Enacting Scientific Knowledge : A Case Study of the Japanese HPV Vaccine Crisis

Background: Human papillomavirus (HPV) is responsible for most cervical cancer cases. In Japan, the HPV vaccination coverage has dramatically fallen since the government suspended proactive recommendations for the vaccines in 2013, following sensational media reports on alleged adverse reactions. The suspension has not been lifted till today. The government has been criticized by medical establishment for lacking evidence-based policymaking. Grounded on the constructivist approach to scientific knowledge, the study examines how scientific knowledge has been enacted, interpreted, translated into policies by the government and the pro-vaccine institutions throughout the HPV vaccine crisis in Japan. Method: The study analyses the minutes of the governmental expert committee, as well as the proceedings, statements, and publications of three pro-vaccine and pro-resumption institutions. The analysis is conducted using the qualitative content analysis method. Results: The study shows that the government suspended recommendations based on an etiological uncertainty instead of epidemiological calculations and has prolonged the suspension based on the framing of HPV vaccination as an individual’s protection by choice in contrast to seeing it as a public health issue to be promoted in a national effort. It also shows that there is ample heterogeneity among the pro-vaccine and pro-resumption institutions in terms of grounds of arguments and scientific evidence they use to call for an early resumption of governmental recommendations for the HPV vaccines. Conclusions: The study shows a way to understand the Japanese government’s HPV vaccination policy over the past eight years, beyond criticizing it as lacking evidence that supports their policy. This analysis highlights the complexity of scientific knowledge, thus how contingently scientific knowledge come to be enacted as a basis for policy decisions, depending on the values and purposes the decision makers believes in

Hyaluronidase gene profiling and role of hyal-1 overexpression in an orthotopic model of prostate cancer

Hyaluronidase gene profiling and role of hyal-1 overexpression in an orthotopic model of prostate cancer. The mRNA levels of hyal-1, hyal-2, LUCA3 and PH20, the 4 hyaluronidases with demonstrated endoglucosaminidase activity, were extensively profiled in normal and tumor tissues and cell lines, using dot blot analysis and quantitative PCR. In normal tissues, hyal-1, hyal-2 and LUCA3 all showed unique patterns of mRNA expression, but were generally of widespread distribution, whereas PH20 mRNA was restricted to testes. In a small set of breast tumor samples, no elevations in hyal-1, hyal-2 or LUCA3 mRNA were seen. Hyaluronidase activity measured by a novel assay or zymography was also not elevated in sera from a number of breast cancer patients, compared to sera from normal volunteers. In ex vivo xenograft tumor cell lines, however, hyal-1 or hyal-2 mRNA levels were frequently elevated, whereas LUCA3 was only infrequently elevated and PH20 not at all. Two cell lines were engineered to overexpress hyal-1: a breast cancer line (CAL51) and a prostate cancer line (PC3M). Although the in vitro properties of the hyal-1 over-expressing cell lines were indistinguishable from the parental cells, the orthotopic growth of hyal-1 expressing PC3M cells in nu/nu mice resulted in significantly increased numbers of metastases, supportive of a role for hyal-1 in extravasation and metastatic tumor formation in this model of prostate cance