more common in women, from the perspective of public health, vaccination for males is equally useful in stopping the spread of the disease. The fact that mandatory vaccination efforts have continued to focus primarily on women and girls further indicates that the real concern is individual health, not public safety.

I suspect that a lot of people who consider themselves pro-choice on abortion rights nonetheless believe Perry was right when he required HPV vaccination and wrong when he reversed course. But I am not the first to notice that vaccination mandates actually eliminate choice.

From 2008 through 2009, federal immigration authorities required all immigrant women between ages 11 and 26 to complete a six-month series of HPV shots. Pro-choice and immigration rights groups protested, and in the final weeks of 2009, the federal Centers for Disease Control removed HPV from the list of required vaccinations for immigrants.

So on this issue, at least, Perry, along with his fellow conservative Republicans, belatedly finds himself in the pro-choice camp. I never expected them to join my side, but I don’t mind at all.

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