Texas Requires Cancer Shots For Girls

HOUSTON, Feb. 2 — Texas on Friday became the first state to require all 11- and 12-year-old girls entering the sixth grade to be vaccinated against a sexually transmitted virus that causes cervical cancer.

Averting a potentially divisive debate in the Legislature, Gov. Rick Perry, a Republican, signed an executive order mandating shots of the Merck vaccine Gardasil as protection against the human papillomavirus, or HPV, starting in September 2008.

Mr. Perry’s action, praised by health advocates, caught many by surprise in a largely conservative state where sexual politics is often a battleground.

“I had no idea; I was absolutely caught off guard,” said Representative Jessica Farrar, Democrat of Houston, who sponsored a bill to require the vaccinations starting this September. “Normally, the governor does not take things like this upon himself, although I’m glad he did.”

Under the order, girls and women from 9 to 21 eligible for public assistance could get free shots immediately. The governor’s office said parents could opt out of the school program “for reasons of conscience, including religious beliefs.”

“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,” said Mr. Perry, who was re-elected to his second full term last November.

HPV, affecting 20 million people nationally, including one in four 15-to-24-year-olds, is the nation’s most common sexually transmitted disease. Texas has the second-highest number of women with cervical cancer, with nearly 400 deaths last year, the governor’s statement noted.

The vaccine, approved for ages 9 to 26, is given in three shots over eight months. The shots are effective for at least five years, and together cost $360, said Curtis Allen, a spokesman for the federal Centers for Disease Control and Prevention.

The governor did not put a price on the effort. But, extrapolating from school figures, vaccinations for about 170,000 sixth-grade girls would come to about $60 million, with insurance covering many families’ costs, and the federal government assisting the state in subsidizing shots for needy schoolgirls and women.

The governor’s executive order directing his Health and Human Services Commission to adopt rules mandating the HPV inoculations along with others required for schoolchildren saved legislators from having to go on record for or against a bill involving child sexuality.

Some parents have voiced concern that the plan could send a message that sexual activity was condoned or that vaccinations made it safe. On the whole, however, conservative and religious groups have not come out strongly against the vaccinations as long as families can opt out.

The Texas Freedom Network, a nonpartisan advocacy group often critical of Mr. Perry, issued a statement praising his move. “Today’s decision by the governor is not just a positive step forward in efforts to promote women’s health,” said the group’s president, Kathy Miller. “It is also an important acknowledgment that health and science should not be held hostage to politics and ideology.”

A spokesman for the governor, Robert Black, discounted news accounts that Merck’s high-powered lobbyist in Austin, Mike Toomey — chief of staff for Mr. Perry from 2002 to 2004 as well as for a Republican predecessor, William P. Clements — might have swayed his former boss. “I don’t put a whole lot of stock in that talk,” Mr. Black said. The governor’s order, he said, “protects human health; it was the right thing to do.”

Mr. Toomey did not return a call. A Merck spokesman, Raymond F. Kerins Jr., declined to discuss the company’s lobbying efforts in Austin, part of a nationwide campaign that has enlisted women in state legislatures to advance the program.

“Merck’s goal is to support efforts to implement policies that ensure that Gardasil is used to achieve what it was designed to do: help reduce the burden of cervical cancer,” Mr. Kerins said.

http://www.nytimes.com/2007/02/03/us/03texas.html?_r=1&ref=us&oref=slogin