Last Updated:Tuesday - 07/13/2010

Guidance, not needles, immunizes girls

The Alberta government's desire to immunize all 11-year-old girls in the province with Gardasil, a vaccine that purports to prevent cervical cancer, should be viewed with a great deal more skepticism than it has been since the June 12 announcement. That announcement has been greeted with a cacophony of criticism of any nay-sayers that appears to be aimed at stampeding parents into having their pre-pubescent girls immunized against a sexually-transmitted disease - human papilloma virus (HPV).

The protection of women's health must be a top priority for any society. But we ought to have serious questions about whether this vaccine will protect women's physical health. We also ought to question whether it will undermine women's spiritual and emotional health.

Dr. Abby Lippman, a McGill University epidemiologist, has been outspoken in criticizing the mad rush to spend hundreds of millions of dollars to use a vaccine that has not been proven effective against a disease whose mortality rate has already been cut in half using a far-less expensive technique.

In an Aug. 28, 2007 article in the Canadian Medical Association Journal, Lippman and three co-workers argue, "There is no epidemic of cervical cancer in Canada to warrant the sense of urgency for a vaccination initiated by the federal finance minister's announcement" of $300 million in federal funding for the vaccine.

Cervical cancer rates in Canada have been declining for decades ever since the development of Pap smear testing. The populations where incidence has not declined -Aboriginal women, new immigrants, poor women and those living in rural or remote locations - are the same groups where the rate of Pap smear testing is lowest.

Lippman et al note there is "a thin information base" for a reasoned conclusion that mass vaccination would be effective. Few quality studies have been done and, in those few studies, "relatively few" of those tested were pre-teen girls. And those 11-year-olds who were tested have not been followed up for any longer than 18 months.

Lippman and colleagues conclude that Canadian governments may spend up to $2 billion of limited health care dollars promoting a procedure that may make no difference whatsoever to cervical cancer rates. They do not ask the obvious question of why governments are so hell-bent on pushing Gardasil on the public when they should be promoting Pap smear testing among the poor and marginalized. It is a question that begs for an answer.

A further question that calls for an answer is why governments are not doing more to promote the cheapest, most effective means of preventing HPV - abstinence from non-marital sexual relations. HPV is spread by sexual contact and this is why 11-year-old girls have been chosen as the government's and pharmaceutical industry's guinea pigs - they are not yet sexually active.

The answer one typically gets to this question is that teenagers are sexually active whether we like it or not. This answer amounts to adults' abdicating their responsibility to pass on knowledge that would enable the next generation to live better and happier lives than we are living.

If we were truly concerned about the health of the young, we would strive to teach them a way of life that would promote their own happiness and strengthen their ability to build strong, enduring families when they are adults. That we are so willing to take a pass on this responsibility does not speak well of us.

There is no question that parents will be getting an earful of propaganda on this issue in the months and years ahead. They should take heart from Ontario where 40,000 of 76,000 eligible girls did not receive Gardasil this year. Despite all the propaganda, you do have a choice.

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