The Surprising History of Opposition to HPV Vaccination in Japan

Opposition to HPV Vaccination in Japan

Human papillomavirus (HPV), cancer-causing viruses is the type we encounter most frequently. Studies have established that this virus, with more than 150 subtypes, is closely associated with many cancers, including cervical, vulvar, vaginal, anal, and head and neck cancers. HPV-related cancers are most effectively prevented by HPV vaccines. Although many studies have shown vaccination's substantial protective effect, particularly against cervical cancer , opposition to HPV vaccination in Japan has been observed. The cost of this attitude to Japan has been considerable: every year, 10.000 women receive a new cervical cancer diagnosis, and 3.000 die from the disease. Over the last 10 years, the uterine cancer-related death rate increased by %9.6.

HPV Vaccination Has Been an Important Issue in Japan's Recent History

A study was conducted toward the end of 2019 in response to the widespread claim in Japan that “the HPV vaccine is harmful.” The figures showed that cervical cancer incidence in Japan, compared with 1990, in 2017 showed a twofold increase . In 2017, 10.000 new cervical cancer cases were identified and approximately 2800 people died from the disease. By contrast, Australia, a world leader in HPV vaccination, provides the vaccine free to all children, and Australia is seen as the first country likely to almost eliminate cervical cancer in the future . Studies reiterated the role of HPV subtypes 16 and 18 in cervical cancer, and the HPV vaccine was found to be %95.93 successful . Subsequently, in March 2017, 71 countries included HPV vaccination in their National Immunization Program (NIP). In Japan, HPV vaccination became free in 2010 and, from 2013, included girls between 12 and 16 years old.

How Did Opposition to HPV Vaccination Begin in Japan?

Adverse effects observed following routine vaccination, such as injection-site pain, muscle pain, sleep disturbances, and sensitivity to light and sound, spread rapidly through Japanese and social media, triggering vaccine opposition. In June 2013, the Japanese government consequently stopped recommending HPV vaccination. Unfortunately, because these scientifically unsupported rumors spread quickly, vaccination rates rapidly fell from around %70 to below %1. Although HPV vaccines remain accessible, public opposition makes it difficult for families to decide. This will increase the medical costs of combating HPV-related cervical cancer and other associated diseases on a large scale and reduce quality of life. To resolve this uncertainty in Japan and base conclusions on scientific evidence, risk–benefit ratios following HPV vaccination were calculated. Even if publicly reported adverse effects such as chronic pain occurred, the HPV vaccine's benefits were shown to be much greater . Large-scale scientific studies support that the reported adverse effects are unrelated to HPV vaccination, yet circulating rumors will lead to very dangerous consequences in the coming years. To prevent this, the Japanese government has begun programs to raise public awareness of HPV. - Related topic: Forgetting what a disease looks like thanks to vaccines

When a Politician Becomes a Patient, the Balance Changes

In November 2019, ruling party member Junko Mihara, who had been diagnosed with cervical cancer and treated, said she wanted to give an informational talk about vaccination that summer. Together with eight other regional leaders, she signed a letter supporting HPV vaccination. The Ministry of Health subsequently stated in December that vaccination leaflets were being revised, but there was not yet any timeline for returning to regular vaccination.

When Social Media News Overtakes the “Facts”…

Because of misinformation in the media, girls and their families are not properly informed about vaccination and cannot make sound decisions. A study published on Monday, 11 February 2020, stated that approximately 11.000 people in Japan could die of cervical cancer unless the decision to suspend HPV vaccination in adult girls is reconsidered. Another study stated that without a change, over the next 50 years, 10.800 “preventable” cervical cancer cases could result in death. At this point, health institutions in particular need to educate the public and emphasize that the benefits far outweigh the risks. After the Japanese government resumes recommending HPV vaccination, it must act very carefully to prevent similar situations recurring. The adverse long-term consequences are not difficult to foresee now. Vaccinated girls and families should be informed about possible adverse effects and monitored. This can prevent confusion in society. As health professionals, we support the protection provided by HPV vaccination based on scientific data and believe Japan's mistake must be reversed as soon as possible.

• Why did Trump have to backtrack on his anti-vaccine statements?