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To jab or not to jab: confusion reigns over HPV

On September 24, Quebec joined the march of other Canadian provinces to provide free HPV vaccinations to schoolgirls. Almost immediately, women's health activists there due to safety concerns. Health Minister Philippe Couillard the voluntary program is safe. "We are not doing this just because there is a company with the vaccine on the market (or) ... because other provinces are doing it. We're doing it because it is in the interest of public health," he said.

Quebec's HPV drama echoes what's been happening across the country and around the world. A group of Canadian public health researchers published a commentary in the CMAJ voicing their concerns that we don't know enough about safety and efficacy of the jab in kids to rush through the vast immunization program we're seeing.

One of the authors, Dr Abby Lippman, : “I couldn’t understand why there was suddenly such a rush to do this when cervical cancer only kills about 400 people a year in Canada, and most of them are dying because of lack of treatment. I couldn’t see anything like the sort of evidence one would expect to support a decision like this.”

MDs on the frontlines have expressed concerned that, in light of the confusion, we should wait for more data (read Waterloo family doctor Dr Neil Arya's editorial on the subject ). On the other hand, an of physicians revealed that two thirds of Canadian MDs think we shouldn't wait if we can prevent cervical cancer.

Meanwhile, presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago showed that Gardasil appears to partially protect against 10 more HPV strains than was previously thought. These strains are responsible for 20% of cervical cancer lesions. The vaccine is currently indicated for strains 6, 11, 16 and 18.

One simply doesn't know what to think.

Nurse slain by MD ex inquest begins

Creepy. Obnoxious. Abusive.

That's how thoracic surgeon Dr Craig Pearce his former colleague Dr Marc Daniel (right), the anesthetist who stabbed his ex girlfriend Lori Dupont (below) to death at their workplace, Windsor's Hotel-Dieu Grace Hospital, in November 2005.

Dr Pearce is testifying at the coroner's inquest into Ms Dupon's death. Dr Daniel killed himself soon after the murder with an overdose of narcotics he is thought to have stolen from his own OR.

A picture of a toxic working atmosphere is emerging from the testimonies. Dr Pearce - who tried desperately to save Ms Dupont's life after finding her in a pool of blood in a recovery room - testified: "There are a number of obnoxious people who work in the OR. But there's obnoxious and there's abusive."

Nurses at the hospital contend Hotel-DieuGrace has a culture of "physician dominance" where abusive MDs like Dr Daniel are allowed to thrive.

"It was a tragic situation," Dr Pearce testified. "I and a lot of people did everything we could to try to save Lori, and we're sad that it didn't turn out in a different way."

Read of the story when it happened.

Images: Windsor Star

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