Catholic bioethical perspectives on Ontario’s HPV vaccination

N 17 OCTOBER 2007 A CATHOLIC SCHOOL board in northern Ontario — the Huron-Superior Catholic District School Board (H-SCDSB) — voted 5 to 4 to disallow within their schools the human papillomavirus vaccination programs for grade 8 girls that were being led by local public health units. As this was the only school board in On-tario to disallow the program (other school boards had close votes), the motivation and reasoning behind this decision have come under scrutiny and provoked debate. The H-SCDSB's decision rested on two concerns: that Gardasil (the only currently available HPV vaccine) might pose excessive medical risks, and that vaccinating girls against a sexually transmitted virus constituted " hypocrisy " in an educational system dedicated to teaching Catholic values, including sexual abstinence before marriage. 1 This decision meant that some Catho-lics in the region had to make alternative arrangements with the Algoma Public Health authority to obtain the vaccine for their daughters. Many families who commute to H-SCDSB schools do so from rural settings, and it is known that rural residence additionally challenges patients' ability to participate in health care programs. 2 This has had the effect of reducing the potential reach of the vaccination program to the target population of grade 8 girls in the Sault Ste. Marie area. Of broader concern is the fact that, even though H-SCDSB was the only school board to disallow an on-site vaccination program, various authorities have given moral direction against the vaccine in the name of Catholic beliefs. Foremost among these is the Ontario Conference of Catholic Bishops (OCCB), who in a letter to the province's Catholic educators affirmed the right of parents to decide whether to vaccinate their daughters , but also made non-scientific linkages between the vaccination program and sexual sin and warned parents about what the OCCB deemed to be insufficient scientific knowledge about the vaccine. 3 Thirty-two percent (or 674 970 students) of all Ontario's primary and secondary school students attend publicly funded Catholic schools, 4 and Ontario has so far seen an overall provincial participation rate in the vaccination program of less than 50% (and, in some regions, of only 28% 5). The HPV vaccination effort is falling short of its potential reach, and misinformation regarding the vaccine may continue to hinder the program's success. Informed non-participation in any public health program by any individual or group is perfectly legitimate. My real concern is …