OTTAWA - On the surface, it sounds like any another crowd-pleasing funding announcement in a budget filled to the brim with pre-election goodies. But if the experience south of the border is any indication, the proposal to spend $300-million to kickstart a Canada-wide immunization program to protect Canadian girls and women against the Human Papilloma Virus(HPV)could put Stephen Harper's government on a collision course with social conservatives.

The debate over using taxpayer money to vaccinate girls as young as nine years old against a sexually transmitted disease has been raging across the United States since last summer, when the FDA gave final approval for Merck Frosst's next-generation vaccine . 

Texas Governor Rick Perry set off a political firestorm by issuing an executive order that would mandate HPV immunization for all girls, beginning in sixth grade. The move outraged conservative groups, which accused Perry of going against the state's long-standing abstinence-based approach to sexual health education and violating the right of parents to raise their children as they see fit. 

Last month, Republican lawmakers in Arkansas fired back against a Democrat-backed proposal to provide Gardasil to girls as young as 12 by introducing a bill to prevent the state from requiring female students to be vaccinated against "sexually transmitted infections."  But similar resistance failed in Colorado after a legislative committee voted down a bill that would have made the vaccine mandatory for middle schoolers unless parents chose to "opt out" of the program. Virginia and New Mexico have also passed laws making the vaccine mandatory for female students - although in both cases, parents have the right to refuse.Meanwhile, the federally-administered Centers for Disease Control quietly added Gardasil to its Vaccines for Children Program, which provides free immunization to thousands of under- and uninsured children between nine and 18

In Canada, several provinces have been looking into the cost of adding Gardasil to existing immunization programs. And given the high cost of the vaccine - $300 per shot, with three treatments required for maximum effectiveness -  they welcomed the news that Ottawa would pick up part of the tab. Nova Scotia chief medical officer Robert Strang told the Halifax Daily News that the federal funding support means a program could be in place for girls between the ages of nine and 13 by this fall. Prince Edward Island Health Minister Chester Gillan told the CBC that his government also plans to take advantage of the offer. And a spokesperson for Ontario Health Minister George Smitherman told Macleans.ca that the announcement is "a positive development", but cautioned that further details on the funding arrangement is required before any decision on a program.

According to the Canadian Federation for Sexual Health, which has been campaigning to give Canadian women access to the vaccine since it got the nod from Health Canada last fall, the federal funding "came as a surprise."

"It's a welcome surprise, certainly," executive director Linda Capperauld told Macleans.ca. "We had no idea that it was going to be part of the budget, since not that much time has passed since it was approved. Most of our members have been focusing on provincial drug plans and it hadn't moved to the federal level."

Capperauld doesn't expect the vaccine to prove nearly as contentious as among Americans. "Just based on past experiences, it seems as though we are different from the United States when it comes to these issues," she said. "Ill be surprised if it becomes a huge debate. There are always going to be some people who believe that if you give young girls a shot, you'll make them feel like they should go out and have sexual relationships. But to deny young women this protection is irresponsible."

Early evidence suggests she might be right - up to a point. While the Canadian Family Action Coalition has campaigned against same-sex marriage, abortion and religious discrimination - many of the issues that have raised the hackles of the same US-based lobby groups at the forefront of the anti-Gardasil lobby - its director, Brian Rushfeldt, told Macleans.ca that he's willing to reserve judgement for now. But that will change if talk turns to making the vaccine mandatory.

"I haven't seen the details of the proposal yet," Rushfeldt said. "But if they're going to try to make it mandatory, it will be a battle for sure, and we will encourage people across Canada to file lawsuits to prevent their daughters from receiving this vaccination. If it isn't mandatory, we'll have to look at how they're going to provide it and promote it - and if there's no balance in the information, it needs to be opposed."

Rushfeldt called the notion of making any vaccine mandatory "repulsive," suggesting that decision by some U.S. states is draconian. "How could a government dare force the vaccination of all young girls?" he said. "I would compare it to what happened in Germany, for a government to impose that on its people."

Like U.S. conservatives, he also expressed concern about giving tacit endorsement of what he contends is the main cause of HPV infection: multiple sex partners for young girls.

Having been caught by surprise, as Capperauld was, Rushfeldt plans to ask Conservative MPs how the vaccine became a priority. "Did the drug companies come to their door?" he said. "Was there heavy lobbying?"

On that front, he may be onto something. During pre-budget consultations last fall, the Federation of Medical Women of Canada called on the government to invest in new vaccines - including Gardasil - and to move swiftly to establish a national HPV immunization program. Also making an appearance before the House finance committee was Merck Frosst, the company that produces the vaccine. Last month, Ken Boessenkool - formerly a senior policy advisor to then Opposition Leader Stephen Harper, now vice-president at Hill and Knowlton - registered to lobby on behalf of Merck on issues related to immunization. And at the same time that Boesenkool filed with the federal registry, H&K associate Bob Lopinski - a former senior advisor to Dalton McGuinty - registered to lobby the Ontario government on a proposal to "support a childhood immunization program for HPV and funding related thereto." 

In an interview with Macleans.ca, Merck spokesperson Sheila Murphy said that Boesenkool is working for Merck "on a range of issues," but wouldn't confirm whether that includes Gardasil. "I would imagine that it fits into that range, but I don't know for sure," she said. "Everybody and his dog appears before the Finance committee, but one never expects anything. We'll have to wait and see."

Perhaps mindful of the controversy that erupted in the U.S. after it was revealed that Merck had made sizeable campaign donations to several politicians who supported making the vaccine mandatory, Murphy refused to speculate as to whether the decision to fund the program was driven by the recommendations from the committee or more intensive lobbying in the ministerial backrooms. 

As both a former provincial health minister and a cancer survivor, NDP Health Critic Penny Priddy says she's "thrilled" that the vaccine is available. At the same time, she acknowledges some concerns over the lack of information on what the long-term effects of the vaccine could be.

"I don't know enough about the longitudinal research, so I would be very interested in making sure that, over time, there would be mandatory reporting of any side effects," Priddy told Macleans.ca. "But we don't even have mandatory reporting requirements around immunization."

Priddy says she's glad that the vaccine isn't yet mandatory and isn't slated to become part of the standard vaccination program for Canadian children. But she has little patience for the argument made by the vaccine's opponents in the United States.

"Those groups are debating whether it sends the wrong message and I'm not the least bit concerned about it," she told Macleans.ca. "That's what the same people say about access to birth control or even support programs for teen moms, which allow them to keep their babies. But I think before we start including it in children's vaccines, we should look into the long-term effects."

Priddy would also have liked to see at least some of the funds earmarked for education. "I don't think the answer to every sexually transmitted disease is to find a vaccine for it," she said. "Let's not keep shying way from education and preventing sexually transmitted diseases. After all, with this vaccine, you're immunized against cervical cancer - but not HIV/AIDS or other STDs." 

Overall, Canadian Cancer Society public affairs director Paul Lapierre says he's pleased by Monday's announcement. But he points out that since immunization falls under provincial jurisdiction, Ottawa's role will be limited to creating a trust from which provinces can draw funds. And as yet, not one province has made a formal commitment to implementing a wide-scale HPV vaccination program.

As for comparing the Conservative spending initiative to the U.S. controversy, he called it "apples and oranges."

"What we saw in the U.S. was a very different situation," he told Macleans.ca. "This is a product that was approved for use by Health Canada last year which is a bit expensive, but will prevent 70% of cervical cancers."

The reality, Lapierre said, is that young people are becoming sexually active at a "much younger age,"

"This is today's reality," he said. "And while there may be a debate amongst parents over whether my child is sexually active, it's crucial that we keep all our children as safe as possible."

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