New HPV Vaccine Causing A Stir

Gardasil, a relatively new HPV vaccine, has been the focal point of much political and social controversy of late in Canadian media. Saskatchewan, however has to date been quiet on the subject, and currently has no plans as to whether or not it will be providing free immunization to school age girls.

Background: (All information comes from Health Canada website unless otherwise stated.)

• Health Canada estimates HPV to be the most common STI nationally and around the world.


• Some types of HPV lead to cervical cancer, and some others to genital warts.


• Cervical cancer kills about 400 women a year in Canada. (CBC News Article)


• Health Canada estimates 75% of sexually active people will have at least one HPV infection in their lifetime, although only a small proportion would potentially develop cancer.


• Gardasil protects against two HPV strains that cause about 70% of cervical cancer, and two other strains that cause about 90% of genital warts.


• Use of Gardasil is recommended by the National Advisory Committee on Immunization for:
  Females between 9 and 13 years of age, before the onset of sexual intercourse;
  Females between the ages of 14 and 26 years of age, even if they are already sexually active, have had previous pap abnormalities, or have had a previous HPV infection.


• The federal government allocated $300 million in the last budget to help provinces with HPV vaccination programs. (CBC News Article)


• Ontario, PEI, Nova Scotia and Newfoundland have already begun programs giving free vaccinations to school age girls with parental consent. (GlobeandMail Article)

Despite great results over 5 years of clinical trials involving 20,000 individuals, there have been a number of points of opposition to the vaccine. A CBC News article points out that some more socially conservative parents are worried that the vaccination may “encourage promiscuity and provide a false sense of invulnerability to sexual disease.” Others are concerned that there is not yet enough long term data to determine the true effectiveness of the vaccine or possible negative long term side-effects. Some parents are also questioning the motives of Merck Frosst Canada Ltd (the company that is marketing Gardasil) who stand to make huge profits, or the motives of politicians looking for votes. Catholic school boards, most notably in Toronto, have also shown opposition as their schools are trying to teach abstinence as the best protection against sexually transmitted disease.

In spite of the opposition, many groups (especially in the medical field) are supporting the vaccine, even highly encouraging it for all young girls. The Canadian Pediatric Society representing 2,500 pediatricians across Canada officially endorsed the vaccine in a position paper released yesterday according to a Leader Post article. Other supporters of the Gardasil vaccination include the Society of Obstetricians and Gynecologists of Canada, and the Federation of Medical Women of Canada.

The key in administering the vaccination is making sure it happens before girls become sexually active. This is really the underlying cause of the controversy in my opinion, because parents don’t want to think of their kids having sex at such a young age. Vaccinating 9 year olds against a sexually transmitted infection is going to lead to a conversation that some parents might not yet be ready to even think about. The fact is that Gardasil is statistically shown to be a very safe and effective vaccine and is the only one of its kind. The only important question should be is this going to save lives, and is this going to lead to improved public health? Ultimately parents and their children will have the final say, so if a large portion of the funding has already been made available for the vaccination, what objection should parents or policymakers in Saskatchewan really have?

Pre-Election Promises

Surgery cancellations due to faulty air conditioning systems… a record breaking number of West Nile cases… leaked memos claiming the Regina-Qu'Appelle Health Region is in a state of crisis… and just a pinch of striking unions in various health sectors have all contributed to creating an exciting summer for health care in Saskatchewan. Add to that the ever problematic shortage of doctors and nurses, rural hospital closures, increasing waiting times, and it seems as though health care (in the home of Medicare itself) has nearly flat-lined. Yes, it does appear that measures must soon be taken to revitalize health care in Saskatchewan, and what divine intelligence that there should be an upcoming provincial election. This of course guarantees that even if measures aren’t taken, you can rest assured measures will be promised. Enter Brad Wall, and his defibrillation team that is the Saskatchewan Party... CLEAR!!

In a Saskatchewan Party Caucus news release from September 5, Brad Wall announced a plan that lays out the first steps his party will take to address health care in Saskatchewan. The plan involves investing $275 million (in their first term of government) to add 300 registered nurse training seats, and also involves bringing the number of physician training seats to 100 (currently there are 60). It sounds pretty great. We spend a bit of money and out come 300 more nurses and almost double the amount of doctors every year. Sort of like a vending machine when you think about it. But could it really be that simple?

An article by Murray Mandryk in the Sept 7th Leader Post titled “Sask Party’s Faulty Diagnoses” raises a number of doubts, not least of which is who is going to train these people? Mandryk points out that “nurse educators are retiring at a faster rate than the general nursing complement.” Another concern will be finding the resources to hire these 300 extra nurses once their training is complete. Just how many I-Owe-Yous is the province willing to write?

Mr. Wall might also want to take into consideration that the University of Saskatchewan’s College of Medicine was put on probation for three years and risked losing their accreditation beginning in February of 2003. According to their website, deficiencies identified included library assets and number of faculty members compared to number of students. So, while it may be easy to accept 40 more students every year, Mr. Wall may want to consider who will teach them, and which library they will be loaning books from. The even bigger question for Mr. Wall to consider is… how many doctors with MD’s from non-accredited medical schools does it take to thread an IV?

The bottom line is that with an approaching election, promises are flying. Parties are going to fix all of the problems that plague Saskatchewan. They are going to do it better than their opponents, and for less money. No promise is too ridiculous if it will court at least a few votes. I’m not saying there’s anything wrong with unveiling big plans so close to an election, or firming up positions on issues important to the province. But why not add a little substance to these plans. Mr. Wall’s announcement is little more than a summary of the end result he would like to see, and an estimated dollar amount. I find it offending that politicians believe voters opinions will be swayed by such superficial announcements.