Free Markets, Free People

Rick Perry’s Gardasil problem

Rick Perry got some deserved heavy fire for something he attempted as governor of Texas.  That is, he attempted to mandate a vaccine for sixth grade girls designed to help prevent cervical cancer.  

Last night Michelle Bachman, trying to revive her flagging campaign, lit into the Texas governor for attempting to establish the mandate by executive order:

“To have innocent little 12-year-old girls be forced to have a government injection through an executive order is just wrong,” Bachmann said. “Little girls who have a negative reaction to this potentially dangerous drug don’t get a mulligan.”

Two points here that need to be considered.  One, as some defending Perry are saying, we mandate shots for kids right now before they can attend school and there are some who suffer adverse effects.

True.  But here’s the difference – they’re for communicable diseases that can spread quickly in schools and cause all sorts of problems up to and including death.  Most Americans realize the difference between a program designed to prevent the spread of a communicable disease and one that isn’t.  They accept the need for the shots to prevent communicable diseases among children as well as the risk associated with them.

The HPV vaccine is designed to help prevent a non-communicable disease.  It isn’t a “public health” matter or threat the same way the communicable diseases are.  So the vaccine should be optional in terms of whether or not a person decides to chose to be vaccinated.  

Additionally there are some pretty bad side effects if a child has a negative reaction.

Guillain-Barré Syndrome (GBS)

Guillain-Barré syndrome (GBS) has been reported after vaccination with Gardasil® . GBS is a rare neurologic disorder that causes muscle weakness. It occurs in 1-2 out of every 100,000 people in their teens. A number of infections have been associated with GBS. There has been no indication that Gardasil® increases the rate of GBS above the rate expected in the general population, whether or not they were vaccinated.

Blood Clots

There have been some reports of blood clots in females after receiving Gardasil®. These clots have occurred in the heart, lungs, and legs. Most of these people had a risk of getting blood clots, such as taking oral contraceptives (the birth control pill), smoking, obesity, and other risk factors.

Deaths

As of June 22, 2011 there have been a total 68 VAERS reports of death among those who have received Gardasil® . There were 54 reports among females, 3 were among males, and 11 were reports of unknown gender. Thirty two of the total death reports have been confirmed and 36 remain unconfirmed due to no identifiable patient information in the report such as a name and contact information to confirm the report. A death report is confirmed (verified) after a medical doctor reviews the report and any associated records. In the 32 reports confirmed, there was no unusual pattern or clustering to the deaths that would suggest that they were caused by the vaccine and some reports indicated a cause of death unrelated to vaccination.

It is obviously unclear if Gardasil was the culprit here, but then it’s also unclear it wasn’t.  However, it does seem rather interesting that 68 youngsters died after its administration.  That many young people dying in close relation to the administration of the vaccine is at least highly suspicious.

You could write it off to bad screening … why was it administered to those people who had risks of getting blood clots.  But that’s irrelevant if it is mandated, isn’t it?

Unless the mandate specifically states such exceptions, everyone, to include those with the risks outlined, are going to get the vaccine and health care workers aren’t going to bother to screen, are they?

And of course that brings us to the real problem.  The mandate.  Sort of hard to be outraged about ObamaCare’s mandate when you’ve been mandating things yourself, and without even a legislative okay – not that that would justify a mandate.  However, the point is Perry decided to do this with an executive order, thereby placing the entire fiasco squarely on his shoulders.

The point, of course, is what he did is not exactly in keeping with what he claims he wants to do as president, i.e. “get Washington (government) out of our lives”.  His action in this case was exactly the opposite.  And while, as he claims, his intentions were good, we all know the road to hell – and serfdom – are paved with good intentions.

“At the end of the day, this was about trying to stop a cancer,” Perry said. “At the end of the day, I am always going to err on the side of life.”

Not your job, Governor, at least in this context.  And especially by executive order mandate.

Compound this mess with the fact that also a hint of political cronyism involved:

“There was a big drug company that made millions of dollars because of this mandate,” Bachmann said. “The governor’s former chief of staff was the chief lobbyist for this drug company.”

The company in question is Merck and his former chief of staff was indeed it’s chief lobbyist.  And we know that sort of former relationship buys access in political circles.   And we also know that fosters cronyism.  None of that may be the case here, but politicians running for president can’t really afford that sort of implication, can they?

Perry shot back that he was offended that anyone would think, after raising $30 million dollars that he could be bought off by a $5,000 campaign contribution.  Well he wasn’t running for president then was he?

Lots of questions.  Less than satisfactory answers to this point.

Oh, and in case you’re wondering, “Romneycare” still stands as my answer to any question Mitt Romney might ask.  If you think Perry’s answer was unsatisfactory about the HPV vaccine, I’ve still yet to hear one from Romney about his mandated health care for MA.

~McQ

Twitter: @McQandO

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43 Responses to Rick Perry’s Gardasil problem

  • Here’s a link to the past – on the Guardasil issue here in Texas, at the time it was going on.
     
    Not exactly favorable (I recall thinking it was high handed and none of his damned business, that hasn’t changed).
     
    Note his arguments for what he did, also note the ‘opt out’ which some people are questioning.  Yes, there was an opt-out.
    While the opt out is in there it doesn’t make Perry look much better, seeing it now 3 odd years later and recalling what I thought at the time.
     
    My only hope is it taught him a lesson.  Heavy emphasis on a word that burned us all to hell in 2008 – HOPE.

  • Several points…
    1. COMMUNICABLE is EXACTLY the kind of disease HPV IS.
    2. Bachmann was WRONG…and she lost a lot of creds last night…

    “To have innocent little 12 year old girls to be forced to have government injections through an executive order is just flat-out wrong,” Bachmann said.
    She was, of course, attacking Perry on the HPV EO, which is fair game. It was wrong.
    But she should tell the truth.
    “Government injections”…?
    Of course, by age 12 virtually any child in the US has been “forced” to have various injections, procedures, oral vaccines, etc. Even Ron Paul, who boasts of delivering thousands of babies, has been a willing participant in MANY MANDATED procedures for new-borns.
    If the mandate had come from the Texas legislature, would that make it morally OK? There are MANY such mandates in Texas statutes…and the statutes of ALL other states, as well. They are standard public health policy.
    “I’m offended by what happened to all those girls”.
    What girls??? There were none. Perry’s order never “forced” a single “girl” to be vaccinated.
    “We cannot forget that in the midst of this executive order there’s a big drug company that made millions of dollars because of this.”
    Not if she means Perry’s EO. Merck didn’t make anything from the EO.
    IF she means Merck’s HPV vaccine, how is that a bad thing? Drug companies that produce cures for disease are SUPPOSED to make money doing it, RIGHT???
    3. There are a number of MANDATORY procedures just about universal in all states that have NOTHING to do with a communicable disease…at all…period.
    4. As to the “side effects”, you should have stuck a POSSIBLE in front of the “side”. 

    The FDA found no causal connection to any of these serious adverse events and found plenty of contributing factors to all — and all of the events are exceedingly rare.

    • 1. It is an STD and we don’t give mandatory shots for any of the others. But it is certainly not a communicable disease in the sense of cholera, typhus, typhoid, diphtheria, etc, which could, worst case, infect and wipe out an entire school.
      2. Disagree. Thought she was on target.
      3. Doesn’t make em right, just makes em mandatory.
      4. Those are off the CDC website. Perhaps they should have put “possible” in front of them.

      “Exceedingly rare” doesn’t mean the abrogation of choice through a mandate is ok, it just means a correlation hasn’t yet been found, which is irrelevant to the point about the mandate.

      • Communicable is COMMUNICABLE, McQ.  You are playing games here.  POLIO is NOT highly contagious.  It never “wiped out an entire school”.
         
        Bachmann may have been “on target”.  She was also FACTUALLY FULL OF SHIT.
         
        So, I gather you want to fight the “vaccination”, “TESTS”, and “procedures” battle on all existing public health statutes?
        REALLY….????

      • She was wrong in the sense that there was an opt out.  So the parents of the innocent 12 year old would have had to allow the shot.  It’s like sex education in middle school here, you default opt-in, but you CAN opt your kid out if you take the time.  So you take the time to get the kid vaccinated, or you take the time to get the form to opt them out.
         
        Default on Guardasil was opt-in, I know, but let me tell you had I had a daughter, there would have been serious review of the literature before I allowed the default opt-in to take place.  And I had precisely Thalidomide in mind at the time thinking of drugs that were administered that caused down stream effects.
         
        Whether you believe in vaccinations or not, doesn’t dismiss Perry’s attempt to use an executive order to do it. But as Rags note, any handwaving about Texas girls being FORCED by Perry to have this treatment is just that, handwaving (no thanks to Perry, but reality stands) and any opponent, Bachmann in this case, is full of bull to make that argument.  That sort of argument becomes as relevant as theorizing what would have happened if Napoleon had won at Waterloo.

      • The first rule of holes is, when you’re in one–and Bruce your in one–is quit digging.
         
        There was no mandate.
        It is a vaccine for a communicable disease.
        I don’t know there are vaccines for other VDs, why shouldn’t we treat VD as other diseases as vaccines become available?
        The side effects of the vaccine are no more prevalent or worse for this vaccine than for any other.
        Either you are condemning the entire concept of coercive action by government to encourage vaccine use, or you have nothing to say except gabble, gabble, gabble.
        And to argue from authorityby reasonable extension–look at how the people in the Founder’s time treated plague ships and epidemics.  Tremendous inhumanity and general warrants all around–because it was the best they could do.  Vaccines are nicer, and it’s the least we can reasonably do.
        So we should.

        • Forcing you to be vaccinated for a STD is so deep in “we’re going to protect you from yourself” territory it isn’t funny.

          • Any government program you can opt out of with your own (or parent’s)  signature borders on meeting the libertarian definition of a perfect gov program.
            And it’s not to protect you from yourself, it to protect everyone from an endemic lethal disease.
            There are no grounds to argue agaisnt this which are not also grounds to argue against everyother coerced/mandatory vaccination.
            So put up or shut up!
            Do you love polio, small pox, and cervical cancer?  Why isn’t the fix for the first two good enough or the second?  There’s no difference.

  • While we can debate should the state have the power to require this, “It is obviously unclear if Gardasil was the culprit here, but then it’s also unclear it wasn’t.”, is probably the dumbest thing I’ve seen you write … ever. That’s the logic of liberals.

    “The nature of the evidence is irrelevant; it’s the seriousness of the charge that matters.”

    • Well Jay, perhaps you can point out the substantial proof that Gardasil was the culprit. You may find the sentence stupid, but what it does is remove those two points from the argument and focus on the real problem – mandating treatment, regardless of the consequences of that treatment, is wrong. I figured you’d be sharp enough to figure that out. Guess I was wrong.

  • Bachmann (who I generally like) stepped off into a pile of mess last night…

    There’s a woman who came up crying to me tonight after the debate. She said her daughter was given that vaccine. She told me her daughter suffered mental retardation as a result of that vaccine.

    She said that on Fox, and it has already started to get her in trouble.  It is daffy.
    Is this really an issue at all, given that Perry has eaten the blame for it?  Reagan was NOT mistake…even some very BIG mistakes…free.
    Do we want to make this a NEW social issue, given that this is SOP for about the last century?

  • You write: “It is obviously unclear if Gardasil was the culprit here, but then it’s also unclear it wasn’t.”
     
    Bruce – I don’t defend Perry’s executive order, for the exact reasons you outline based on the non-communicability of HPV.  However, the above statement is nonsensical.  It is not only “unclear” that Gardasil was the culprit, there is zero evidence even suggesting that it was.  Negatives are hard to prove, but in the absence of any supporting evidence at all, one should regard any suggestion of causation with extreme skepticism.  Read the JAMA report : http://jama.ama-assn.org/cgi/content/abstract/302/7/750 .  Using basic mortality statistics, we’d expect to have seen nearly 17,000 deaths among the population that has been administered Gardasil.  None of the 32 confirmed deaths showed anything that might suggest Gardasil had anything to do with it.
    This is the same type of faulty post hoc ergo propter hoc reasoning that has led to the nonsensical vaccine/autism scare, which has actually led to real problems (e.g. measles outbreaks) as some parents endanger their own children and other children by refusing to vaccinate.
     
     

    • See answer to Jay, Rich. Then read up on Thalidomide. Saw precisely the same sorts of reports on it at the time. Until, finally, well, yeah ….

      Point is, whether or not it is or isn’t a culprit in the deaths is almost immaterial – the mandating is wrong.

      • WRONG, McQ.  There were NOT extensive trials of Thalidomide in pregnant women.  It was so broadly in use…for so many things…world-wide that many ASSUMED it was safe in that narrow population, too.
        Thalidomide IS CURRENTLY being used to treat a variety of maladies, world-wide.
        As Milton Friedman has asked, how many drugs are NOT helping people or saving lives because of the FDA.

        • The Thalidomide problem came about because there are two variants of most molecules: left and right handed (there’s a better term for it but I cannot recall what it is). One of them worked very well for morning sickness, the other affected the development of blood vessels, or something like that, which is what caused the fetal deformaties. When making drugs, it is important to make the correct “handedness” otherwise you can get completely incorrect behavior. This is all from addled memory so I may have some of the details incorrect…

    • “for the exact reasons you outline based on the non-communicability of HPV.”
       
      It’s for VD, by definition it’s communicable.  You don’t get it from rolling in the dirt, you get if from a person.

  • As an aside to this, is the control oversight of communicable diseases an actual government function in the libertarian sense? It does seem to server a legitimate purpose in preventing the spread of diseases from one to another. Iv never really thought about it.

    • Its an interesting question. You’ll have one side claiming you have no right to demand I have shots to prevent them, but then on the other side, it is an equally valid argument to say you have no right to infect me by not taking advantage of technology that will prevent it. I think as a matter of rights, it can be argued on both side of the issue. And, of course, that makes it complex. Is it strictly something that government should be involved in? Not necessarily. Look at flu shots. No mandate there and it is certainly a communicable disease that can kill if the proper strain.

      Government encourages you to get them but it doesn’t mandate them.

      I think where government comes in has to do with the schools which have become a government function and we’ve agreed government has a role in public health. It also has to do with children who are not yet able to decide on preventive treatment. So it isn’t quite as cut and dried as Perry’s attempt. But it is an interesting question on the libertarian side.

      • Take a hypothetical–
        A “magic bullet” is developed that will kill all HIV virus in any individual to which it is administered.
        Do we have a law that MANDATES…PERIOD…that ANY HIV + person has to have the “magic bullet”?
        Do individuals have a “right” to willfully maintain in themselves a population of deadly virus?  IF they do, what rights does society have relative to them?
        This was not even an issue a hundred years ago.  You were often quarantined…period.  In fact, it has been said that AIDS was the first disease with the political clout to end what was considered fundamental sound health practice.

      • Look at flu shots. No mandate there and it is certainly a communicable disease that can kill if [you get] the proper strain.

        Silly example, McQ.  Flu shots are a PALLIATIVE.  They MIGHT help you ward off a full-blown case of any given flu.  They are NOT a PREVENTATIVE.
        The flu (as a broad, non-scientific category) is the kind of threat it is because it moves (changes) so fast, defying efforts to find a preventative drug, vaccine, etc.

    • I always thought of myself as a libertarian but I got to come down here on the side of big government. At least to this extent:  If, after a lot of trials, time and testing, it is discovered that there is valuable vaccine for a deadly “killer epidemic” type of disease, then I think that mandatory vaccination could be called for.
       
      Our rights are very important, but innocent people have a right to not be infected by someone else when a good method appears which will remove or lower that risk.
       
      And the way that vaccines operate, a certain percentage of the population has to be inoculated before the danger of epidemic is removed.
       
      And even if a vaccine has an adverse effect upon a very tiny minority of people, so what? will you weight that against the many millions who might die in a full blown epidemic?

      • Is that “BIG GOVERNMEN”T?  I don’t think so.

        • Its as BIG GOVERNMENT as it gets.
           
          In fact, many vaccines are actually pretty poor at protecting an individual.  The Primary Protection comes from thet fact the diseases progress is slowed as it transmits through the public.  So slow other measures can be taken.
           
          If you have a disease that you infect one person every day, at the end of 16 days, over 65,000 people are infected.  If you immunize the public and it only cuts the infection rate in half so only 1 other person is infected every 2 days, at the end of 16 days 256 people are infected.  In the latter case society as a whole being immunized, made chance to catch the disease less than 0.5% of what it was without vaccination.  Whereas only you being immunized improved your chances by only 50%.
           
          Just because something like ‘BIG GOVERNMENT’ is the wrong thing 99.9% of the time, doesn’t mean there isn’t some usefulness 0.1% of the time.
           

    • One aspect of this is that vaccines are provided to large numbers of people at low cost or free by the government. Since this would tend to drive up demand (it’s free!), the government tends to impose cost controls on the vaccine.

      This results in a lack of incentive to produce the vaccine. Leading to shortages and a bottleneck in production. It probably also reduces incentives towards creating new vaccines.

      This is all without considering mandates, etc. Just the underlying economics.

      • Obviously, while the government may povide the vaccine for free, those who produce it want to be paid.

        • That was part of the argument with Guardasil that Perry used – that it would be low cost.  There were several other states investigating such a mandate.  See the link I provided.  It had also been blessed, and recommended by the Federal government.
           
          It’s clear Merck stood to profit, but I think they were prepared to deliver the vaccines.  Cost wise, not a clue, but we were going to subsidize it, so…hell!  the sky is the limit, it’s FREEEEEEEEEEEEEEE!

          • I was arguing more about “free” government vaccines in general.

            Government pays for it (with our money, or our children’s), but they don’t want to spend all of our money on it (they have lots of other things they want to spend it on) so they impose cost controls.

            The result is a bottleneck in vaccine production.

            My point is that a market based approach would eliminate the bottleneck. Profit would increase vaccine production. Supply and demand, and all that.

    • You may recall the phrase “The Constitution is not a suicide pact” floating around lately. Neither is my libertarianism. No philosophy perfectly survives contact with the real world, and subject to high standards of safety and analysis, which for the most part are actually reached in practice, mandatory vaccinations may be in the best interests of society. I don’t spend a lot of time getting freaked out about the inconsistencies. (Probably because my libertarianism ultimately springs from a relatively utilitarian point of view anyhow; I’m not a libertarian because I like the ideals and then try to project it out, I’m a libertarian because I believe the empirical evidence backs it. If the evidence occasionally points the other way, shrug.)

      • As a serial father, I was impressed by the battery of tests MANDATED for my newborn kids.
        One such, the PKU screening, tests for a fairly rare metabolic disorder that has NO public health ramifications (i.e., it isn’t at all implicated in COMMUNICABLE disease).
        It IS mandatory in almost all states…maybe ALL states.  The only individual effected is the child.  If it is not detected, the child’s ability to metabolize an amino acid will lead to very serious neurological problems.  If it is detected, a dietary and medication regime can result in a long, productive life.
        I dunno who would have a kick against this MANDATORY test.

  • First, I think Bruce should have simply left off the “risks” claimed of the drug, given the lack of evidence. It certainly enhances any emotional argument against the drug and Perry, but doesn’t add to the basic argument with respect to the mandate.

    Now the mandate had an opt out. One that only required a simple form. It isn’t quite the Obamacare mandate, with its taxes (or fines, depending upon the phase of the moon or whatever), and with the economic significance of the Obamacare mandate. My understanding is that Perry did it the way he did in order to provide it free to the poor, although that’s just something I’ve read in internet discussion of the issue.

    It is clear that this thing isn’t much of a plus for Perry. Yet Bachmann hasn’t exactly come off well in this even if her attack on Perry scored (and frankly I don’t see her or any other representative as a serious contendor anyway). Bachmann toook this issue well to far, beyond the mandate and into vaccine hysteria territory. And a lot more damage needs to be done to Perry before he falls below Mitt in my estimation.

    This debate may have hurt Perry but it hasn’t helped any of the others.

  • Perry did wrong.
    He has said so.
    But implying he did it as a quid pro quo is utterly without support in the evidence.
    http://www.nationalreview.com/articles/275294/perry-s-patronage-problem-daniel-foster?page=1

  • What is being lost in the argument about this or that about the vaccine is this:
    Perry has admitted he was wrong and wouldn’t do it again.
    Romney still thinks Romneycare was a good idea, even though it is already broke, and refuses to admit the failure.
    So do you want the guy who overreached and admitted his failure when it was shown to him, or the guy who tells you that you’re just too stupid to know what is going on when he’s presented the evidence?


  • Opt-Out / Opt-In

    The dad got the letter from one of the children.  The school had sent it home to inform parents about a collaborative study being done between the public school and the local state university.
    The study was on the subjects of sexuality and drug-use.
    The letter informed parents that there was a survey of all students to be taken concerning their exposures and activities regarding sex and drug-use.
    The letter promulgated the idea that the knowledge gathered through the survey would affect teaching and counseling in the district and would benefit all involved.
    The option to opt-out the child was presented in the letter. 

    The dad thought, “Hmmm, that’s odd…opt-out…what if the letter didn’t make it home?  I wouldn’t even know about this survey.” 

    So the dad did a little research.  Making telephone calls to other parents of children who would be subject to the survey, the dad did not find one who had received the letter. 
    None of the other kids had completed the task of delivering the letters to their parents. 
    The dad was not surprised.
     
    He made one more phone-call…to the School Superintendent, and set up an appointment to speak with him on the matter. 
    At the meeting, the dad asked the superintendent exactly what he would have to do in order to stop the survey and to change the mode of communicating such information to parents, and to change the opt-out option to an opt-in option, so that participation in such things would be a conscious decision on the part of the parents.
    The Superintendent assured the dad that he, and the administration knew what they were doing, and reminded the dad that “we are Professionals.”  This did not sit well with the dad, who had a strong sense of his role as the father of his children and their primary leader and protector.  He had gone to the meeting knowing in his gut that he might confront this kind of facade, and had pre-determined not to lose his cool or behave in any-way inappropriately.  He had also firmed-up his conviction that this was not a parental-rights issue, but rather an issue of the duty and responsibility of a father.  From that position of strength, the dad responded to the Superintendent’s admonition saying, “Yes, you are professionals, but there is one thing you will never be.”
     
    “What is that?” the Superintendent asked.

     The dad said “Professional parents.”

    The meeting ended shortly after that, but the dad now knew what he had to do, and that was to take the matter to the school board, which he did.  Because of his one voice, the school board re-thought the matter, conceding that such projects would be communicated to parents by letter, and that the opt-in option would be offered, rather than the opt-out.

    Current political events are bringing to light another opt-out controversy – the Texas, Governor Perry executive order to have girls innoculated with Guardasil.

    Wake up parents.  You have duties and responsibilities.

  • And one other thing:
    Perry is offended “If you think I can be bought for $5,000″.
    Ok, Governor, what IS your price?

  • i guess all the social conservatives are upset that the government even considered their little angels might be swapping bodily fluids in the future with an unclean boy.

  • Last night Michelle Bachman, trying to revive her flagging campaign, lit into the Texas governor for attempting to establish the mandate by executive order:

    Well, first of all, that EO was stopped, but Bachman wants to impose HER version of health and sex rules on everyone.