The HPV Flashback

The HPV debate players (clockwise, from top left): Merck lobbyist Mike Toomey, Gov. Rick Perry, Sen. Jane Nelson, US Rep. Michele Bachmann

More from the "New Campaign, Old story" files: Gov. Rick Perry is getting pummeled on the national stage for his 2007 order to vaccinate school girls against human papillomavirus. But, as is the way with much of this campaign, this is old news in Texas and in our pages.

It all goes back to 2007, when Perry mandated that 11- and 12-year old girls be vaccinated against HPV, which has been linked to cervical cancer. He was finally forced to back down on that, but it has now become a political kickball again, courtesy of presidential nomination rival Michele Bachmann. The Minnesota Republican congresswoman (who seems to increasingly be an ally/proxy/replacement for failed vice-presidential candidate-turned-reality TV star Sarah Palin) laid into Perry at the Sept. 12 CNN/Tea Party Express debate, saying "We cannot forget that in the midst of this executive order there is a big drug company that made millions of dollars because of this mandate." She was joined by former US Senator for Pennsylvania Rick Santorum who argued that the vaccination order was unnecessary "unless Texas has a very progressive way of communicating diseases in their school by way of their curriculum." Palin herself has now weighed in via her friends at Fox News, similarly lambasting Perry for "crony capitalism."

Let's go back to the beginning. On Feb. 2, 2007, Perry issued an order to the Department of State Health Services adding HPV vaccination to the Texas Vaccines for Children program. Since Gardasil, produced by Merck & Co., was the only HPV vaccine on the market, that meant a very lucrative and state-mandated pay day for a drug that seemed to be pretty effective. However, it became such a political hot potato that Perry backed off and Merck backed down on its state-by-state campaign to make HPV vaccination mandatory.

So why the fuss? From the fringe right, there were a multiplicity of issues: That it overstepped the role of the governor, that it was another impingement on personal liberty, that it would encourage all those horny kids to have more premarital sex, and the general anti-science bent of the anti-vaccination crowd.

Out of all those issues from the right, the most meaningful one was probably the first – the question of the governor's role in this process. After all, Perry issued the directive on Feb. 2: Three days later, Senate Health and Human Services Committee Chair Jane Nelson, R-Lewsiville, asked him to rescind the mandate until further study. She, Perry and House Ways and Means Committee Chair Jim Keffer, R-Eastland, had been working on a $3 billion cancer initiative and both lawmakers seemed blindsided by Perry's move. Similarly, Democrats were concerned that Perry was circumventing the constitutional process (at the time, Democratic attorney Buck Wood remarked, "There is no such thing as an executive order. It's made up.")

What seemed particularly galling was that this huge new program was coming down the pipe just as the Texas Cancer Council was facing a massive cut to its already pitiful state funding.

So why did Perry, who is not exactly famous for his willingness to expand public health programs (especially those covering women's cancer prevention), decided to take step up to the plate on this one issue? At the time, a lot of speculation centered around the links between Perry and Merck, and most especially Mike Toomey, Perry's former chief of staff and, by 2007, a registered lobbyist for Merck.

Then there was the timing of the deal. When Perry issued his order, he was frantic to get the contract inked as fast as possible. Why the speed? Well, at that point Gardasil had only been on the market for six months but, and here's the big but, it was the only HPV vaccine on the market. However, Merck's big rival GlaxoSmithKline was working on its own vaccine, Cervarix: When that hit the market, Gardasil would no longer have monopoly power, and that $360 per three shot regimen may have dropped dramatically.

There were the medical issues. Even though Gardasil was FDA approved, Nelson still wanted more information before locking in to a multi-million dollar, multi year contract (not terrible thinking: new research shows that Cervarix may be more effective after fewer doses than initially thought.)

Another medical issue: Why only vaccinate girls? After all, research at the time showed that Gardasil might reduce anal cancer rates: But that part of the study, which would have benefited sexually active gay men in particular, seemed to fall off the table.