The Ontario, Canada, auditor general recently decided that an advertising campaign for a new human papillomavirus vaccination program in the province must be postponed until after the Oct. 10 election, the Toronto Star reports (Gillespie, Toronto Star, 9/18). Ontario officials last month said they plan to launch a program this fall that will provide Merck's HPV vaccine Gardasil at no cost to all eighth-grade girls in the province.

Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with HPV strains 16 and 18 cause about 90% of genital wart cases among women not already infected with these strains. Canada's health ministry, Health Canada, last year approved Gardasil for girls and women ages nine to 26.

The Canadian government in March announced that it is including about $258 million in the 2007-2008 budget to help pay for provincial HPV programs. The national government plans to provide 117 million Canadian dollars, or about $111 million, over three years for Ontario's program, which aims to vaccinate 85,000 eighth-grade girls this fall. Provincial officials plan to call on the national government for permanent funding (Kaiser Daily Women's Health Policy Report, 8/3).

According to the Star, the ads do not promote Gardasil but do talk about the connection between HPV and cervical cancer. They also provide information about the vaccination program in schools and encourage parents to look for the consent forms and to visit a Web site for more information.

Auditor General Jim McCarter decided that the ads broke rules that regulate government advertising that is allowed during an election, the Star reports. "We look very closely at [ads] they want to run during the writ period," McCarter said, adding that the only exceptions would be an "urgent" matter that affects public health and safety or something that is not offensive. An ad about girls and sex is bound to bring on a heated debate, he said.

A.G. Klei, a spokesperson for the Ontario Ministry of Health and Long-Term Care, said the ads will run after the election. In the meantime, the provincial government aims to reach parents and students using fact sheets that are being sent along with consent forms and brochures to public heath centers, the Star reports (Toronto Star, 9/18).

Catholic School Board Defeats Motion To Ban Program in Schools
According to the Star, several Catholic school boards across Ontario recently have received complaints about the HPV vaccination program. The Halton Catholic District School Board on Tuesday voted 4-3 to defeat a motion that would have banned health officials from administering the vaccine to its students during the 2007-2008 school year.

Trustees in favor of the motion said they were concerned the province implemented the program too soon before enough research was conducted to prove the vaccine's efficacy and safety. They said they also were concerned that students would be able to receive the vaccine against their parents' wishes. Trustee David Wilhelm said that the motion was too strong and that parents should have the ultimate decision to decide if their children will be vaccinated (Ogilvie, Toronto Star, 9/19).

"I'm not sure what elements of our Catholicity are being threatened here," Wilhelm said, adding, "What the bishops are telling us is that parents have the right and the responsibility to make these decisions for their children, and I don't think any of us have the right to take that away, as difficult as that may be." Oliver Carroll, chair of the Toronto Catholic District School Board, said trustees will vote on Wednesday on whether to ban the program in their district (Alphonso/Gandhi, Globe and Mail, 9/19). The Huron-Superior Catholic District School Board last week unanimously decided to delay implementing the program in its schools until it receives more information from the health ministry.

Ontario Premier Dalton McGuinty said the government hopes to conduct the program in schools because of convenience for girls and parents, but he added that if there is "a lot of resistance from a particular school board ... we can do it through public health" (Toronto Star, 9/19).

Opinion Piece
In a related Star opinion piece, Rondi Adamson, a Toronto-based writer, writes that the reaction to Gardasil has been "over-the-top." According to Adamson, Gardasil is being attacked on "several fronts," including safety concerns, a concern that HPV vaccination could lead to fewer women receiving Pap tests and that vaccinating young women against a sexually transmitted infection could cause them to become sexually active. "Risks are inherent with any medical discovery," Adamson writes, adding, "I'm not suggesting we should blithely accept what we are told without asking questions. Only that one would think that a vaccine that could prevent many cases of cancer among women would be welcome news, yes?" (Adamson, Toronto Star, 9/19).