‘We won’t know the impact of this for a long time:’ Toronto school vaccine program for preventable cancers on the backburner

TORONTO — Throughout the pandemic, routine medical practices have been pushed to the backburner out of necessity, including immunizing children for preventable cancers.

Typically, students in Grade 7 and 8 receive their hepatitis B, meningococcal and human papillomavirus (HPV) vaccines at school to protect them from preventable illnesses, such as liver, cervical, head and neck cancers. Without immunization, about 75 per cent of sexually active Canadians will contract an HPV infection at some point in their lives.

The objective of bringing vaccines directly into schools is to reduce health inequities. This way, every Toronto student is protected, regardless of whether they have a family doctor.

Dr. Milena Forte, a family physician at Mount Sinai Hospital, has a son in Grade 8. Along with his classmates, he received first doses of the preventable cancer vaccine series pre-pandemic, but his second dose was postponed.

A Toronto District School Board (TDSB) spokesperson told CTV News Toronto that they were not aware of when the program would restart.

“Some of them will graduate out of the TDSB, some of them may become sexually active before their vaccinations happen, some of the families don’t even know that they haven’t completed their full course,” Dr. Forte said.

Toronto Public Health (TPH) told CTV News Toronto the nurses who normally administer these vaccines were redeployed amidst the pandemic response.

“TPH is working with the Ontario Ministry of Health to determine the best approach to have students who missed their vaccines in schools due to the pandemic, to be caught up in the 2021-22 school year,” says TPH spokesperson Dr. Vinita Dubey, associate medical officer of health.

At the moment, family physicians and pediatricians can order vaccines from TPH to get eligible patients immunized, Dr. Dubey said.

According to a TPH immunization update, once students graduate from high school, they lose their eligibility for the free vaccines and will have to pay out of pocket, which can cost up to $200 per dose.

“The whole reason this program exists as it does, jointly between TDSB and TPH, is because it’s a recognition,” Dr. Forte said. “The most effective and equitable way to administer them is through the school program.”

After conducting an informal survey, Dr. Forte said well over 50 per cent of the students at her son’s school have not received the second vaccine series.

Dr. Forte took the matter into her own hands and contacted TPH and TDSB to set up a pop up clinic at her son’s school and their sister school. She acquired the support of school administrators, on the condition that TPH was present for the immunizations, and organized a special order of the vaccines.

But then, after several weeks of planning, it all fell apart. TPH could not send someone to oversee the clinic because their resources were focused on the pandemic response.

“I’m really concerned there will be kids down the road who end up developing preventable cancers because these vaccination programs didn’t capture who they were meant to capture,” Dr. Forte said.

“I don’t think the impact of this we’ll know for a long time.”

Dr. Amanda Selk, a gynaecologist at Women’s College Hospital, points out that once the Grade 8 students graduate and move on to different high schools, vaccinating them as a cohort will be a challenge.

“People don’t think about these cancers,” Dr. Selk said. “Until they have a pre cancer or they’re sick, but we actually have ways to prevent them now if kids get immunized, which is amazing.”

Dr. Selk adds, “COVID-19 is important, we know, but we don’t want to forget about all the other advances we’ve made in health care.” 

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