When Leah Smith presented the results of a large-scale study last week that found vaccinating girls against the human papillomavirus (HPV) doesn't lead them to rush out and have sex, quite a few people told her the basic premise of the research was stupid. Of course the HPV vaccine doesn't lead to risky sexual behaviour, they said. So why bother spending time and research dollars answering a question with such an obvious answer?
Well, because a surprising number of people continue to ignore some very basic realities about science and instead erroneously frame the debate about a public-health vaccination program as a moral quandary.
Some of those people include Mike Del Grande, chair of the Toronto Catholic District School Board. During his opening speech as chair earlier this month, Del Grande launched into a discussion about how too many Christians are giving in to secularization and making excuses for not following the "right way." And what is one of the big issues that Del Grande says will test the board's commitment to "faithfulness"? The HPV vaccination program, which he described as a "moral" issue.
The Calgary Catholic School District also stands out for posting a letter on its website stating there are "very important" moral and spiritual considerations about the vaccine. (Most school boards in Canada offer in-school HPV vaccination programs.)
The HPV vaccine is as much a moral and spiritual issue as is wearing sunscreen to prevent skin cancer. In fact, it is a slap in the face to science that instead of celebrating the fact that we now have access to a shot that can prevent the majority of cervical cancer cases, some people are caught up in a patronizing debate over whether allowing access to this medical breakthrough will corrupt the morals of the nation's young girls.
"I don't think morality should come into play at all. It's about preventing a very common infection," said Dr. Shelley Deeks, medical director of immunization and vaccine-preventable diseases at Public Health Ontario.
There are two HPV vaccines available in Canada – Gardasil and Cervarix – and they both protect against two strains of the virus that are responsible for 70 per cent of all cervical cancer cases. There is also mounting evidence that these vaccines protect against other types of cancer, including anal, vaginal, penile and some oropharyngeal cancers.
All provinces and territories offer publicly funded HPV vaccination programs, but so-called "moral" concerns mean that some students have not been able to access in-school vaccination programs. Until last year, for instance, the Halton Catholic District School Board in Ontario wouldn't offer the HPV vaccine to girls in its schools. It's worth highlighting that only Alberta and Prince Edward Island currently offer publicly funded HPV vaccines for boys, and there are growing calls for more provinces to follow suit. Conservative member of Parliament Peter Kent has been an outspoken advocate after being diagnosed with throat cancer caused by HPV.
The morality debate came about because the HPV vaccine is designed to prevent girls from contracting a very common sexually transmitted virus. It is most effective to vaccinate before girls become sexually active, which is why most programs are aimed at elementary school-aged pupils.
In the eyes of some, inoculating girls against a sexually transmitted virus is an open acknowledgment – even a tacit endorsement – that one day, those girls will become sexually active.
But guess what? Withholding a vaccine won't change that fact. The vast majority of human beings will engage in sexual activity over the course of their lives. As Dr. Joan Murphy, clinical lead of Cancer Care Ontario's cervical screening program points out, even girls that have one sexual partner throughout their lifetime face an HPV risk if they are with someone who has had more than one sexual partner.
Perhaps some of the board trustees and parents who fret over the message that the HPV vaccine sends should take a few minutes to stroll down the memory lane of their personal sexual history. It seems like a fair bet that a Catholic education and messages about abstinence didn't dissuade many from making certain decisions about sexuality. So why would they want to withhold a vaccine that could help protect girls – and boys – from future health problems that could potentially arise as the result of a normal, healthy part of life?
The research published by Smith and colleagues at Queen's University in the Canadian Medical Association Journal last week should offer relief to those who worry about the impact of the HPV vaccine. The study, based on a quarter of a million Ontario girls, found that the vaccine did not lead to an increase in risky sexual behaviour.
If anything, awareness about HPV, along with messages about other sexually transmitted infections and how to minimize risk, will help young people make better choices than the generation that came before.