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Wrong, Right, and Then Wrong Again: Rick Perry and Vaccinations

Ever since the September 7 Republican debate, a lot of attention has been paid to Governor Rick Perry's executive decision requiring that young girls receive a vaccine for human papillomavirus (HPV). Perry's measure was admirable: Persistent HPV infections are the primary cause of cervical and anal cancers.

Perry's decision was never implemented, but he's sustained criticism from Michele Bachmann and movement conservatives -- who implied that the governor's support for the vaccination, Merck's Gardasil, was the result of a bribe. The thrust of their opposition is that vaccinations are a type of moral hazard: If young girls can have sex without the specter of an STD, they say, what's to stop them?

Lost in the coverage of the Gardasil flap is that Perry once took a more libertarian stance towards vaccines and basically got burned. In the months before he took office, amid the run-up to the 2000 election, Texas's immunization rates had become a national joke. Houston's were particularly bad -- the worst of any major city in the country. The Centers for Disease Control and Prevention speculated that Houston's "low immunization rate puts the entire nation at risk because it could serve as the portal for an epidemic." This prompted the Democratic National Committee spokesperson to issue a rather tongue-in-cheek warning:

We highly recommend that those traveling to Texas immediately check to ensure their immunization shots are current before entering the state.

In August 2002, Texas -- which had been last in childhood immunization rates -- jumped seven spots to forty-third in the nation, even as Dallas, El Paso and Houston still comprised three of the U.S.'s six lowest-ranking metropolitan areas. An optimistic Perry said that "the improved numbers are welcomed news" and he professed to be "committ[ed] to work even harder to protect children against vaccine-preventable diseases."

But Perry apparently believed that a laissez-faire approach would work best. In 2003, Perry signed a law allowing parents to refuse vaccinations for their children as a matter of "conscience." Here's The Texas Observer:

The law [was] a response to a number of vocal parents who have become convinced that vaccines are responsible for the dramatic rise in autism cases over the past decade—despite the fact that several large, peer-reviewed studies have found no evidence that this is the case.

This was a particularly controversial decision because Houston's vaccination rate dropped from 63 percent in 2001 to 61.4 percent in 2002; among urban areas, only New Orleans and Newark trailed Houston. The immunization rate for Texas at large was only marginally better at 67.9 percent, or forty-fourth in the nation.

The law "infuriated physicians and public health experts," who saw it as "a giant step backward in the fight to prevent potentially fatal childhood illnesses." The president of the Texas Pediatric Society also expressed disappointment, noting that vaccination "is one of the greatest public health accomplishments of the 20th century. . . . Expanding exemptions will only increase the outbreak of deadly infectious diseases."

Here, again, is The Observer:

According to data from the Texas Department of State Health Services, in 2003, parents of 2,314 children applied for an exemption. By the end of 2009, the total had reached beyond 12,600.

The freedom to forgo immunization was not without consequence. In 2009, whooping cough (pertussis) -- which hadn't been common in a century -- was contracted by 3,358 Texans, killing three. "It was the most reported cases in half a century," reported the Star-Telegram.

In mandating the HPV vaccine, Perry -- and especially his wife, Anita -- simply tried to do the smart, healthy thing. Sadly, he's already repudiated his executive order. "I readily stand up and say I made a mistake on that," he said last week.