Reported August 08, 2007

B.C. school girls probably will receive a controversial vaccine starting in September 2008 aimed at preventing a virus linked to cervical cancer.

Health Minister George Abbott told CBC News yesterday the inoculation program for the human papilloma virus (HPV) could start as early as this fall. But provincial health officer Dr. Perry Kendall said yesterday it's "very, very, very unlikely" the program would begin before September 2008.

"We couldn't roll it out this year," Kendall said. "We would need more lead time for the educational component ... and training."

The provincial health officer has proposed dovetailing the HPV vaccine program with the inoculations elementary and high-school students already receive in grades 6 and 9.

Grade 9 girls would receive the vaccine as part of a "catch-up" program for the first three years, Kendall said. After that, just girls entering Grade 6 would receive the vaccine, along with the hepatitis B vaccination they now receive.

Vaccination programs are slated to begin in schools in Ontario, Nova Scotia and Prince Edward Island in September.

The vaccine, backed by the Society of Obstetricians and Gynecologists of Canada and the Canadian Cancer Society, is already offered free to girls in Australia and in some U.S. states, including Texas and Virginia.

Kendall said the B.C. Communicable Disease advisory committee has submitted its recommendation and implementation strategy to the Health Ministry.

The ministry is now looking at whether the province can afford the full program as recommended, Kendall said. A federal trust fund for the program runs out in three years, leaving provinces to fend for themselves. The federal government has allocated $300 million to vaccinate girls ages nine to 13.

Gardasil, which is the only cervical-cancer vaccine on the market, is the most expensive childhood vaccine developed for mass use.

Gardasil protects against two strains of HPV associated with about 70 per cent of cervical cancers.

It does not protect against other HPV strains, or other sexually transmitted diseases.

Some Canadian scientists and women's health groups fear mass inoculation could undermine more comprehensive and successful screening programs like Pap testing, which prevents about 80 per cent of deaths from cervical cancer.

They also worry a vaccine will wrongly lead teens to believe they are protected from sexually transmitted diseases, encouraging them to engage in unsafe sex.

"That could happen, so it really is critical we not in any way stop promoting and educating about safe sex and Pap tests," Kendall said.

"It's a concern but I don't think it's enough of a concern to say we won't provide you with a vaccine that will stop you from getting infected in the first place."

HPV isn't a reportable disease.

But the majority of sexually active people acquire one or another of the more than 100 HPV infections -- 16 of which can cause cancer, Kendall said.

"I would say the majority, 50 to 75 per cent, acquire HPV at some point during their sexual lives."

About 90 per cent of the infections clear up spontaneously, but a small percentage turn into pre-cancerous lesions, cancer or genital warts.

Source : Times Colonist (Victoria) 2007