HPV Immunization in Texas:

Last Friday, Texas Governor Rick Perry issued an executive order requiring that "[t]he Health and Human Services Executive Commissioner shall adopt rules that mandate the age appropriate vaccination of all female children for HPV prior to admission to the sixth grade," though allowing parents to refuse on conscientious grounds. (The relevant state statute, Health & Safety Code ยง 161.004(d), provides that "A child is exempt from an immunization required by this section if ... a parent, managing conservator, or guardian states that the immunization is being declined for reasons of conscience, including a religious belief.")

The governor's action has led to a good deal of objection, from both social conservative and libertarian circles. I thought I'd pass along a few tentative thoughts of my own. Because the aggregate of the thoughts is long, I'll break it up into a few posts; in this one I'll just set out the key facts:

HPV (Human Papillomavirus) apparently causes about 70% of cervical cancers; there are about 10,000 new cases of cervical cancer in the U.S. per year, and 3700 deaths, which means that HPV kills about 2500 American women each year. HPV is sexually transmitted; the vaccine, the CDC reports, has been tested on 9-to-26-year-olds and appears to be nearly 100% effective if administered before a woman acquires HPV. It has not, however, been tested on women over 26, and thus is not recommended for them.

I can't speak to how safe the vaccine is, though I have no reason to doubt the CDC's view that it is safe. If it is indeed too risky, that would of course be a plausible objection to it, but I'll set that aside for now. Rather, in coming posts, I'll discuss whether the vaccine is likely cost-effective; whether it might be counterproductive because it will lead to more risky sex and thus more diseases that stem from it; whether HPV is different enough from other diseases that government-mandated or even government-strongly-suggested HPV vaccination is improper; and how we might think about truly mandatory vaccination (which this doesn't seem to be) more generally.