WACC I-06ANALYSIS OF INFLUENCES AFTER SUSPENSION OF PROACTIVE RECOMMENDATION FOR HPV VACCINATION IN JAPAN

30. Advocacy, acceptability and psychology
E. Miyagi 1, Y. Motoki 1, Y. Suzuki 2, M. Asai-Sato 2, A. Sukegawa 1, T. Egawa-Takata 3, Y. Ueda 3, R. Kudo 4, M. Sekine 4, T. Enomoto 4, S. Hanley 5, R. Konno 6.
1Dept. of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine (Japan), 2Dept. of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine (Japan), 3Dept. of Obstetrics and Gynecology, Osaka University Graduate School of Medicine (Japan), 4Dept. of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences (Japan), 5Dept. of Women’s Health Medicine, Hokkaido University, Sapporo (Japan), 6Dept. of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Saitama (Japan)

Background / Objectives

Cervical cancer incidence and mortality among young Japanese women is increasing. Although HPV vaccination was implemented as a part of the national vaccine program from April 2013, Japanese governmental authorities suspended proactive recommendation of HPV vaccines two months later in July 2013, because of repeated media reports of adverse events after vaccination. We analyzed scientific reports concerning HPV vaccination in Japan published thereafter.


Methods

PubMed was used to find related articles. We divided about 30 topics into related categories (epidemiological topics, socio-medical studies, adverse events, etc.)  and analyzed the content.　


Results

 Epidemiological topics focused on the low uptakes of HPV vaccination for the targeted age-group after suspension of recommendations, and stressed the necessity of HPV vaccination in Japan considering low-uptakes of cervical cancer screening. Studies using a socio-medical approach revealed the enormous influence of the media and governmental attitudes on general citizens’ decision not to vaccinate adolescent girls against HPV. Reports concerning adverse events after HPV vaccination in Japan described various symptoms including Postural Orthostatic Tachycardia Syndrome (POTS) and/or Chronic Regional Pain Syndrome (CRPS). However, some investigator groups claimed that causality had not been proved at all. Related academics both within and outside Japan expressed their determinate support for HPV vaccines.


Conclusion

Restart of governmental recommendations for HPV vaccines is considered to be a minimum requirement to change the present negative recognition of HPV vaccines in Japan. In addtion, risk communication among health care providers, academics, citizens and the media are indispensable for the progress of cervical cancer prevention in Japan as a developed country.


References

Motoki Y, Miyagi E, et al. Increasing trends in cervical cancer mortality among young Japanese women below the age of 50 years: an analysis using the Kanagawa population-based Cancer Registry, 1975-2012. Cancer Epidemiol. 2015; 39: 700-6.

Hanley SJ1, et al. HPV vaccination crisis in Japan. Lancet. 2015; 27; 385:2571.

Egawa-Takata T, Ueda Y, Sekine M, Enomoto T, et al. Survey of Japanese mothers of daughters eligible for human papillomavirus vaccination on attitudes about media reports of adverse events and the suspension of governmental recommendation for vaccination. J Obstet Gynaecol Res. 2015, 41; 1965-71.

Kinoshita T, Ikeda S, et al. Peripheral sympathetic nerve dysfunction in adolescent Japanese girls following immunization with the human papillomavirus vaccine. Intern Med. 2014; 53: 2185-200.