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Executive Kudos

Very few people like to contemplate the likelihood that, at some point, their children will have sex lives.  When our children are small, it's discomfiting to imagine, and even when they're adults, it's not something most parents want to dwell on.  Couple that uneasiness with the natural repugnance most of us have for sexually transmitted diseases and you can see why some parents aren't entirely comfortable with the notion of vaccinating their young daughters against genital human papillomavirus (HPV), a sexually transmitted disease which is linked to cervical cancer.  It doesn't help that doctors recommend that girls receive Gardasil, the HPV vaccine, before they're likely to become sexually active, which means planning for your daughter's future sex life when she's eleven or twelve and still very much your little girl. 

It's unsettling, but perhaps less so when weighed against the benefits of the vaccine.  HPV itself has very few obvious symptoms, but the Center for Disease Control estimates that 80% of women will be infected with the virus by age fifty.  There is no cure for HPV.   Although the infection can become undetectable over time, it can still result in abnormal pap smears, and in some cases, cervical cancer, one of the three most prevalent types of cancer in women (the American Cancer Society estimates that 3,900 women die of cervical cancer each year).  Being vaccinated against HPV significantly reduces a woman's chances of developing cervical cancer.

When you put it that way, it seems like a no-brainer to me, especially when you consider that there's no evidence of any harmful side effects to Gardasil.  But some conservative groups have campaigned against this vaccine, arguing that eliminating (one) possible consequence of sexual activity will encourage girls to be promiscuous.  Apparently, the only thing stopping our daughters from emulating the Girls Gone Wild of late-night video fame is the fear of cervical cancer; remove that threat and they'll be lifting their shirts for sleazy photographers and hopping into the backseat with every guy in school.  For similar reasons, many of these same groups also oppose birth control, sex education, and other means through which girls and women might escape what some conservatives view as the natural consequences of sex.  At heart, it's the same philosophy that previously led many religious groups to forbid the use of anesthesia in childbirth: pain and suffering are the wages of sexual "sin" and no sexually active woman should have the option of escaping her rightful punishment.

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Governor Rick Perry of Texas has courted the very groups that espouse this philosophy, so you could have knocked me over with a feather when he recently issued an executive order (neatly bypassing the Legislature entirely) making Texas the first state to require Gardasil for school attendance.  Starting in 2008, all girls entering the sixth grade must have received the vaccine, although, as with all immunization requirements, there's a process for those who oppose vaccinations to apply for a waiver.  In addition, Perry's executive order also includes provisions for uninsured girls and those whose insurance doesn't cover the vaccine to receive it free of charge.

I'll admit I'm not Perry's biggest fan, but this took guts.  Quite possibly, a major factor in Perry's decision was the campaign contributions he received from Merck, the manufacturer of the vaccine, and his ties to Mike Toomey, Perry's former Chief of Staff and a current lobbyist for Merck.  But I'm not too concerned about whether Perry's love for Big Business trumped his affection for the Religious Right in this case or if he genuinely wanted to do the right thing.  The bottom line is that many women will avoid suffering and even death because of this order, regardless of Perry's motivation. 

The vaccine is currently very expensive ($300 - $500 per dose)  and to be effective, it must be administered in three shots over six months.  The cost and the fact that some insurance companies don't yet cover the vaccine will put it out of reach for many families, who must prioritize immediate medical needs over preventative care.  And even those who can afford it might not be motivated to get their daughters to the doctor for all three shots.  Some parents may feel uncomfortable with the whole idea or may not make it a priority, since the prospect of their preteen daughters becoming sexually active seems so distant.  Without Perry's order to tie the vaccine to school attendance and the safety net he's provided for those who don't have insurance coverage, I suspect very few girls would actually receive the vaccine at the time when it would be most beneficial. 

On both sides of the political spectrum there are parents who are suspicious of the mercenary motives of pharmaceutical companies in promoting new vaccines and of the federal and state government for mandating so many childhood immunizations.  An argument can be made that Americans are too quick to rely on vaccines, even for diseases that are inconvenient rather than life-threatening, such as chicken pox, and that the risks of some vaccines may outweigh their benefits.  But the benefits of Gardasil -- a vaccine which will prevent an insidious, difficult to detect, and impossible to cure disease with potentially lethal consequences -- far exceed the risks.  So kudos to Governor Perry.  Whatever drove his decision, he's given the girls of Texas a magnanimous and enduring gift.
About the Author:  
Melissa Lipscomb
lives in Austin with her children Drew, Franny, Alec and husband Adam. Some days she feels like she's figuring out, and others she's just waiting for the other shoe to drop. Visit her blog.



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