Ontario to offer HPV vaccination to all boys and girls

It’s a controversial shot in the arm. Dr. Eric Hoskins, the Minister of Health in Ontario, recently announced that starting in the 2016-2017 school year, boys in seventh grade will now have the opportunity to receive a vaccination for the Human Papillomavirus (HPV). The vaccine has been available to eighth grade girls since 2009. The Ministry of Health has decided to shift the immunization program to seventh grade based on recommendations from Health Canada’s–the Federal Department of Health–National Advisory Committee on Immunization. The idea behind expanded immunization is to create what public health professionals call “herd immunity,” a rather agricultural term to describe immunizing a large number of people so they don’t pass it on to even more people. It’s the same concept used in past mass-immunization efforts against serious diseases like polio.

HPV is a cancer-causing virus and is often transmitted through sexual activity. The types of cancer the virus causes include cervical, anal, and penile. This is where things get controversial. Religious conservatives and other advocates of sexual abstinence believe vaccinating young teenagers will encourage them to engage in sexual activity with less regard for possible negative consequences and the religious teachings they have been raised with.

Although opposition from groups and individuals like these has been fairly quiet following the HPV vaccination announcement, when the Ontario government announced an update to the sex education curriculum last year, there were protests. An unlikely alliance of mostly conservative Christian and Muslim parents formed in opposition, some withdrawing their children from the public school system and protesting outside the legislative building in Toronto. Inside that building, a bitter, personal debate erupted over sex education between Premier Kathleen Wynne and opposition legislator Monte McNaughton.

The lack of significant opposition to the HPV vaccination program is probably because it is voluntary. Unlike mandatory immunizations that students in Ontario public schools are required by law to have, the HPV vaccination is optional. Saying no will be as simple as a parent refusing to sign a consent form. Public health professionals and the government argue vaccination is a major preventative measure. The government news releases on the subject state there are approximately 1,090 cases of cancer and 254 deaths in Ontario each year caused by HPV. The admission by officials that teenagers are sexually active has been muted, but the announcement that immunization will now be offered to boys and moved from grade eight to grade seven implies there is a public health concern.

The HPV vaccine used in Canada most commonly is Gardasil, manufactured by Merck, or Cervarix made by GlaxoSmithKline. Both are approved by Health Canada. The actual vaccination clinics in schools will be run by local public health departments. This is another source of controversy. While the regular public school boards in Ontario do not usually oppose HPV immunization, some Roman Catholic school boards have objected in the past due to concerns it will encourage behavior contrary to church teaching. The challenge with this is that Roman Catholic school boards in Ontario are fully funded by the provincial treasury under constitutional protection.

Opinions for and against HPV vaccination of seventh graders in Ontario have (without much surprise) been most vocal, and not always very dignified, in the comment sections of news websites. Anti-vaccination commenters (aka anti-vaxxers) allege the plan is just a big conspiracy from the pharmaceutical industry, children are being used as “guinea pigs,” and the vaccine has led to devastating side effects for some who have had it. Social conservatives express concern about encouraging sexual promiscuity. Supporters of HPV vaccination defend it from a public health perspective and note that young people are sexually active, even if their parents and/or religion don’t like it. Some commenters who identify as parents say they wish the government had begun funding HPV vaccination for boys sooner and regret they had to pay out of pocket for their sons to receive it.

HPV vaccination programs also exist for girls in all other Canadian provinces and territories. Ontario joins Alberta and Prince Edward Island as the only provinces to offer it to boys.

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