[JURIST] The governor of Texas [JURIST news archive] signed an executive order Friday making that state the first to require that girls be vaccinated for human papilloma virus (HPV) [US CDC fact sheet], which is the primary cause of cervical cancer. Gov. Rick Perry's order [text], which directs the state Department of Health and Human Services [official website] to promulgate rules mandating the vaccinations for girls entering the sixth grade next year, takes the issue out of the hands of the Texas Legislature [official website], where such a proposal faced strong opposition [Houston Chronicle report]. "The HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer," Perry said in a press release [text]. "Requiring young girls to get vaccinated before they come into contact with HPV is responsible health and fiscal policy that has the potential to significantly reduce cases of cervical cancer and mitigate future medical costs." To address concerns about the vaccine's cost – more than $360 for a series of three injections – the executive order makes it available through the subsidized Texas Vaccines For Children program [official website; TVFC memo] and through Medicaid. Finally, the executive order authorizes the Department of State Health Services [official website] to modify the process for parents to opt their children out of mandatory vaccinations. Parents will be allowed to submit "conscientious objection" affidavits [TX Dep't of Health news release] online rather than on paper. The Dallas Morning News has more. The Houston Chronicle has additional coverage.

Legislatures in nearly a dozen other states are considering whether to mandate HPV vaccinations. Among them are Arkansas, California, Colorado, Indiana, Kansas, Kentucky, Virginia, West Virginia and Wisconsin [media reports]. In Maryland, a lawmaker who introduced such a bill withdrew it [Baltimore Sun report] this past week, saying the "timing is just not right." A legislator in Michigan is re-introducing such a bill [Grand Rapids Press report] that was defeated last year. Additionally, lawmakers in New Jersey and Pennsylvania either have introduced or plan to introduce bills that would require insurers to pay for the HPV vaccine [Courier-Post report; Pittsburgh Post-Gazette report].

The vaccination proposals are controversial because of the sexually transmitted nature of HPV. It is the most common sexually transmitted infection in the United States, affecting some 20 million people at any time. In January, the American Cancer Society recommended routine HPV vaccination [article text] for girls 11 to 12 years old. While also recommending vaccination for girls 13 to 19, the Society found insufficient evidence to support routine vaccination for women as old as 26.

This report was prepared in partnership with the Pittsburgh Journal of Environmental and Public Health Law.