Two months after introducing the HPV vaccine into the National Immunization Programme, the Japanese Ministry of Health, Labour, and Welfare (MHLW) suspended proactive recommendations for the vaccine due to reports of adverse events following immunization (AEFI) in the media. Despite the Vaccine Adverse Reactions Review Committee repeatedly concluding no evidence exists to suggest a causal association between the HPV vaccine and reported AEFI, uptake rates plummeting from >70% to <1%, a study of 70,000 vaccinated and unvaccinated women in Nagoya showing no statistical association between reported symptoms and the HPV vaccine and Japan being criticized by GACVS for its policy decisions, the MHLW has, to date, failed to reinstate proactive recommendations. This paper reviews the political, socio-cultural and health system factors that have led to such an unprecedented situation.
Government data and offline, online/social media are examined.
Firstly, the HPV vaccine was introduced without any forward planning or systematic investigation of parental concerns. Most educational materials were developed by pharmaceutical companies, none by the government, leading to an atmosphere of mistrust among the media and the public in general. Additionally, lack of precise epidemiological data based on a national surveillance system has meant the MHLW had not been able to carry out observed versus expected analyses to provide the public with incidence rates of purported side effects before and after introduction of the vaccine. Secondly, the MHLW has been hit with a better organized anti-vaccination movement who have gained control of the narrative through offline, online/social media, sensational video clips and highly publicized events. Furthermore, the MHLW has never refuted or criticized false media reports. Finally, the involvement of a few senior physicians proposing a new condition, HPV Vaccine Associated Neuropathic Syndrome (HANS), along with the involvement of a drug disasters monitoring NGO, who brought the case of HIV-contaminated blood products the most notorious drug scandal in Japan, to reconciliation in 1996, has meant most major Japanese media outlets present the HPV vaccine ‘victims’ in the same light as the hemophiliacs who developed AIDS after receiving the tainted blood products.
No vaccine safety signal has been recorded in Japan. Instead, individuals who have the misfortune to be unwell with rare or difficult to treat disorders have been encouraged by antivaccination advocates to blame the HPV vaccine, especially in an unrestrained media environment and with little reassurance and systematic addressing of these events by the government​.