Human Papillomavirus Vaccination by Birth Fiscal Year in Japan

Yagi A., Ueda Y., Oka E., et al. Human Papillomavirus Vaccination by Birth Fiscal Year in Japan. JAMA network open 7, e2422513 (2024); https://doi.org/10.1001/jamanetworkopen.2024.22513.Importance: The Ministry of Health, Labour, and Welfare (MHLW) of Japan aggregates human papillomavirus (HPV) vaccination data across Japan for each fiscal year (FY) by age at vaccination. Birth FY (BFY)-specific vaccination coverage remains unknown. Objective: To calculate the BFY-specific vaccination coverage for each FY and the cumulative first-dose coverage for each BFY in Japan, to understand the generation-specific vaccination coverage, and to estimate the cumulative first-dose coverage of each BFY that would be achieved by FY 2028 vs World Health Organization (WHO) targets. Design, Setting, and Participants: In this cross-sectional study, MHLW-published national age-specific HPV vaccination numbers and demographic data for female individuals were used to calculate the BFY-specific first-dose coverage for each FY and the BFY-specific cumulative first-dose coverage. It was assumed that the BFYs 2007 to 2012 vaccination coverage in FY 2023 to 2028 would remain the same as the vaccination coverage of the same grade in FY 2022 to estimate the cumulative first-dose coverage that would be achieved by FY 2028. Data analysis was performed from December 2023 to January 2024. Exposure: Two MHLW policy changes were the government's suspension of proactive recommendation for HPV vaccination in June 2013 and the government's resumption of proactive recommendation for HPV vaccination in April 2022. Main Outcomes and Measures: The primary outcome was generation-specific vaccination coverage among female individuals born in BFYs 1994 to 2010 in FYs 2010 to 2022, calculated using reconfigured published data. Results: In this study of vaccination data for 9 414 620 female individuals, the generation-specific vaccination coverage was 71.96% for the vaccination generation (BFYs 1994-1999), 4.62% for the vaccine-suspension generation (BFYs 2000-2003), 16.16% for the generation that received information individually (BFYs 2004-2009), and 2.83% for the vaccine-resumed generation (BFY 2010). HPV routine vaccination coverage was extremely low in BFYs 2000 to 2010 (0.84%-25.21%) vs BFYs 1994 to 1999 (53.31%-79.47%). The cumulative first-dose coverage that was estimated to be achieved in the vaccine-resumed generation by FY 2028 plateaued at 43.16%. Conclusions and Relevance: Even after the resumption of MHLW's proactive recommendations, HPV vaccination coverage has only minimally recovered in Japan. The cumulative first-dose coverage that was estimated to be achieved in the vaccine-resumed generation by FY 2028 is below the WHO target. These findings reveal that stronger cervical cancer control measures are required, particularly for the vaccine-resumed generation, which will plateau at approximately one-half the WHO target values

Even though active recommendation for HPV vaccination has restarted, Japan's rates have not recovered

Yagi A., Ueda Y., Oka E., et al. Even though active recommendation for HPV vaccination has restarted, Japan's rates have not recovered. Cancer Science , (2024); https://doi.org/10.1111/cas.16167.Japan has a particularly critical situation surrounding its collapsed HPV vaccination program for preventing HPV-caused cervical cancers, a problem exacerbated by the lack of a national immunization database. We have determined the year-to-year HPV vaccination uptake by Japanese females and analyzed by birth fiscal year (FY) the monthly number of people receiving initial HPV vaccination. Our analysis covers the period from the start of public subsidies in 2010 to September 2023, using data provided by local governments. We calculated the cumulative number of monthly immunizations for those unimmunized as of April (the beginning of each vaccination year). The monthly number of initial HPV vaccinations was highest in August for every FY from FY 2010 to FY 2023; a second vaccination peak tended to occur in March when the vaccination year ended. The highest number of August vaccinations occurred in FY 2011, followed (in order) by 2012, 2021, 2022, 2023, and 2013. In Japan's ongoing catch-up vaccination program for young women, the monthly number of vaccinations increased in August 2022 but then slowed the following year. After FY 2021, the cumulative vaccination coverage of subjects unvaccinated at the beginning of the vaccination year but subsequently covered by routine immunizations was slightly improved. FY 2021 was when the governmental recommendations for HPV vaccination were resumed. More recent vaccination rates are considerably lower than those in FY 2011–2012 when vaccinations were first fully endorsed. Paralyzing HPV vaccination hesitancy, which began in FY 2013, will linger in Japan in FY 2024

Health consciousness and cervical cancer screening rates in HPV-unvaccinated girls: comparison from HPV-recommended and HPV-recommendation-suspended program periods

In Japan, the vast majority of females between 13 and 24 are now unvaccinated for HPV and thus unprotected from HPV-caused cervical cancer. We analyzed the differences among these unvaccinated females regarding their understanding of the HPV vaccine, its role in cervical cancer prevention, and their need for cervical cancer screening–based on whether they refused vaccination when their government’s recommendation for HPV vaccination was still in effect (vaccination-recommended group)–or during the last 7 years, while the government suspension was in effect (recommendation-suspended group). The vaccination-recommended group understood more about the HPV vaccine and the best timing for HPV vaccination than the recommendation-suspended group (p < .0001 and p = .002, respectively). We found that girls in the vaccination-recommended group had more chances to talk with the family about cervical cancer and they were more afraid of acquiring the disease (p < .0001 and p < .0001, respectively). The girls in the recommendation-suspended group tended to feel more inhibited from talking about cervical cancer with friends and acquaintances (p = .0262). The cervical cancer screening rate of the vaccination-recommended group was significantly higher (p = .014)

Parental gender influences their intention to HPV vaccinate their children, and the association between HPV and COVID-19 vaccination intentions

Oka E., Ueda Y., Yagi A., et al. Parental gender influences their intention to HPV vaccinate their children, and the association between HPV and COVID-19 vaccination intentions. Vaccine: X 17, 100441 (2024); https://doi.org/10.1016/j.jvacx.2024.100441.Purpose: The coronavirus disease of 2019 (COVID-19) pandemic has increased public awareness of infectious diseases and interest in vaccines, including the human papilloma virus (HPV) vaccine. We investigated differences between parental gender and intentions to vaccinate their child for HPV and COVID-19. Methods: We analyzed data from Japan's COVID-19 and Society Internet Survey (JACSIS), a web-based cross-sectional survey of 2,444 respondents in 2021. Results: Females were more knowledgeable and more afraid of HPV and COVID-19 than males. The proportions of females in favor of, or against, HPV vaccination was higher than among males. The fathers’ intention for HPV vaccination was significantly associated with the child's gender, knowledge regarding HPV, and intention to inoculate with the COVID-19 vaccine. The mothers’ intention was also associated with her knowledge of HPV and her intention to seek the COVID-19 vaccine, but it included a greater fear of HPV infection. Both male and female parents favored the COVID-19 vaccine over the HPV vaccine. Parents approving of COVID-19 vaccination believed in the overall efficacy of vaccines and were more receptive to opinions from the administration and physicians, even if the parent was currently against HPV vaccination. Conclusions: Mothers were more knowledgeable about HPV and more favorable to vaccinate their child for HPV than fathers. The intention to have children COVID-19 vaccinated was also higher than for HPV vaccination. During this period of heightened public interest in vaccines due to the COVID-19 pandemic, this is a good time to educate and inform the public about HPV

Human papillomavirus vaccine to prevent cervical intraepithelial neoplasia in Japan: A nationwide case-control study

Ikeda, S, Ueda, Y, Hara, M, et al. Human papillomavirus vaccine to prevent cervical intraepithelial neoplasia in Japan: A nationwide case‐control study. Cancer Sci. 2020; 00: 1– 8. https://doi.org/10.1111/cas.14682

Epidemiologic profile of type-specific human papillomavirus infection after initiation of HPV vaccination

Funding Information: This work was supported by the Health and Labor Sciences Research Grant [26272001] and the Japanese Agency for Medical Research and Development [JP15ck0106103]. Acknowledgments: We would like to thank Yuka Watanabe, Sachiko Ono, Anna Ishida, Yoko Motoki and the administrator of Niigata city for their support in conducting the surveyPeer reviewedPublisher PD

Japan's Ongoing Crisis on HPV Vaccination.

Funding: This work was supported by the Health and Labor Sciences Research Grant [26272001] and the Japanese Agency for Medical Research and Development [JP15ck0106103]. Acknowledgments: We would like to thank Yuka Watanabe, Sachiko Ono, Anna Ishida, Yoko Motoki, Tomomi Egawa-Takata, Akiko Morimoto, Yusuke Tanaka and the administrator of Niigata city for their support in conducting the surveyPeer reviewedPublisher PD

Internet Survey of Awareness and Behavior Related to HPV Vaccination in Japan

Funding Information: Funding: This work was supported by the Health and Labor Sciences Research Grant No. 26272001 and the Japanese Agency for Medical Research and Development (JP15ck0106103).Peer reviewedPublisher PD

Long-term effectiveness of HPV vaccination against HPV infection in young Japanese women : Real-world data.

ACKNOWLEDGEMENTS We would like to thank Ms. Yuka Watanabe, Ms. Sachiko Ono, Ms. Anna Ishida, and the administrator of Niigata city for their support in conducting the surveyPeer reviewedPublisher PD

Long-Term Effects of Human Papillomavirus Vaccination in Clinical Trials and Real-World Data : A Systematic Review

Peer reviewedPublisher PD