In January 2007, Gardasil's manufacturer, Merck, lobbied state governments to require schoolchildren to be vaccinated with the newly approved treatment. They quickly found an ally in Perry, who offered a relatively straightforward argument: why not reduce Texan girls' exposure to cancer?
But before the legislature could take up the issue, Perry signed an executive order mandating that sixth-grade girls receive the drug before entering middle school, with an opt-out for parents who objected. Lawmakers revolted almost immediately over being cut out of the process, demanding that he rescind the requirement until they could review it first.
The most notable early criticisms of Perry's plan came from social conservatives, some of whom fretted that protecting children from HPV -- a sexually transmitted disease -- could encourage promiscuity. Perry sought to address these questions up front in his State of the State address only days after the Gardasil order.
"I understand the concern some of my good friends have about requiring this vaccine, which is why parents can opt out if they so choose," he said. "But I refuse to look a young woman in the eye ten years from now who suffers from this form of cancer and tell her we could have stopped it, but we didn't. Others may focus on the cause of this cancer. I will stay focused on the cure. And if I err, I will err on the side of protecting life."
Although some religious groups supported the move, Perry's argument failed to quell growing dissent from the religious right.
"They're hitting two nerves: They're not only taking away parental rights, but they're talking about a vaccine against a purely sexually transmitted disease," Linda Klepacki, then an analyst for the national evangelical organization Focus on the Family, told the Dallas Morning News. "Does the public health industry truly believe that all children and adolescents are sexually active? This is not something kids are going to contract sitting in the classroom."
While the break with social conservatives is notable, especially in the context of today's GOP primary, it only tells part of the story. In fact, opposition to the vaccine quickly spread to encompass a wide variety of groups across the political spectrum.
One very prominent angle in news reports at the time was Merck's personal connections to Perry. The governor's former chief of staff, Mike Toomey, did lobbying work for the company, which was at the time waging a very aggressive campaign to convince state governments to distribute their drug. Toomey currently runs a Super PAC supporting Perry's presidential campaign. Merck's PAC made a $5,000 donation to Perry's campaign, hardly a huge number in the context of his overall fundraising, but one that generated intense scrutiny in the press -- especially as it came the same day his senior staff met to discuss the HPV issue. Perry's office denied being influenced by the drug manufacturer.
The special interest angle drew the state Democratic party into the mix, who accused Perry of circumventing the usual legislative process in order to reward his friends. Not everyone in the medical community was on board either. The powerful Texas Medical Association came out against the move as well, in part because they feared it would be too costly and logistically difficult for them to administer the drug en masse.
In the end state lawmakers forced Perry's hand, passing a law overturning his decision with veto-proof majorities in both chambers. Perry acknowledged defeat and announced he would withdraw his efforts to implement the policy, but went down in spectacularly defiant form, lashing out at members of his own party. At a press conference, he played a video message from a 31-year old cervical cancer patient hooked to an oxygen tube, who was too sick to testify earlier at the statehouse.
"I challenge legislators to look these women in the eyes and tell them, `We could have prevented this disease for your daughters and granddaughters, but we just didn't have the gumption to address all the misguided and misleading political rhetoric,'" Perry said.
His tone has shifted markedly, however, since he began his presidential campaign. In a Saturday appearance in New Hampshire, he told reporters that he regretted his handling of the vaccine.
"I signed an executive order that allowed for an opt out, but the fact of the matter is that I didn't do my research well enough to understand that we needed to have a substantial conversation with our citizenry," Perry said, according to ABC News. "But here's what I learned. When you get too far out in front of the parade, they will let you know, and that's exactly what our legislature did and I saluted it and I said, 'Roger that, I hear you loud and clear' and they didn't want to do it and we don't, so enough said."
The episode has lingered in Texas politics. Sen. Kay Bailey Hutchison (R-TX) attacked Perry for "cronyism" on the vaccine issue in her 2010 primary challenge of the governor and an independent anti-Perry group aired ads as well.
The question now is whether the issue will gain traction again as national Republicans absorb Perry's record. There are some rumblings of discontent so far: a coalition of New Hampshire Tea Party groups recently published a blog post condemning Perry's "attack on parental rights."
"You still have people extremely upset about it," Felicia Cravens, a founder of the Houston Tea Party Society, told TPM. " But at the same time, many of them understand that you can get in the door to talk to Perry and he can be made to change his mind when he's off track. He is movable."
One veteran Texas Republican strategist told TPM that the episode was "very illustrative" of one Perry trait: a willingness to sometimes "go it alone." He compared it to the recent Texas budget battle, where Perry clashed with Republican lawmakers over his insistence against using the state's rainy day fund to help make up the budget deficit.
Critics of Perry's decision claim vindication in subsequent stories on Merck's vaccine that have questioned its effectiveness. The New York Times ran a lengthy article in 2008 airing concerns from medical experts that the company was pushing the drug on state governments before they could fully assess its effectiveness. And the CDC has raised concerns in recent years about potentially dangerous side effects even as it still recommends the vaccine.
Correction: An earlier version referred incorrectly to a meeting with Merck representatives and Perry aides the same day as a donation from the company's PAC. The meeting was between Perry's aides only.
This story has been updated.