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Originally published Saturday, February 3, 2007 at 12:00 AM

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Texas orders cancer vaccine for girls

Republican Gov. Rick Perry issued an order Friday making Texas the first state to require that schoolgirls be vaccinated against the sexually...

The Associated Press

AUSTIN, Texas — Republican Gov. Rick Perry issued an order Friday making Texas the first state to require that schoolgirls be vaccinated against the sexually transmitted virus that causes cervical cancer.

By using an executive order, Perry sidestepped opposition in the Legislature from conservatives and parents-rights groups that fear such a requirement would condone premarital sex and interfere with how Texans rear their children.

Beginning in September 2008, girls entering the sixth grade — meaning, generally, girls 11 and 12 — will have to receive Gardasil, Merck's new vaccine against strains of the human papillomavirus (HPV).

Perry also directed state health authorities to make the vaccine available free to girls 9 to 18 who are uninsured or whose insurance does not cover vaccines. In addition, he ordered that Medicaid offer Gardasil to women 19 to 21.

In Washington state, "Gov. Christine Gregoire is not pursuing an executive order to make the vaccine mandatory at this time," said Christina Hulet, the governor's health-policy adviser. However, the governor put $26.2 million in her budget for childhood vaccines, including the HPV vaccine.

Perry, a conservative Christian who opposes abortion and embryonic stem-cell research, counts on the religious right for his political base. But he has said 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," Perry said.

Gardasil


Human papilloma virus, or HPV, is the most common sexually transmitted disease in the United States, with about 20 million people infected.

Gardasil prevents four strains of HPV. Two are thought responsible for 70 percent of the 15,000 cases of cervical cancer diagnosed and 4,000 deaths caused by HPV in the U.S. each year. Worldwide, 400,000 women are diagnosed with cervical cancer each year; 200,000 die of it.

The federal government approved Gardasil in June, and a government advisory panel recommended all girls get the shots at 11 and 12, before they are likely to be sexually active. The vaccine is most effective before girls have sex.

Merck, which makes Gardasil, could earn billions if the vaccine — at $360 for the three-shot regimen — were made mandatory in all states. Most insurance companies cover the vaccine.

Seattle Times archives, The Associated Press

The shots will cost the state $50 million the first year.

The vaccine is Merck's most important new product, capable of generating up to $3 billion in annual sales, analysts said. Revenue from Gardasil in the fourth quarter reached $155 million.

Merck is bankrolling efforts to pass state laws mandating Gardasil. The company doubled its lobbying budget in Texas and has funneled money through Women in Government, an advocacy group made up of female state legislators across the country.

Perry has ties to Merck and Women in Government. One of the drug company's three lobbyists in Texas is Mike Toomey, Perry's former chief of staff. The governor's current chief of staff's mother-in-law, Texas Republican state Rep. Dianne White Delisi, is a state director for Women in Government.

Perry also received $6,000 from Merck's political-action committee during his re-election campaign last year.

Reaction to his order was mixed.

"Today's decision by the governor ... [is] an important acknowledgment that health and science should not be held hostage to politics and ideology," said Kathy Miller, of the liberal-leaning Texas Freedom Network.

Cathie Adams, who heads the Texas Eagle Forum, said she was "very sad" Perry issued the order and warned that state health officials and Merck are usurping the role traditionally played by parents.

"I am absolutely opposed that Merck and the state government are planning to inject young girls with a cancer-causing virus," Adams said.

Scientists, however, say the HPV vaccine uses particles that look like the virus on the outside but aren't infectious. The particles trick the body into thinking it has been infected, prompting the development of immunity to the virus.

Some legislative aides said they are looking for ways around the order for parents who oppose it.

"He's circumventing the will of the people," said Dawn Richardson, president of Parents Requesting Open Vaccine Education, a citizens group that fought for the right to opt out of other vaccine requirements. "There's no emergency except in the boardrooms of Merck, where this is failing to gain the support that they had expected."

Texas allows parents to opt out of inoculations by filing an affidavit objecting to the vaccine for religious or philosophical reasons.

In Washington state, the state Board of Health has the authority to decide if a vaccine should be required for school entrance.

The board uses nine criteria to make that decision but usually doesn't make an evaluation until a vaccine has been licensed for about two years.

Lawmakers also can decide to make a vaccine mandatory. No such legislation has been introduced this year, although a bill has been introduced to mandate educating parents of girls in sixth grade and higher about the virus and the vaccine.

Seattle Times staff writer Marsha King contributed to this report. Material from Bloomberg News and McClatchy Newspapers is included in this report.

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