Last fall, Brigitte Leclerc got her daughters immunized with a vaccine that protects against two strains of human papilloma virus (hpv), which is responsible for most cases of cervical cancer. She knew from painful experience just what was at stake.

Leclerc had surgery in June to remove a tumour from her cervix. Her operation went well, and after a long, anxious wait for test results, she’s learned that she doesn’t need chemotherapy. So when she heard about the vaccine ““ newly approved by Health Canada for girls and women aged nine to 26 and marketed under the name Gardasil ““ there was no question that Cindy, 17, and Nadia, 22, would get it. “I don’t want a doctor to tell them they might die,” says Leclerc, who lives just outside Montreal.

Now Leclerc is lobbying the Quebec government to cover the cost of the vaccine ““ about $500 for three shots ““ for preteen girls, who stand the best chance of benefiting if they’re immunized before they become sexually active. The vaccine has been approved since last July, but at press time no provincial health plan covered it.

The cost, and the fact not many people have heard of hpv and its link to cancer, means few parents have considered the vaccine for their daughters. Health professionals are working hard to change that. In fact, groups such as The Society of Obstetricians and Gynaecologists of Canada and Gardasil’s manufacturer, Merck Frosst Canada, are in the midst of a major marketing campaign to make people aware of the vaccine.

“Parents are going to have a hard time thinking of their nine-year-old daughter as a sexually active person. It’s something they want to push as far to the back of their minds as possible,” admits Dr. Barbara Romanowski, a University of Alberta expert in infectious diseases. “But they should view this vaccine as a gift to their children to protect them in the future.”

After breast cancer, cervical cancer is the second most common cancer in Canadian women aged 20 to 44. An estimated 1,400 new cases were diagnosed in 2006, and approximately 400 women were expected to die from the disease.

The bulk of those cases are caused by hpv, the most common sexually transmitted virus in the world. As many as three-quarters of sexually active men and women are infected by the virus at some point in their lives, but the good news is that the majority of them never suffer any ill effect. Most of the 100 strains of hpv cause no symptoms and disappear without treatment. The problem is with two strains that are responsible for 70 per cent of cases of cervical cancer, and another two that cause 90 per cent of ano-genital warts, which are spread through sexual contact and can be uncomfortable but do not cause cancer. The vaccine is effective against all four strains.

Merck Frosst recommends the vaccine for females between the ages of nine and 26. It says the side effects could include mild pain or swelling at the injection site, or fever. In February, Canada’s National Advisory Committee on Immunization recommended that Gardasil should ideally be administered to girls aged nine to 13, before the onset of sexual intercourse, and also to all girls and women aged 14 to 26, even if they are already sexually active.

Yet even before the recommendations were made, Dr. Lamont Sweet, Prince Edward Island’s chief health officer, was urging his province to add the vaccine to its list of free, routine immunizations that Grade 6 girls receive in school. “The immunity that it gives for cervical cancer is so important,” he says.

Sharon Oosthoek is a Toronto writer and editor and frequent contributor to the CBC, Canadian Family and ON Nature.