Just one day before Ontario Premier Dalton McGuinty announced plans to offer a human papillomavirus vaccine to about 84,000 Grade 8 girls across the province, a paper published by the Canadian Medical Association Journal urged the government not to be so hasty in its attempt to fight cervical cancer.

The paper pointed to many "unanswered questions" about the vaccine, Gardasil, including how long it would protect a patient, whether a booster shot would be needed, how the HPV vaccine would interact with other immunizations, the potential bias of its clinical trials(which were supported by the manufacturer)and the high cost(the three required doses cost $404).

Not to mention the questionable demand. "There is no epidemic of cervical cancer in Canada to warrant the sense of urgency for a vaccination program," the paper says.

Researchers warn the HPV vaccine could even have "unintended negative consequences," including an increase in cervical cancer rates if a false sense of security leads young women to stop screening themselves regularly for cervical cancer.

Abby Lippman, an epidemiologist at McGill University, was the lead researcher on the study.

Macleans.ca: Were you surprised that the federal government earmarked $300 million in its last budget for the Gardasil HPV vaccine?

Abby Lippman: Oh yes, we all were. We knew that the vaccine had been approved and so on, but we did not expect that there would be an announcement [in March] from the Finance Minister [Jim Flaherty] of $300 million for this particular vaccine. I was just as surprised when I learned, sometime yesterday, that Dalton McGuinty was going to make his announcement.

M: So is that why you chose to look into Gardasil?

AL: We were sort of watching it quietly, and starting to think about what to do, and how to do it – and lo and behold, this happened. We geared ourselves up to look at this question, and we said to ourselves, "We have an opportunity to do it really right. We have an opportunity to figure out what we want to do to promote women’s sexual reproductive health. What, if any, is the place of this vaccine in it?" Because at that point, certainly in March, all of the information about the vaccine was being driven by the manufacturer [Merck & Co., Inc.] They were marketing that vaccine even before it was approved by the Food and Drug Administration.

M: Do you still find that’s the case now?

AL: Well, I don’t know who else is pushing it. And there’s another vaccine(Cervarix)that’s likely to be approved in North America soon; it’s been approved in Australia and in the European Union. I don’t know enough about it, but maybe that’s an even better vaccine for Canada, because they’re claiming that it covers a broader set of viral strains than Gardasil does. I think we should look at that. If it does, maybe we should be doing that.

What’s the goal of spending all this money? When people tell me it’s because we don’t want people to die of cervical cancer, I need to say: "Take a deep breath." Yes, 400 women may die of cervical cancer this year, and that’s 400 too many. But we do have a few things in place. One, most women [90 per cent] who are affected by the human papillomavirus clear it by themselves in one or two years. So as long as we’re healthy, in good shape, we have good nutrition, we’re not smoking, we’re practicing safer sex and so on, that’s number one.

Number two, we have Pap testing programs in place, which are not ideal - they’re not perfect and they need a lot of help - but they do pick up changes in the cells that would indicate what’s going to move on to cancer. No one who has ever had a Pap smear really likes them, but we need to make sure that, if people are going to be vaccinated, they don’t think that they’re now protected and don’t have to do any other things to keep themselves healthy.

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