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Govenor Perry (Texas) on the Hot Seat regarding HPV vaccination

26th February 2007 by Arrow Durfee Posted in Uncategorized

[Dear PROVE Members,
Last week we walked the halls and delivered packets to all offices in the Texas House and Senate providing information on why the HPV vaccine should not be mandated. Our visits were met with friendly grateful appreciation. On Monday, some of us were at a House Public Health Committee hearing until after midnight to support HB 1098 which would prohibit HPV vaccine from being required and would overturn the governor’s executive order. On Wednesday, the House Public Health Committee passed the bill with a vote of 6 to 3 and the bill is on its way to the full House where it already has 91 joint sponsors out of 150 Representatives. Now as more journalists are using open records requests to piece together the puzzle, the corruption is starting to become clear - Perry was working on this mandate for months and even had the health dept write it! Additionally, some of our friends in Congress have just filed a bill to prohibit federal funding or other assistance to states that mandate the HPV vaccine. Your calls and letters to your elected officials in Texas and Congress are working! Thank you everyone for your hard work and keep the communication with your elected Representatives and Senators in Texas and Washington DC going! They need to hear from you! – DR]

Perry surprised by backlash to HPV order
Mandate was months in the making, but few were in the loop.
By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Friday, February 23, 2007

www.statesman.com/news/content/region/legislature/stories/02/23/23govhpv.html

In the days before his Feb. 6 State of the State address, Gov. Rick Perry dribbled out announcements of several initiatives so they wouldn’t get lost in bigger news the day of the speech. On Jan. 30, a disaster contingency fund. On Feb. 1, higher education reforms. And on Feb. 2, the mandate that schoolgirls be vaccinated against the human papillomavirus.

That turned out to be one of the most controversial initiatives of Perry’s tenure, but the governor’s office never saw the backlash coming.

The next day, when the governor’s executive clerk went to church, he was unprepared for the criticism he would encounter.

“I got hammered in church this morning on the Merck thing — and it was just Saturday,” Chief Clerk Greg Davidson wrote in a Feb. 3 e-mail to colleagues, referring to the company that makes the vaccine. “Do we have any talking points or stats or anything that can help me fight through Sunday. This is brutal.”

This e-mail and other documents obtained by the Austin American-Statesman under Texas open records laws reveal new details about how Texas became the first state to require the vaccine that helps prevent cervical cancer. They show that the governor’s office had been talking about HPV with drug maker Merck for at least five months and that the same state agency that the governor directed to implement the executive order actually drafted the order. And they show that, as Davidson’s experience illustrates, the governor’s office had simply failed to predict the firestorm.

Critics have blasted the executive order, with some saying Perry overstepped his authority and others worrying about the vaccine itself: that it’s too new to know about long-term effects or that getting vaccinated against the sexually transmitted virus could encourage young girls to be promiscuous.

A House health panel led by state Rep. Dianne White Delisi, R-Temple, a member of Perry’s own Republican Party and the mother-in-law of the governor’s chief of staff, Deirdre Delisi, this week recommended that the full chamber pass a bill that would essentially overturn Perry’s mandate.

“Did we expect such an uproar?” Perry spokesman Robert Black asked during an interview. “I think it’s fair to say no. Would it have changed (Perry’s) mind if he would have known that? No. What people thought of his order or the fact that we were the first state in the nation — for the governor, none of that really comes into play.”

Rather, it is a women’s health issue, Black said.

Much of the controversy has centered on Merck, which this week suspended efforts to lobby statehouses around the country to mandate the vaccine, Gardasil. The company had been funneling money through an advocacy group, Women in Government.

In Texas, some had questioned Perry’s Merck ties: Mike Toomey, Perry’s former chief of staff, is one of Merck’s lobbyists here, and Merck gave $6,000 to Perry’s re-election campaign. Black said that Toomey and Perry have never discussed HPV and that “it’s a bit of a red herring” since another drug company, GlaxoSmithKline, is also developing an HPV vaccine.

However, documents show that on Nov. 7, the day Perry was re-elected, a gubernatorial policy adviser sent an e-mail to Toomey and to Lara Keel, both of the Texas Lobby Group, with the subject “HPV numbers.” The e-mail included projected costs of providing the HPV vaccine to low-income Texans.

In fact, the governor’s office was talking with Merck representatives not long after Gardasil was approved by the FDA in June, documents show.

In an Aug. 17 e-mail to Dr. Charles Bell, deputy executive commissioner of the Health and Human Services Commission, gubernatorial adviser Heidi McConnell wrote: “There is a good chance that we are going to do something on the HPV vaccine, so (a colleague) and I met with Merck representatives earlier this week to get an update on the vaccine.”

Black said that conversations between the governor’s office and Merck “shouldn’t surprise anyone. They’re the ones who had the vaccine,” he said.

When preparing to announce the executive order, Perry’s staffers apparently worried about coming across as too Merck-friendly.

On the day before the executive order was issued, in response to a draft of the news release, the governor’s assistant director of budget, planning and policy wrote: “(T)hat first line sounds almost like a Merck commercial.”

The draft was not provided to the Statesman. The governor’s office has asked the attorney general’s office for an opinion on whether it may keep HPV-related draft documents confidential, said Chelsea Thornton, the governor’s assistant general counsel.

While the governor’s office was worrying about the wording of the announcement, key lawmakers were out of the loop. State Sen. Jane Nelson, R-Lewisville, chairwoman of the Senate Health and Human Services Committee, told reporters Feb. 5 that she was surprised Perry hadn’t contacted her about the mandate. She called on him to rescind it, saying, “I just don’t think he thought this one through.”

The same day, Brandon LeBlanc, the governor’s community affairs public liaison, wrote an e-mail to colleagues with the subject “Why the rush?” He asked for an answer to “why we didn’t let HPV vaccine run its course in the Leg.? Preferably one I can use in public.”

Even some members of the governor’s staff were blindsided by the executive order.

Ken Armbrister, a retired state senator who is the governor’s new liaison to lawmakers, was inadvertently left off the list of officials who were to be notified ahead of time. Because Armbrister was unaware, he was unable to alert key lawmakers to what was coming.

Perry’s support of mandating the vaccine surfaced during the gubernatorial race, though few took notice.

In September, after Democrat Chris Bell had said he favored mandating the vaccine, the Fort Worth Star-Telegram reported that Perry spokesman Ted Royer said: “Perry supports requiring the cervical cancer vaccine, as long as parents retain the right to opt their children out.”

At the time, perhaps because Bell and Perry agreed, “no one batted an eye,” Black said.

After Election Day, when Perry switched from campaigning to preparing for the 2007 legislative session, he began to consider how to implement the mandate, Black said.

State health officials could have added the vaccine to the required list without the drama of an executive order.

But “after spending a lot of time thinking about it, talking to folks, not the least of which was Mrs. Perry, who feels very strongly about this issue, I think the governor felt so strongly that it was the absolute right thing to do to protect life, that when we had an opportunity like this to prevent a cancer in young women, that he needed to put the weight of the entire executive branch behind it,” Black said.

The executive order directs the Health and Human Services Commission to adopt rules that mandate the vaccination against HPV for girls before starting sixth grade.

But documents show that state health officials were the ones writing a draft of the executive order that directs their own agency to write the rules.

On Jan. 18, Dr. Charles Bell of the commission wrote an e-mail to a gubernatorial adviser:

“(A)ttached is the draft Executive Order that was requested by the Governor’s Office staff. Neither my staff nor I have ever drafted such a document so we just patterned it off the ones that we found on the Governor’s website. I hope the draft is satisfactory to edit and create the official document.”

Commission spokeswoman Stephanie Goodman said it’s not surprising that the agency drafted the order because “we know the language necessary to implement the vision laid out by the governor’s office.”

The order says that beginning in September 2008, sixth-grade girls must be vaccinated against the four strains of HPV that cause 70 percent of cervical cancers. The shots cost $360 for the three-dose series, and it will cost $71.7 million a year to pay for the shots for low-income Texans, Perry spokeswoman Krista Moody said. Parents may opt not to have their daughters vaccinated.

Three weeks after Perry issued the order, he is standing by it despite widespread opposition from lawmakers and the social conservatives who have traditionally backed him. Perry is trying to shape the debate into one that’s more about people with cervical cancer and less about politics and money. On Monday, Perry introduced reporters to a 31-year-old Houston woman who is dying of cervical cancer caused by HPV.

“This debate should be based on whether or not this state is going to do everything it can to prevent cervical cancer in young women, to save women’s lives,” Black said. “Anything else is a distraction from the real issue.”

cmaclaggan@statesman.com; 445-3548

Additional material from staff writer Laylan Copelin.

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Parental Right to Decide Protection Act (Introduced in House)

HR 1153 IH
110th CONGRESS
1st Session
H. R. 1153

To prohibit Federal funding or other assistance for mandatory human papillomavirus (HPV) vaccination programs.

IN THE HOUSE OF REPRESENTATIVES

February 16, 2007
Mr. GINGREY (for himself, Mr. PITTS, Mr. CARTER, Mr. GOODE, Mrs. MYRICK, Mr. LAMBORN, Mr. GARRETT of New Jersey, Mr. BOOZMAN, Mr. WELDON of Florida, Mr. KINGSTON, Mr. ADERHOLT, Mrs. BLACKBURN, Mr. BARRETT of South Carolina, Mr. PEARCE, Mr. HOEKSTRA, Mr. PAUL, Mr. AKIN, Mr. SAM JOHNSON of Texas, Mr. SOUDER, Mr. MCCOTTER, Mrs. MUSGRAVE, Mr. SENSENBRENNER, Mr. PENCE, Mr. SALI, Mr. MANZULLO, Mr. WESTMORELAND, Mr. FORTENBERRY, and Mr. JORDAN of Ohio) introduced the following bill; which was referred to the Committee on Energy and Commerce

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A BILL

To prohibit Federal funding or other assistance for mandatory human papillomavirus (HPV) vaccination programs.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.
This Act may be cited as the `Parental Right to Decide Protection Act’.

SEC. 2. FINDINGS.
The Congress finds as follows:

(1) HPV, the human papillomavirus, is the most common sexually transmitted infection in the United States. HPV types 16 and 18 cause about 70 percent of cervical cancers. The Centers for Disease Control and Prevention estimates that about 6,200,000 Americans become infected with HPV each year and that over half of all sexually active men and women become infected at some time in their lives. On average, there are 9,710 new cases of cervical cancer and 3,700 deaths attributed to it in the United States each year.

(2) Early detection is the key to diagnosing and curing cervical cancer, and therefore the Food and Drug Administration (FDA) recommends that all women get regular Pap tests. The Pap test looks for cell changes caused by HPV, so the cervix can be treated before the cells turn into cancer. The FDA also states the Pap test can also find cancer in its early stages so it can be treated before it becomes too serious, and reaches the conclusion that it is rare to die from cervical cancer if the disease is caught early.

(3) On June 8, 2006, the FDA approved Gardasil, the first vaccine developed to prevent cervical cancer, precancerous genital lesions, and genital warts due to human papillomavirus (HPV) types 6, 11, 16, and 18. Gardasil is a recombinant vaccine, it does not contain a live virus, and it is given as three injections over a six-month period. The vaccine is approved for use in females 9-26 years of age. However, the FDA also states that since the vaccine is new, more studies need to be done to determine how long women will be protected from HPV. For example, the FDA does not know if a booster is needed after a couple of years to ensure continuity of protection.

(4) As detailed by the FDA, four studies were conducted in 21,000 women, one in the United States and three multinational, to show how well Gardasil worked in women between the ages of 16 and 26. The study period was not long enough for cervical cancer to develop; however, preventing cervical precancerous lesions is believed highly likely to result in the prevention of cervical cancer.

(5) In January 2007 the Advisory Committee on Immunization Practices (ACIP), under the Centers for Disease Control and Prevention, issued changes to the previous childhood and adolescent immunization schedule. The ACIP recommends the new human papillomavirus vaccine (HPV) to be administered in a 3-dose schedule with the second and third doses administered 2 and 6 months after the first dose. Routine vaccination with HPV is recommended for females aged 11-12 years, the vaccination series can be started in females as young as age 9 years, and a catch up vaccination is recommended for females aged 13-26 years who have not been vaccinated previously or who have not completed the full vaccine series.

(6) States historically have maintained the practice of applying immunization recommendations to their school admittance policies so as to protect schoolchildren from outbreaks of contagious disease. The Association of American Physicians and Surgeons states that there is no public health purpose for mandating HPV vaccine for schoolchildren. HPV is a sexually transmitted disease.

(7) With at least 16 States entertaining legislation which takes the unprecedented step in requiring young girls to obtain a vaccine for a disease that is not spread by casual contact in order to attend school, many organizations and associations have come out against mandatory HPV vaccine programs.

(8) The Texas Medical Association has stated that although it strongly supports the ability of physicians to provide the HPV vaccine, at this point, it does not support a State mandate.

(9) The American College of Pediatricians and the Association of American Physicians and Surgeons are opposed to any legislation which would require HPV vaccination for school attendance. They have stated that excluding children from school for refusal to be vaccinated for a disease spread only by intercourse is a serious, precedent-setting action that trespasses on the right of parents to make medical decisions for their children as well as on the rights of the children to attend school.

(10) Federal funds should not be used to implement a mandatory vaccine program for a disease that does not threaten the public health of schoolchildren in the course of casual, daily interaction between classmates and inserts the government into the lives of children, parents, and physicians.

SEC. 3. PROHIBITION AGAINST FUNDING FOR MANDATORY HUMAN PAPILLOMAVIRUS (HPV) VACCINATION PROGRAMS.
No Federal funds or other assistance may be made available to any State or political subdivision of a State to establish or implement any requirement that individuals receive vaccination for human papillomavirus (HPV).

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Dawn Richardson
PROVE(Parents Requesting Open Vaccine Education)
prove@vaccineinfo.net (email)
vaccineinfo.net/ (web site)
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PROVE provides information on vaccines, and immunization policies and practices that affect the children and adults of Texas. Our mission is to prevent vaccine injury and death and to promote and protect the right of every person to make informed independent vaccination decisions for themselves and their family.
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This information is not to be construed as medical OR legal advice.
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