Mothers who have not vaccinated their daughters for human papillomavirus (HPV) may be justified in waiting, according to sexual health groups.

The HPV vaccine Gardasil is being offered free of charge to Grade 5 girls across the province, but groups such as the Canadian Women’s Health Network are concerned that the government rushed the implementation of a national vaccination program when there are still questions about the vaccine.

“Normally, a vaccination program would take much longer to implement,” says Ellen Reynolds of the Canadian Women’s Health Network (CWHN). “A lot of questions that have been raised [in the approval process] still haven’t been answered.”

The health groups’ concerns are not shared by the rest of the medical community, says Sheila Murphy, a spokesperson for Gardasil’s manufacturer, Merck Frosst. She says the vaccine has already been approved in 110 countries.

The CWHN has just released an HPV fact sheet, which it will distribute via its website and newsletter. Reynolds says it will allow parents to make an informed decision about the vaccine by educating them about HPV and Gardasil.

This adds to the controversy that started when the Calgary Catholic School District decided not to partake in the school-wide vaccination program implemented in Alberta last fall. Bishop Fred Henry of the Roman Catholic Diocese of Calgary says that it would be seen as condoning premarital sex.

Local musician Tricia Edwards has a daughter who attends Catholic school. Her daughter has not been vaccinated, but for Edwards, the issue has nothing to do with the debate over premarital sex. Edwards says she is still weighing the benefits and risks of this vaccine because, among other things, it is still very new. She says that although the risk of side-effects may be small, it still appears to be there, and health officials don’t know how effective the vaccine will be in the long-term. “It makes this batch of girls guinea pigs,” Edwards says.

An international trial funded by Merck Frosst included over 20,000 women aged nine to 26. Laura Wershler of Sexual Health Access Alberta says that the trial only included about 1,200 girls in the nine to 15 age bracket, the targeted age for the national vaccination program. “It doesn’t provide adequate data to make solid claims about what we can expect. There are valid concerns about long-term outcome that have yet to be determined.”

Merck Frosst’s Sheila Murphy responds that the vaccination was approved by Health Canada for girls aged nine to 26. Asked if Merck Frosst considered it to be safe for girls aged nine to 15, she says, “It’s a scientific fact, it has been approved.”

One of the biggest unanswered questions for Reynolds has to do with the “real world” effectiveness of this new vaccine. “While there is definitely a link between HPV and cervical cancer, [Gardasil] hasn’t been proven to reduce the rate of cervical cancer.” She is worried that the vaccine will give young girls a false sense of security, and they won’t take important precautions such as regular pap testing and safe sexual practices.

Reynolds says she is also concerned “that the extensive marketing and lobbying by the drug’s manufacturer played a role in how quickly the federal government announced a national vaccination program in Canada.” In her opinion, the government didn’t allow for enough time for a public education campaign about the disease and vaccine.

While Edwards says she didn’t feel pressured to get her daughter vaccinated, Wershler is concerned that some parents will have a difficult time going against the grain, especially because of the intense marketing by Merck Frosst and the fact that respected organizations such as the Canadian Paediatric Society and Society of Obstetricians and Gynaecologists of Canada are wholeheartedly supporting the vaccine.

Wershler and Reynolds are also wondering if the government is putting funds in the right place with the vaccination program. They would like to see more money put into pap testing for high-risk segments of the female population, and education about prevention of HPV through safe sexual practices.

Wershler says she hopes the vaccination issue will open the door for parents to discuss all aspects of sexuality and sexual health with their children. Edwards has already begun to talk to her daughter about sexuality. “It’s such a dominant theme in our culture and society, it’s important to talk about it,” Edwards says.

“This is a decision that demands an informed choice. As women, we owe it to ourselves to do the research,” says Wershler.