Canada Cancer Vaccination Launched in Controversy

Canada cancer vaccination launched in controversy
Thu Aug 2, 2007 2:52PM EDT

By Louise Egan

OTTAWA (Reuters) - Canada's most populous province will begin vaccinating Grade 8 girls against cervical cancer this fall, the Ontario government said on Thursday, but some medical experts say the campaign is premature and could lead to more unsafe sex.

Ontario will offer the vaccine against human papilloma virus (HPV), a cause of cervical cancer, on a voluntary basis to 84,000 school girls aged 13 and 14.

The assumption is that age group has not yet been exposed to the viruses that cause the sexually transmitted disease.

"We're providing this vaccine to women at a young age so we can help prevent the spread of HPV and save lives," Ontario Premier Dalton McGuinty said in a statement.

About 400 Canadian women die from cervical cancer every year, 140 of them in Ontario. It is the second most common cancer in women aged 20 to 44, after breast cancer.

The federal government approved the routine vaccine of young girls in July 2006 to protect against two types of HPV that are responsible for about 70 percent of cervical cancer cases in Canada. Many governments around the world have endorsed the same concept. In June, Britain became the ninth European country to do so.

Texas was about to become the first U.S. state to offer the vaccine but the order was overturned in May by the state legislature after social conservatives complained it would lead to sexual promiscuity.

The Ontario launch was clouded by concerns from some doctors who said more independent study was needed on the effectiveness of the Gardasil vaccine and on the implications for teenage sexual behavior.

In a commentary published online in the Canadian Medical Association Journal on Wednesday, a group of experts said the reported vaccine trials of Gardasil, manufactured by Merck & Co. Inc., had been funded wholly, or in part, by the manufacturer.

"A careful review of the literature ... reveals a sufficient number of unanswered questions to lead us to conclude that a universal immunization program aimed at girls and women in Canada is, at this time, premature and could possibly have unintended negative consequences for individuals and for society as a whole," said Abby Lippman, an epidemiologist at McGill University in Montreal and lead author of the commentary.

Lippman said there is no urgency for a massive vaccination in Canada, where deaths from cervical cancer have been declining. More needs to be known about the vaccine, including the duration of immunological protection it provides and whether factors such as smoking or poor health influence its effectiveness, she said.

Without a public education campaign, misunderstandings about the vaccine could lead teenagers to practice unsafe sex, Lippman says.

"Might misunderstandings about what the vaccine does and does not do lead to reductions in safer sex practices and Pap screening rates? These are among the questions raised ... and they remain pertinent and unanswered," the article said.

A similar vaccine, Cervarix, produced by GlaxoSmithKline Plc won a green light from European medical experts earlier this month. The company aims to launch its vaccine in Europe in the second half of 2007 but is not expected to get approval for the U.S. market until 2008.

Reuters