It’s hard to figure out what is going on in Texas Gov. Rick Perry’s mind and in his presidential campaign. In the Florida debate on Monday, he defended his HPV mandatory vaccination on the basis that he would “always err on the side of saving lives.” He did, however, admit that using an executive order was an error. That is a perfectly defensible position, but he was ferociously attacked by rivals Rep. Michele Bachmann (R-Minn.) and Rick Santorum. Then, nearly 48 hours after the debate and the ensuing firestorm, he decided the mandatory vaccinations with an opt-out for parents was a mistake. He told a Virginia GOP gathering Wednesday afternoon: “We should have had an opt-in instead of an opt-out.” A Perry spokesman did not respond to a request for an explanation of the about-face.

To recap, in the 2010 Texas gubernatorial race, Perry vehemently defended the HPV vaccination effort. In the first days of the presidential campaign, he then said it was a “mistake,” but didn’t say why. In the debate he said only that the executive order was wrong. Santorum said to the audience members that they should take note that Perry was defending the merits of the program. Santorum suggested that an opt-in would have been a better plan. After a couple of days, Perry decided that his latest previous position was not tenable.

Santorum’s communications director, Hogan Gidley, e-mailed me: “I’m glad that Gov. Perry is finally listening to Rick Santorum — and now understands a conservative’s position: that the government take over of a 12 year old girl’s body is a horrible thing. Hopefully Sen. Santorum can now get Gov. Perry to flip his position on building a border fence, giving special tuition rates for illegals and supporting gay marriage at the state level.” (I think he missed a reversal on the gay-marriage point, but I’m not sure precisely what Perry’s position is on gay rights at the state level. In prior interviews and in his book, “Fed Up!,” he supported states’ right to determine this issue. I don’t believe that is his current view.)

Perry, I would suggest, should take a few days off from the campaign trail. He should enlist some advisers with presidential-campaign experience and go through his positions issue by issue. He needs to know what he thinks and why he thinks it, and then he needs to articulate consistent views at every opportunity. Right now, he appears to be confused or in over his head. It’s not an acceptable image for a presidential candidate, and it suggests he didn’t fully understand that a presidential campaign is fundamentally different from a gubernatorial race in a red state.

Unfortunately for his campaign, an impression is forming that, without prompting and a phalanx of nationally experienced staff, he is adrift. He better kick it up a notch or he’ll find he is another “former front-runner.”