In the fall of 2007, the Quebec Immunization Committee (CIQ) presented Minister Couillard with a scenario for the implementation of the program. This provides for the use of Gardasil, the only HPV vaccine approved by Health Canada for the moment.

On April 11, 2008, the MSSS announced the terms of application of the HPV vaccination program. Thus, from September 2008, those who will receive the vaccine free of charge are:

• girls of 4^e year of primary school (9 years and 10 years), as part of the school vaccination program against hepatitis B;
• girls of 3^e secondary (14 years and 15 years), as part of the vaccination against diphtheria, tetanus and pertussis;
• girls of 4^e and 5^e secondary;
• 9-year-old and 10-year-old girls who have left school (through designated vaccination centers);
• Girls aged 11 to 13 deemed to be at risk;
• girls aged 9 to 18 living in indigenous communities, where there is more cervical cancer.

It should be noted that girls aged 11 to 13 (5^e and 6^e years) will be vaccinated when they are in 3^e secondary. By the way, teenage girls from 4^e and 5^e will have to go on their own to the appropriate service units to receive the vaccine free of charge. Finally, people not targeted by the program can be vaccinated, at a cost of approximately CA $ 400.

One of the uncertainties about the HPV vaccination program relates to the vaccination schedule.

Indeed, the MSSS provides for a schedule that spans 5 years, for girls aged 9 and 10: 6 months between the first two doses and – if necessary – the last dose would be administered in 3^e secondary, i.e. 5 years after the first dose.

However, the schedule prescribed by the manufacturer of Gardasil provides for 2 months between the first 2 doses and 4 months between the second and third doses. So that after 6 months the vaccination is over.

Is it risky to change the vaccination schedule in this way? No, according to D^r Marc Steben from the National Institute of Public Health (INSPQ), who participated in formulating the CIQ’s recommendations.

“Our evaluations allow us to believe that 2 doses, in 6 months, will provide an immune response as great as 3 doses in 6 months, because this response is optimal in the youngest”, he indicates.

The INSPQ is also closely following a study currently being conducted by the University of British Columbia, which examines the immune response provided by 2 doses of Gardasil in girls under 12 years of age.

The announcement of a universal HPV vaccination program has raised a debate in Quebec, as in Canada elsewhere.

Some organizations question the relevance of the program due to the lack of precise data, for example the duration of vaccine protection or the number of booster doses that may be required.

The Quebec Federation for Planned Parenthood Rejects Priority Granted to Vaccination and Campaigns for Better Access to Testing². That is why she is asking for a moratorium on the implementation of the program.

The D^r Luc Bessette agrees. “By focusing on screening, we can treat real cancer,” he says. It will take 10 or 20 years to know the effectiveness of the vaccination. Meanwhile, we are not addressing the problem of women with cervical cancer who do not get screened and who will die this year, next year, or in 3 or 4 years. “

However, he does not believe that the HPV vaccine poses a health hazard.

One of the main benefits of the immunization program is that it will “break the inequity of dropping out of school,” says Dr Marc Steben. Dropping out of school is one of the main risk factors for HPV infection identified by the INSPQ¹.

“Because the immune system’s response to the vaccine is optimal in 9-year-old girls, immunization in elementary school is the best way to reach as many girls as possible before the risk of dropping out of school. “

In fact, over 97% of youth aged 7 to 14 attend school in Canada³.

Here is a table summarizing some arguments for and against an HPV vaccination program. This table is taken from a scientific article published in the English newspaper The Lancet, in September 2007⁴.