'A crisis': Health experts urge resuming school-based vaccine program for preventable cancers in Ontario

Koushik Mahamud, 9, gets his COVID-19 vaccination at a clinic as the campaign to vaccinate children aged 5-11 against COVID-19 continues, in Montreal, Friday, Nov. 26, 2021. THE CANADIAN PRESS/Ryan Remiorz

Toronto Public Health is running catch-up clinics this month for students who missed their preventable cancer vaccine series due to pandemic-related disruptions. But health experts urge that on top of city-run immunization clinics, school-based vaccine programs must resume in order to capture the wide-net of kids either partially vaccinated or entirely unvaccinated against preventable cancers.

Recent Public Health Ontario data reveals the severity of the situation – particularly for 12-year-olds eligible for the Human Papillomavirus (HPV) vaccine. Before the pandemic, 58 per cent of students were immunized against HPV. In the 2019-20 school year, that number plummeted below five per cent. The following year, it dropped to less than one per cent.

“The bottom line is it truly is a crisis,” said Dr. Vivien Brown, a family physician in Toronto and the chair of a task force addressing the necessity of reinstating school-based immunization programs in Ontario.

Prior to the pandemic, Hepatitis B, HPV and Meningococcal vaccines were administered at schools across the province to prevent liver, cervical, head and neck cancers. But since March 2020, that school-based program has been halted.

“It’s not just a vaccine to prevent an infection the way the COVID-19 vaccine is preventing COVID-19 infection. It’s actually preventing cancer. That’s something that I think gets lost,” Brown said.

In an effort to get back on track, TPH is offering these vaccinations at city-run clinics on an appointment-only basis. When CTV News Toronto asked if there was a timeline for reintroducing precancerous vaccination programs at schools, a spokesperson for TPH said that officials are working with stakeholders.

“TPH will continue to work with community stakeholders, including school boards, to consider how to provide the school vaccinations to grade 7-12 students,” a TPH spokesperson told CTV News Toronto.

“I think this is a great start,” said Dr. Milena Forte, a family physician at Mount Sinai Hospital. “But there's no doubt that what would be more effective is a return to school-based vaccination programs because we know it remains the most effective and equitable way to immunize.”

“It's just a matter of time until these numbers translate into increased cancers and cancer related deaths,” Forte said.

Students arrive for in-class learning at an elementary school in Mississauga, Ont., on Wednesday, January 19, 2022. THE CANADIAN PRESS/Nathan DenetteOn top of the challenge of reintroducing school-based programs is catching up with the three cohorts of kids – some of whom are now in high school, Brown points out – that are either not immunized or incompletely immunized.

“I think we need an in-school-based program as number one, but we also need the public health units to hold after school programs, we need mobile immunization clinics to go to certain areas, we need the primary care clinics and of course, pharmacies,” said Brown.

However, pharmacists can’t administer these vaccines, which Toronto-based pharmacist Allan Malek said has been frustrating. While pharmacies can deliver the COVID-19 vaccine along with flu shots, he says there is red tape up when it comes to preventable cancer vaccines.

“The logic just screams for increased accessibility closer to home during a very challenging time in the health system,” Malek said.

“It sounds so simple,” Brown said. “The government has the vaccine. Give it to the people who can immunize.”

“Immunization is a team sport….who actually is immunizing is not as important as the fact that there should be multiple points of access for a given individual.”