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Lelliott M, Sahker E, Poudyal H. A Review of Parental Vaccine Hesitancy for Human Papillomavirus in Japan. J Clin Med 2023; 12:jcm12052004. [PMID: 36902790 PMCID: PMC10003921 DOI: 10.3390/jcm12052004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Globally, Japan has the lowest rate of vaccine confidence. The persistent parental vaccine hesitancy has been attributed to safety and efficacy concerns and is primarily driven by the negative experience with human papillomavirus (HPV) vaccines. This literature review aimed to identify factors associated with HPV vaccine uptake and potential strategies to reduce vaccine hesitancy among Japanese parents. Articles published in English or Japanese between January 1998 and October 2022 that examined Japanese parental factors for HPV vaccine uptake were identified from PubMed, Web of Science, and Ichushi-Web. In total, 17 articles met the inclusion criteria. Four key themes which affected HPV vaccine hesitancy and acceptance were identified: perceptions of risk and benefits, trust and recommendation, information and knowledge, and sociodemographic characteristics. While governmental and healthcare provider recommendations are important factors, efforts to improve parental confidence in the HPV vaccine are required. Future interventions to counteract HPV vaccine hesitancy should actively disseminate information on vaccine safety and effectiveness, along with information on the severity and susceptibility of HPV infection.
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Affiliation(s)
- Madoka Lelliott
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto 606-8501, Japan
| | - Ethan Sahker
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto 606-8501, Japan
- Population Health and Policy Research Unit, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Hemant Poudyal
- Population Health and Policy Research Unit, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Correspondence:
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Associations between Vaccination Behavior and Trust in Information Sources Regarding COVID-19 Vaccines under Emergency Approval in Japan: A Cross-Sectional Study. Vaccines (Basel) 2023; 11:vaccines11020233. [PMID: 36851111 PMCID: PMC9965898 DOI: 10.3390/vaccines11020233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
We examined the association between COVID-19 vaccination behavior and trust in COVID-19-related information sources during the initial period of COVID-19 vaccination in Japan. A cross-sectional survey was conducted in August 2021, 5 months after the start of COVID-19 vaccination for the general public under emergency approval. Participants were recruited using non-probability quota sampling from among Japanese residents who were under a declared state of emergency. Sociodemographic data, vaccination behavior, and levels of trust in eight media sources of information and three interpersonal information sources were assessed using an online survey form. A total of 784 participants completed the survey. The results of multiple logistic regression analysis showed that age, household income, underlying medical conditions, and living with family were significantly associated with COVID-19 vaccination behavior. Regarding COVID-19 vaccine information sources, trust in public health experts as a source of media information and primary care physicians as a source of interpersonal information showed significantly positive associations with COVID-19 vaccination behavior (odds ratio [OR] = 1.157, 95% confidence interval [CI] 1.017-1.31; OR = 1.076; 95% CI 1.006-1.150, respectively). Increasing trust in public health experts and primary care physicians and disseminating vaccine information from these sources will help promote vaccination under emergency approval.
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Lan Z, Zhang J, Li H, He R, Zhao Q, Yang F. Prevalence of human papillomavirus genotypes and related cervical morphological results in southern Hunan Province of China, 2018-2020: Baseline measures at a tertiary institution prior to mass human papillomavirus vaccination. Front Microbiol 2023; 13:1094560. [PMID: 36687652 PMCID: PMC9845708 DOI: 10.3389/fmicb.2022.1094560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/08/2022] [Indexed: 01/06/2023] Open
Abstract
Background Human papillomavirus (HPV) infection is closely correlated with cervical lesions. However, the HPV prevalence varies among different districts. This retrospective study investigated the HPV genotype distribution and its relationship with cervical lesions in southern Hunan Province. Methods The database at our Pathology Department was searched for HPV and morphological results during 2018-2020 were reviewed. A total of 49,955 gynaecological inpatients and outpatients, each of whom underwent HPV testing based on the amplification of L1 sequence and reverse dot blot hybridization, were included in this study. Available cytology and relevant histological examination results were reviewed. Enrolled cases were categorized into seven groups based on their age. Household registry and educational level were evaluated. Results Seven thousand two hundred eighty-six females were positive for HPV and the overall HPV positivity rate was 14.59%. The top five most prevalent HPV genotypes were HPV52, 16, 58, 53 and 51 (22.98%, 17.54%, 14.29%, 7.47%, and 5.70%, respectively). The HPV prevalence curve specific to the seven age groups showed a bimodal distribution. High school education or blow and rural residence served as risk factors for HPV infection. Single infection was the main type of HPV infection, and multiple infections occurred in 21.92% of the infected women. Of 3,148 cases had cytological results, 1,149 (36.50%) had abnormal cytological abnormalities. Among 2,833 participants with histological examination, 2000 (70.60%) had cervical abnormalities. Cytological and pathological abnormalities were mainly associated with infection with HPV16, 52 and 58. Further analysis found that HPV16, 58, 52 and 33 were the main genotypes associated with high-grade squamous lesions (HSIL) and that HPV16, 31, 33 and 58 were independent risk factors for HSIL (odd ratio [OR] = 1.70, 1.99, 2.59, 2.29; 95% CI = 1.41-2.03, 1.17-3.41, 1.88-3.59, 1.85-2.82; all p < 0.05). HPV16, 58, 52, 18 and 33 were the most frequent genotypes detected in squamous cell carcinoma (SCC) patients, and HPV16 and 18 were independent risk factors for cervical carcinomas (OR = 6.72;95% CI = 5.48-8.25; p < 0.001; OR = 1.67, 95% CI = 1.22-2.30; p = 0.001). Conclusion This retrospective study demonstrated the prevalence and the distribution characteristics of HPV infection and its correlation with cervical lesions in southern Hunan Province. The comprehensive results of this survey can guide HPV vaccine research to protect against some common genotypes in China.
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Affiliation(s)
- Zhihua Lan
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Jing Zhang
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Hongtao Li
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Rongfang He
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Qiang Zhao
- Department of Pathology, The First Affiliated Hospital, Hengyang Medical School of University of South China, Hengyang, China
| | - Fang Yang
- Department of Anorectal Surgery of Traditional Chinese Medicine, The First Affiliated Hospital, University of South China, Hengyang, China,*Correspondence: Fang Yang, ✉
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Imprecision in adverse event reports following immunization against HPV in Japan and COVID-19 in the USA, UK, and Japan-and the effects of vaccine hesitancy and government policy. Eur J Clin Pharmacol 2023; 79:269-278. [PMID: 36527455 PMCID: PMC9759036 DOI: 10.1007/s00228-022-03412-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Erroneous reports of adverse events following immunization (AEFIs) likely exacerbated the 2013 collapse of Japan's HPV immunization program. A similar phenomenon characterized the first months of COVID-19 immunization programs in the USA, UK, and Japan with high rates of reported anaphylaxis. These reports illustrate the susceptibility of supposedly objective medical judgments to public anxiety. PURPOSE AND METHODS This study documents inaccuracies in reported AEFIs using three quantitative methods. RESULTS One of these quantitative methods revealed that false-positive rates for anaphylaxis reports following HPV and later COVID-19 vaccination ranged from 74 to 91 percent. However, unlike HPV vaccinations in Japan, anaphylaxis reports following COVID-19 vaccines fell in Japan, the USA and the UK in the latter months of 2021. Nevertheless, false-positive rates for anaphylaxis reports remained high, suggesting a high degree of imprecision in serious AEFI reports from many countries for many vaccines. Japan's HPV immunization program indicates that media reports, patient hesitancy, healthcare providers' perspectives on vaccine safety, and consistency of government messaging, all influence report number and accuracy. A parallel publication analyzes in depth how such factors affect AEFI reports. CONCLUSION Confidence in the safety of the COVID-19 vaccines may have been bolstered trough rapid monitoring of AEFI reports and communication of these findings. This may partly explain the different trajectories of serious AEFI following HPV immunizations in Japan and COVID-19 immunizations in the USA, UK, and Japan.
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Effect of Different Educational Interventions on Knowledge of HPV Vaccination and Cervical Cancer among Young Women: A Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095191. [PMID: 35564586 PMCID: PMC9105621 DOI: 10.3390/ijerph19095191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/17/2022]
Abstract
The incidence and mortality rates of cervical cancer are rising among young women in Japan. In November 2021, the Japanese Ministry of Health, Labour, and Welfare reinstated the active recommendation for the human papillomavirus (HPV) vaccine, which was discontinued in June 2013 due to reports of adverse reactions, including chronic pain and motor dysfunction, following vaccination. However, vaccine hesitancy among the younger generation remains, and it is essential to identify the barriers in vaccination uptake. Therefore, we aimed to conduct a randomized study using different methods of providing educational contents to improve health literacy regarding cervical cancer and HPV vaccination among female students in Japan. Here, we present the results of our preliminary report and discuss current topics related to HPV vaccination in Japan. Data were collected from 27 female students—divided into three groups: no intervention, print-based intervention, and social networking service-based intervention—using the health literacy scale and communicative and critical health literacy scale. Our primary results indicate that participants’ knowledge and health literacy improved post-intervention. Therefore, medical professionals must provide accurate scientific knowledge regarding routine HPV vaccination and the risk of cervical cancer to young women to improve their health literacy and subsequently increase the HPV vaccination rates.
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Okuno H, Arai S, Suzuki M, Kikkawa T. Impact of Refutational Two-Sided Messages on Attitudes Toward Novel Vaccines Against Emerging Infectious Diseases During the COVID-19 Pandemic. Front Public Health 2022; 10:775486. [PMID: 35223726 PMCID: PMC8873109 DOI: 10.3389/fpubh.2022.775486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Two-sided messages that include two perspectives (i.e., risks and benefits) are more effective than one-sided messages that convey only one perspective (usually only the benefits). Refutational two-sided messages are effective for communicating risks regarding vaccines. To examine the effectiveness of refutational two-sided messages in risk communication regarding novel vaccines against emerging infectious diseases, we conducted the randomized controlled study based on a 3 × 3 × 2 mixed design (Intervention 1: vaccines against subcutaneous influenza, “novel severe infectious disease,” or intranasal influenza; intervention 2: one-sided, non-refutational two-sided, or refutational two-sided messages; two questionnaires) using a Japanese online panel. Participants completed questionnaires before and after receiving an attack message (negative information). We evaluated the impact of attack messages on the willingness to be vaccinated, and the anticipated regret of inaction (ARI). Among 1,184 participants, there was a significant difference in the willingness to be vaccinated among the message groups (p < 0.01). After receiving the attack message, willingness to be vaccinated decreased in the one-sided message group and increased in the non-refutational two-sided and refutational two-sided message groups. Additionally, ARI in the refutational two-sided message groups was significantly higher than in the one-sided groups (p = 0.03). In conclusion, two-sided messages are more effective than one-sided messages in terms of willingness to be vaccinated. Furthermore, the high ARI in the refutational two-sided message group indicated that refutational two-sided messages were more effective than one-sided messages for communicating the risks of vaccines, especially those against emerging infectious diseases.
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Affiliation(s)
- Hideo Okuno
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
- Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan
- *Correspondence: Hideo Okuno
| | - Satoru Arai
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Toshiko Kikkawa
- Faculty of Business and Commerce, Keio University, Tokyo, Japan
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Huang R, Gan R, Zhang D, Xiao J. The comparative safety of human papillomavirus vaccines: A Bayesian network meta-analysis. J Med Virol 2021; 94:729-736. [PMID: 34453758 DOI: 10.1002/jmv.27304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS The safety of human papillomavirus (HPV) vaccines, one of the major challenges to public vaccination, has been controversial. This study assessed the adverse reactions of various HPV vaccines, including bivalent HPV (2vHPV), quadrivalent HPV (4vHPV), and 9-valent HPV (9vHPV) vaccines. METHODS PubMed, Embase, and Central databases were searched for randomized controlled trials (RCTs) on the comparative safety of HPV vaccines. A network meta-analysis was performed based on the Bayesian framework random-effects model. RESULTS This study included 23 RCTs. Analysis across these reports indicated that the 2vHPV vaccine was associated with significantly more systemic adverse events than the 4vHPV vaccine (risk ratio [RR]: 1.28, 95% credible interval [CrI]: 1.14-1.44), 9vHPV vaccine (RR: 1.25, 95% CrI: 1.06-1.49), and placebo (RR: 1.31, 95% CrI: 1.18-1.46). However, there were no statistically significant differences in serious adverse events between the vaccinated and placebo groups. For injection-site adverse events, there were substantial inconsistencies between the direct and indirect effects; therefore, the analysis results of the safety were presented only for systemic and serious adverse events. CONCLUSIONS The 2vHPV vaccine resulted in more systemic adverse events than other vaccines and placebo. No significant differences in serious adverse events were observed. Further studies are needed to obtain more information regarding the safety of HPV vaccines.
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Affiliation(s)
- Rongdong Huang
- Center for Vaccine Clinical Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Ruihuan Gan
- Department of Preventive Dentistry, Affiliated Stomatological Hospital, Fujian Medical University, Fuzhou, China
| | - Dongjuan Zhang
- Center for Vaccine Clinical Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Jianxiong Xiao
- Center for Vaccine Clinical Research, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
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Mezza M, Blume S. Turning suffering into side effects: Responses to HPV vaccination in Colombia. Soc Sci Med 2021; 282:114135. [PMID: 34146986 DOI: 10.1016/j.socscimed.2021.114135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022]
Abstract
How do unpleasant post-vaccination symptoms become recognized as vaccine 'side effects'? In this paper, we argue that it is not necessarily the logical outcome of scientific verification that it is said to be. The paper draws on an ethnographic study carried out in a small town, El Carmen de Bolivar, on Colombia's Caribbean coast from February through May 2019. In 2014, hundreds of girls in the town reported a range of mysterious symptoms following mass vaccination against the Human Papilloma Virus (HPV). Denying the girls' insistence that their symptoms were due to the vaccine, the official diagnosis was Mass Psychogenic Illness. Comparing these events with studies of controversial responses to other vaccines, we suggest that the pathway from post-vaccination symptoms to 'side effects' is cognitively and socially complex. In particular, it is context-dependent. Drawing on research in medical anthropology, sociology and STS, we argue that the official diagnosis was influenced by the subjects' marginal status; by a projection of the region's violent past onto individual inhabitants; by health professionals' commitment to a restricted notion of evidence (devaluing patients' own accounts); and by an institutional inability or unwillingness to stand against 'global consensus', which deems HPV safe.
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Affiliation(s)
- Maurizia Mezza
- Amsterdam Institute for Social Sciences Research, University of Amsterdam, the Netherlands.
| | - Stuart Blume
- Amsterdam Institute for Social Sciences Research, University of Amsterdam, the Netherlands
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Impact of Media Coverage on Influenza Vaccine Coverage in Elderly Individuals from 2020 to 2021 in the Republic of Korea. Vaccines (Basel) 2021; 9:vaccines9040367. [PMID: 33920117 PMCID: PMC8070596 DOI: 10.3390/vaccines9040367] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022] Open
Abstract
Increased awareness of adverse events following immunization (AEFI) can disrupt vaccination programs. In South Korea, a report of alleged influenza vaccine-related deaths attracted significant media attention in 2020. We retrieved the vaccination coverage and AEFI data to determine their association with media coverage. Between 2015 and 2019, the vaccination coverage rate ranged between 80.5% and 83.3%; however, the vaccination coverage rate declined significantly from 2020 to 2021 to 73.6% (p < 0.0001). During the 43rd week of 2020, following a large amount of media coverage on vaccine safety issues, the number of cases with AEFI reached 60. Between 2015 and 2020, the mortality rate ratios for influenza vaccines and non-vaccines ranged between 0.1296 (95% confidence interval (CI), 0.1262–0.1331, p < 0.0001) and 0.1608 (95% CI, 0.1572–0.1644, p < 0.0001). Vaccine safety surveillance should be continued in conjunction with investigation and transparent risk communication to maintain public trust in vaccines and vaccinations.
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Das MK, Singh D, Sharma S. Media news on vaccines and vaccination: The content profile, sentiment and trend of the online mass media during 2015–2020 in India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.100691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Change Point Analysis for Detecting Vaccine Safety Signals. Vaccines (Basel) 2021; 9:vaccines9030206. [PMID: 33801188 PMCID: PMC8001699 DOI: 10.3390/vaccines9030206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022] Open
Abstract
It is important to detect signals of abrupt changes in adverse event reporting in order to notice public safety concerns and take prompt action, especially for vaccines under national immunization programs. In this study, we assessed the applicability of change point analysis (CPA) for signal detection in vaccine safety surveillance. The performances of three CPA methods, namely Bayesian change point analysis, Taylor’s change point analysis (Taylor-CPA), and environmental time series change point detection (EnvCpt), were assessed via simulated data with assumptions for the baseline number of events and degrees of change. The analysis was validated using the Korea Adverse Event Reporting System (KAERS) database. In the simulation study, the Taylor-CPA method exhibited better results for the detection of a change point (accuracy of 96% to 100%, sensitivity of 7% to 100%, specificity of 98% to 100%, positive predictive value of 25% to 85%, negative predictive value of 96% to 100%, and balanced accuracy of 53% to 100%) than the other two CPA methods. When the CPA methods were applied to reports of syncope or dizziness following human papillomavirus (HPV) immunization in the KAERS database, Taylor-CPA and EnvCpt detected a change point (Q2/2013), which was consistent with actual public safety concerns. CPA can be applied as an efficient tool for the early detection of vaccine safety signals.
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Skjefte M, Ngirbabul M, Akeju O, Escudero D, Hernandez-Diaz S, Wyszynski DF, Wu JW. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur J Epidemiol 2021; 36:197-211. [PMID: 33649879 PMCID: PMC7920402 DOI: 10.1007/s10654-021-00728-6] [Citation(s) in RCA: 322] [Impact Index Per Article: 107.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 01/21/2023]
Abstract
With the development of multiple effective vaccines, reducing the global morbidity and mortality of COVID-19 will depend on the distribution and acceptance of COVID-19 vaccination. Estimates of global vaccine acceptance among pregnant women and mothers of young children are yet unknown. An understanding of the challenges and correlates to vaccine acceptance will aid the acceleration of vaccine administration within these populations. Acceptance of COVID-19 vaccination among pregnant women and mothers of children younger than 18-years-old, as well as potential predictors, were assessed through an online survey, administered by Pregistry between October 28 and November 18, 2020. 17,871 total survey responses from 16 countries were obtained. Given a 90% COVID-19 vaccine efficacy, 52.0% of pregnant women (n = 2747/5282) and 73.4% of non-pregnant women (n = 9214/12,562) indicated an intention to receive the vaccine. 69.2% of women (n = 11,800/17,054), both pregnant and non-pregnant, indicated an intention to vaccinate their children. Vaccine acceptance was generally highest in India, the Philippines, and all sampled countries in Latin America; it was lowest in Russia, the United States and Australia. The strongest predictors of vaccine acceptance included confidence in vaccine safety or effectiveness, worrying about COVID-19, belief in the importance of vaccines to their own country, compliance to mask guidelines, trust of public health agencies/health science, as well as attitudes towards routine vaccines. COVID-19 vaccine acceptance and its predictors among women vary globally. Vaccination campaigns for women and children should be specific for each country in order to attain the largest impact.
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Affiliation(s)
- Malia Skjefte
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Michelle Ngirbabul
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Oluwasefunmi Akeju
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Daniel Escudero
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sonia Hernandez-Diaz
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | | | - Julia W Wu
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
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Okuhara T, Ishikawa H, Ueno H, Okada H, Kiuchi T. Examining Long-Term Effects of Human Papillomavirus Vaccine Recommendation Messages: A 4-Month Follow-Up Survey of a Randomized Controlled Study in Japan. Healthcare (Basel) 2020; 8:healthcare8040549. [PMID: 33321946 PMCID: PMC7763459 DOI: 10.3390/healthcare8040549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
We previously conducted a randomized controlled study to examine persuasive messages recommending HPV vaccination to mothers with daughters in Japan. That study showed that the three types of intervention message used (statistical information only, a patient’s narrative in addition to statistical information, and a mother’s narrative in addition to statistical information) all significantly improved mothers’ intention to have their daughter(s) receive the HPV vaccine, in comparison with mothers who received no messaging. The present study is a follow-up survey to assess the long-term effect of the intervention. Four months after the initial study, in January 2018, participants in the previous study were contacted and queried about their current intention to have their daughter(s) receive the HPV vaccine. Statistical analysis was conducted using the paired t-test and analysis of variance. A total of 978 mothers participated in the current survey. Vaccination intention 4 months after intervention had decreased to a level that did not differ significantly from the level prior to intervention in all three intervention conditions. The amount of change in vaccination intention 4 months after intervention did not differ significantly among the three intervention groups (p = 0.871). A single exposure to messaging was insufficient to produce a persistent intervention effect.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
- Correspondence: ; Tel.: +81-3-5800-6549
| | - Hirono Ishikawa
- School of Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan;
| | - Haruka Ueno
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
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Lübker CL, Lynge E. Stronger responders-uptake and decline of HPV-vaccination in Denmark. Eur J Public Health 2020; 29:500-505. [PMID: 30412236 PMCID: PMC6532829 DOI: 10.1093/eurpub/cky235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The purpose of this study was to identify the stronger responders behind the fluctuating coverage with the HPV-vaccine in Denmark in order to facilitate information campaigns targeted at specific subgroups. Methods Newspaper articles published from 2006 to 2009 with information about coverage with the HPV-vaccine in Denmark were identified from the database Infomedia.dk. Vaccination coverage of recent years was retrieved from the publically accessible statistics from the State’s Serum Institute. Data on average disposable income nationally and for each municipality was retrieved from Statistics Denmark. Results According to numbers published in newspapers, girls residing in municipalities with a high disposable income were the first ones to secure the HPV-vaccine in Denmark. Years later, at the start of the debate about possible side effects of the HPV-vaccine, the decline in vaccination coverage was slightly steeper for girls from high income municipalities than for girls from low income municipalities. Conclusions Girls from municipalities with a high disposable income seem to be the stronger responders of the fluctuating coverage with the HPV-vaccine in Denmark. This was the case both during the initial surge in coverage after the vaccine’s introduction on the market, and during the later decline following the debate on possible side effects. Identification of this dispersion pattern enables health authorities to initiate targeted information campaigns.
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Affiliation(s)
- Charlotte Lynderup Lübker
- Centre for Epidemiological Research, Nykøbing Falster Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Elsebeth Lynge
- Centre for Epidemiological Research, Nykøbing Falster Hospital, University of Copenhagen, Copenhagen, Denmark
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Kobayashi KI, Chanyasanha C, Sujirarat D. Parental decision-making on human papillomavirus vaccination for daughters in Japan. Int J Adolesc Med Health 2020; 33:95-105. [PMID: 32304302 DOI: 10.1515/ijamh-2018-0140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/06/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND In June 2013, the fear of adverse events compelled the government to withdraw its recommendation of the Human papillomavirus (HPV) vaccine. Since then, the rate of vaccination among Japanese girls has dropped dramatically. OBJECTIVE This study aims to assess how the Japanese government's policy change against HPV vaccination influenced the degree to which parents in remote areas in Japan accepted the vaccine for their daughters, and to analyze related factors. METHODS A self-administered questionnaire was distributed to parents with daughters attending secondary schools or high schools in two remote areas of the country. RESULTS Out of 700 eligible parents, 246 (35%) responded. The percentage of parents in the "accept group" (those whose daughters had already been vaccinated or those who intended to have their daughters vaccinated) dropped from 54% before the government withdrew its HPV vaccine recommendation to only 4.5% after the withdrawal (1.5% of whom intended to vaccinate and 3% of whom had already had their daughters vaccinated). Vaccine acceptance was higher in parents who were employed as healthcare workers, had been educated through to the completion of high school, had good levels of knowledge about cervical cancer and the HPV vaccine, had low perceived barriers against the HPV vaccine, and received high levels of social support. CONCLUSION The acceptance of HPV vaccination among parents was low overall. Higher acceptance may be possible if the government restores its recommendation and healthcare providers disseminate appropriate information about the HPV vaccination and cervical cancer.
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Affiliation(s)
- Ken-Ichiro Kobayashi
- Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Department of Infectious Diseases, Japanese Red CrossWakayama Medical Center, Wakayama, Japan
| | | | - Dusit Sujirarat
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailands
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Wong LP, Wong PF, Megat Hashim MMAA, Han L, Lin Y, Hu Z, Zhao Q, Zimet GD. Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia. Hum Vaccin Immunother 2020; 16:1611-1622. [PMID: 32429731 PMCID: PMC7482900 DOI: 10.1080/21645515.2020.1756670] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/11/2020] [Indexed: 12/27/2022] Open
Abstract
HPV vaccine hesitancy in Asia is unique compared to Western countries due to multidimensional social-cultural norms that influence beliefs regarding vaccination. Reviews on HPV vaccine hesitancy in Asia lack of in-depth discussion regarding the traditional and social-cultural norms dimensions. This paper puts forward opinions in which culture, normative beliefs, and religion influence HPV vaccine hesitancy in Asian countries. Issues surrounding HPV hesitancy among parents, young adult women, adult women, men and the sexual and gender minority people in Asian countries were highlighted. The shortage of HPV vaccine supply would soon be reduced as some Asian countries are on the way to producing the HPV vaccine which production is currently dominated by Western European countries. The culture of favoring imported Western products among many in Asia and in addition to long-existing fake vaccine crisis pose a challenge for the newly emerging HPV vaccine produced in Asia. Some recommendations, research gaps, and future research needs were discussed.
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Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pooi-Fong Wong
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Liyuan Han
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qinjian Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian Province, China
| | - Gregory D. Zimet
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, U.S
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17
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Bastian H. What the systematic review of HPV vaccine clinical study reports does, and does not, reveal: commentary on Jørgensen et al. Syst Rev 2020; 9:41. [PMID: 32106882 PMCID: PMC7047360 DOI: 10.1186/s13643-020-01299-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 06/14/2019] [Accepted: 02/18/2020] [Indexed: 12/02/2022] Open
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18
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Shimizu K, Sorano S, Iwai K. Vaccine hesitancy in Japan: Is the country well prepared for Tokyo 2020? Travel Med Infect Dis 2020; 34:101609. [PMID: 32112858 PMCID: PMC7129201 DOI: 10.1016/j.tmaid.2020.101609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/19/2020] [Accepted: 02/25/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Kazuki Shimizu
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom; Department of Health Policy, London School of Economics and Political Science, United Kingdom; Graduate School of Medicine, Hokkaido University, Japan.
| | - Sumire Sorano
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Kenji Iwai
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
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19
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Kitano T, Onishi T, Takeyama M, Shima M. Questionnaire survey on maternal pertussis vaccination for pregnant women and mothers in Nara prefecture, Japan. Hum Vaccin Immunother 2019; 16:335-339. [PMID: 31368853 DOI: 10.1080/21645515.2019.1651000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Infantile pertussis is a major concern and causes a significant health burden worldwide. Maternal adult tetanus, diphtheria, and acellular pertussis (Tdap) vaccination is very effective way of preventing infantile pertussis. However, Tdap has not been approved by the Japanese government or been included in Japan's national immunization program (NIP). We carried out a questionnaire survey to investigate whether Japanese women would accept the Tdap vaccination if they were provided with appropriate information.Methods: The questionnaire survey was administered to pregnant women who visited the Obstetrics and Gynecology Department and mothers who visited the Pediatrics Department of Nara Medical University, Kashihara City, Japan, between October 2018 and May 2019. The questionnaire included information about pertussis infection and maternal vaccination, followed by seven questions.Results: A total of 943 participants answered the questionnaire (481 pregnant women and 462 mothers). Before reading the information, just 4.6% of participants knew that infantile pertussis can be prevented by maternal vaccination. After reading the information, 93.0% and 92.6% of participants thought that the maternal Tdap vaccine should be approved by the Japanese government and be included in the NIP, respectively. Although only 67.6% of participants wished to have the maternal Tdap vaccine without government financial support after reading the information, 92.5% said they would have the vaccine with government support (P < .001).Conclusion: Most Japanese mothers and pregnant women would like the maternal Tdap vaccine to be approved by the government and included in the NIP, once they have been provided with appropriate information.
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Affiliation(s)
- Taito Kitano
- Department of Pediatrics, Nara Medical University, Kashihara-shi, Japan
| | - Tomoko Onishi
- Department of Pediatrics, Nara Medical University, Kashihara-shi, Japan
| | - Masahiro Takeyama
- Department of Pediatrics, Nara Medical University, Kashihara-shi, Japan
| | - Midori Shima
- Department of Pediatrics, Nara Medical University, Kashihara-shi, Japan
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20
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Newspaper coverage before and after the HPV vaccination crisis began in Japan: a text mining analysis. BMC Public Health 2019; 19:770. [PMID: 31208394 PMCID: PMC6580608 DOI: 10.1186/s12889-019-7097-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 05/31/2019] [Indexed: 11/26/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccination coverage rate has fallen sharply in Japan since 2013, when newspapers began covering negative campaigns against the vaccination. We examined and compared contents from newspaper articles before and after the start of this HPV vaccination crisis. Methods We collected articles published between January 2005 and September 2017 in the four daily national Japanese newspapers with the highest domestic circulation. We then conducted text mining analysis to chronologically examine content distribution. Results From among the 1178 articles analyzed, 12 types of contents were identified. Contents related to cervical cancer prevention, such as on the risk of developing cervical cancer, causes of cervical cancer, and the effects of vaccination, were frequently conveyed until 2012. However, after March 2013, they were replaced with anti-vaccination contents, such as on adverse effects to vaccines, alleged victims, and related lawsuits. Meanwhile pro-vaccination contents, such as safety statements from the World Health Organization, scarcely received coverage. Conclusions Newspaper contents changed profoundly before and after the start of the vaccination crisis. Those newspaper reports potentially had impact on readers’ beliefs and actions. Journalists should strive for impartial coverage so readers can make more-informed decisions. Health professionals should be expected to work with journalists to help improve impartiality in newspaper coverage. The Ministry of Health, Labour and Welfare should discus benefits and risks of the HPV vaccination based on the scientific evidences, and consider to resume the proactive recommendation of HPV vaccination. Well-organized advocacy among medical societies, scientists and health professionals will also be needed to influence the government.
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21
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Prue G, Grimes D, Baker P, Lawler M. Access to HPV vaccination for boys in the United Kingdom. MEDICINE ACCESS @ POINT OF CARE 2018. [DOI: 10.1177/2399202618799691] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Gillian Prue
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
- HPV Action, Rugby, UK
| | - David Grimes
- School of Mathematics and Physics, Queen’s University Belfast, Belfast, UK
| | | | - Mark Lawler
- HPV Action, Rugby, UK
- European Cancer Concord and Centre for Cancer Research & Cell Biology, Queen’s University Belfast, Belfast, UK
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22
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Ozawa N, Ito K, Tase T, Shibuya D, Metoki H, Yaegashi N. Lower Incidence of Cervical Intraepithelial Neoplasia among Young Women with Human Papillomavirus Vaccination in Miyagi, Japan. TOHOKU J EXP MED 2018; 243:329-334. [PMID: 29269635 DOI: 10.1620/tjem.243.329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The Japanese national immunization programme for Human Papillomavirus (HPV) started in 2010. Vaccination rates increased up to 70% in women in the 1996-1999 birth. However, the proactive recommendation for HPV vaccine was suspended in 2013, following repeated media reports of adverse events. Vaccination rates plumped to less than 1% in women born since 2002. In this study, incidence of abnormal cytology and histology was examined in terms of HPV vaccination among 5,924 women aged 20 to 24 years in the fiscal year (FY) 2014 and 2015. The total rate of vaccination was 16.9% (1,002/5,924). In case of FY 2015, the rates of vaccination were 59.26%, 49.68%, 11.97%, 9.08%, and 4.58% in those aged 20, 21, 22, 23, and 24 years old, respectively. The rates of high-grade squamous intraepithelial lesion (HSIL) or worse were 0.20% (2/1,002) in women with HPV vaccination and 1.14% (56/4,922) in those without HPV vaccination, indicating a significant reduction of 82.46% with vaccination (P < 0.0001). The rates of cervical intraepithelial neoplasia (CIN) 1+ were 0.80% (8/1,002) in women with vaccination and 2.28% (112/4,922) in those without vaccination. The reduction rate of CIN1+ was 64.91% (P = 0.0025). The rates of CIN2+ were 0.10% (1/1,002) with vaccination and 0.69% (34/4,922) without vaccination. The reduction rate of CIN2+ was 85.51% (P = 0.0261). Our data are the first to demonstrate a significant reduction of CIN2+ cases in an Asian population. Scientific discussion is needed to restart the proactive recommendation for HPV vaccine in Japan.
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Affiliation(s)
| | - Kiyoshi Ito
- Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science, Tohoku University
| | - Toru Tase
- Department of Gynecology, Miyagi Cancer Center
| | | | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine
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23
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Ameratunga R, Langguth D, Hawkes D. Perspective: Scientific and ethical concerns pertaining to animal models of autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA). Autoimmun Rev 2018. [DOI: 10.1016/j.autrev.2017.11.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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24
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Tanaka Y, Ueda Y, Egawa-Takata T, Yagi A, Yoshino K, Kimura T. Outcomes for girls without HPV vaccination in Japan. Lancet Oncol 2018; 17:868-869. [PMID: 27396634 DOI: 10.1016/s1470-2045(16)00147-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Yusuke Tanaka
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Tomomi Egawa-Takata
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Asami Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Kiyoshi Yoshino
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
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25
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Okuhara T, Ishikawa H, Okada M, Kato M, Kiuchi T. Contents of Japanese pro- and anti-HPV vaccination websites: A text mining analysis. PATIENT EDUCATION AND COUNSELING 2018; 101:406-413. [PMID: 29031425 DOI: 10.1016/j.pec.2017.09.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/22/2017] [Accepted: 09/23/2017] [Indexed: 05/13/2023]
Abstract
OBJECTIVE In Japan, the human papillomavirus (HPV) vaccination rate has sharply fallen to nearly 0% due to sensational media reports of adverse events. Online anti-HPV-vaccination activists often warn readers of the vaccine's dangers. Here, we aimed to examine frequently appearing contents on pro- and anti-HPV vaccination websites. METHODS We conducted online searches via two major search engines (Google Japan and Yahoo! Japan). Targeted websites were classified as "pro," "anti," or "neutral" according to their claims, with the author(s) classified as "health professionals," "mass media," or "laypersons." We then conducted a text mining analysis. RESULTS Of the 270 sites analyzed, 16 contents were identified. The most frequently appearing contents on pro websites were vaccine side effects, preventable effect of vaccination, and cause of cervical cancer. The most frequently appearing contents on anti websites were vaccine side effects, vaccine toxicity, and girls who suffer from vaccine side effects. Main disseminators of each content according to the author's expertise were also revealed. CONCLUSION Pro-HPV vaccination websites should supplement deficient contents and respond to frequent contents on anti-HPV websites. PRACTICE IMPLICATIONS Effective tactics are needed to better communicate susceptibility to cervical cancer, frequency of side effects, and responses to vaccine toxicity and conspiracy theories.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Masahumi Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Mio Kato
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
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26
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Suzuki S, Hosono A. No association between HPV vaccine and reported post-vaccination symptoms in Japanese young women: Results of the Nagoya study. PAPILLOMAVIRUS RESEARCH 2018; 5:96-103. [PMID: 29481964 PMCID: PMC5887012 DOI: 10.1016/j.pvr.2018.02.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/29/2018] [Accepted: 02/22/2018] [Indexed: 11/26/2022]
Abstract
Nagoya City introduced free HPV vaccination in 2010 and in April 2013 the Ministry of Health, Labour and Welfare included the HPV vaccine in the National Immunization Program. However, in June 2013, the Ministry suspended proactive recommendation of the vaccine after unconfirmed reports of adverse events. To investigate any potential association between the vaccine and reported symptoms, Nagoya City conducted a questionnaire-based survey. Participants were 71,177 female residents of Nagoya City born between April 2, 1994 and April 1, 2001. The anonymous postal questionnaire investigated the onset of 24 symptoms (primary outcome), associated hospital visits, frequency, and influence on school attendance. Totally, 29,846 residents responded. No significant increase in occurrence of any of the 24 reported post-HPV vaccination symptoms was found. The vaccine was associated with increased age-adjusted odds of hospital visits for “abnormal amount of menstrual bleeding” (OR: 1.43, 95% CI: 1.13–1.82), “irregular menstruation” (OR: 1.29, 95% CI: 1.12–1.49), “severe headaches” (OR: 1.19, 95% CI: 1.02–1.39), and chronic, persisting “abnormal amount of menstrual bleeding” (OR 1.41, 95% CI: 1.11–1.79). No symptoms significantly influenced school attendance and no accumulation of symptoms was observed. The results suggest no causal association between the HPV vaccines and reported symptoms. A large-scale epidemiological study on HPV vaccination and reported post vaccination symptoms was performed. Age-adjusted analyses found no significant association between HPV vaccines and occurrence of the 24 reported symptoms. Increased odds of hospital visits for some symptoms is unlikely to be due to any biological association.
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Affiliation(s)
- Sadao Suzuki
- Department of Public Health, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 466-8601, Japan.
| | - Akihiro Hosono
- Department of Public Health, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 466-8601, Japan
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Okuhara T, Ishikawa H, Okada M, Kato M, Kiuchi T. Readability comparison of pro- and anti-HPV-vaccination online messages in Japan. PATIENT EDUCATION AND COUNSELING 2017; 100:1859-1866. [PMID: 28532860 DOI: 10.1016/j.pec.2017.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/14/2017] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE In Japan, the HPV vaccination rate has sharply fallen to nearly 0% due to a series of sensational media reports of adverse events. Online anti-HPV-vaccination activists often warn readers of the vaccine's dangers. We aimed to examine distribution and readability of pro-and anti-vaccination online messages with relation to these authors' professional expertise. METHODS We conducted online searches via two major search engines. Identified sites were classified as "anti," "pro," or "neutral" depending on their claims, and "health professional" or "non-health professional" depending on their authors' expertise. Readability was determined using a validated measure of Japanese readability. Statistical analysis was conducted using two-way analysis of variance and Tukey's test. RESULTS Of the total 270 sites analyzed, up to 137 (50.7%) were deemed anti- and 101 (37.4%) pro-HPV-vaccination. Of the pro-vaccination sites 71% were written by health professionals. Anti-vaccination messages were found to be considerably easier to read than pro-vaccination ones; both among those by health professionals and non-health professionals. CONCLUSION Our findings substantiate concern that the anti messages may serve to prolong the HPV vaccination crisis. PRACTICE IMPLICATIONS We recommend that health professionals use readability assessment tools and improve the text for easier reading if necessary.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Masahumi Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Mio Kato
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
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28
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Kim HJ, Kim HJ. Current status and future prospects for human papillomavirus vaccines. Arch Pharm Res 2017; 40:1050-1063. [PMID: 28875439 DOI: 10.1007/s12272-017-0952-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 08/24/2017] [Indexed: 01/08/2023]
Abstract
Cervical cancer is the fourth most frequent cancer among women worldwide. Human papillomaviruses (HPVs) cause almost all cervical cancers in low-income countries. Three prophylactic HPV virus-like particle-based vaccines have been licensed to date, and they have all shown high efficacy and reliable safety profiles. However, isolated safety issues have resulted in a reluctance to use these vaccinations. In addition, the high prices of the vaccinations have caused the inequitable distribution of the vaccine: the prices are unaffordable for low-income countries. Meanwhile, great effort has been put into the development of therapeutic HPV vaccines, including protein/peptide-, live vector-, DNA- and cell-based vaccines. These new vaccines have considerable therapeutic potential but limited practical use. The development of immune checkpoint inhibitors and personalized immunotherapy remain challenges for future study. In this article, the current status of the licensed vaccines, therapeutic HPV vaccines and biosimilars, and new platforms for HPV vaccines, are reviewed, and safety issues related to the licensed vaccines are discussed. In addition, the prospects for HPV vaccines are considered.
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Affiliation(s)
- Hyoung Jin Kim
- Laboratory of Virology, College of Pharmacy, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, South Korea
| | - Hong-Jin Kim
- Laboratory of Virology, College of Pharmacy, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, South Korea.
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Ogawa Y, Takei H, Ogawa R, Mihara K. Safety of human papillomavirus vaccines in healthy young women: a meta-analysis of 24 controlled studies. J Pharm Health Care Sci 2017; 3:18. [PMID: 28702209 PMCID: PMC5504559 DOI: 10.1186/s40780-017-0087-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccines have been shown to be effective for the eradication of HPV and prevention of cervical cancer. However, the number of women who receive HPV vaccinations has decreased over the last several years in Japan, due to concerns about adverse reactions associated with the vaccines. We evaluated the safety of three types of HPV vaccines separately in young women and the difference in the risk of adverse reactions between HPV and other vaccines by conducting a meta-analysis. METHODS Primary literature was retrieved from MEDLINE, the Cochrane Central Register of Controlled Trials, and Japana Centra Revuo Medicina. Prospective controlled studies with participants consisting exclusively of healthy women who received bivalent, quadrivalent, or 9-valent HPV (2vHPV, 4vHPV or 9vHPV) vaccines were included. Primary safety outcome was the incidence of solicited local and systemic symptoms, and unsolicited symptoms. When two or more studies were found for the same analysis, a meta-analysis was applied. RESULTS A total of 24 controlled studies from 22 articles were included in our study. Of the 24 studies, 16 were placebo-controlled and eight were active-controlled (different HPV vaccine or hepatitis vaccine). Average ages of the participants ranged from 12 to 37 years. A significantly higher incidence of solicited local symptoms was observed following injection of HPV vaccines (2vHPV and 4vHPV) compared to placebo, but there was no difference between HPV vaccines [risk ratio (RR) for 2vHPV: 1.25, 95% confidence interval (CI): 1.09 to 1.43, RR for 4vHPV: 1.16, 95% CI: 1.11 to 1.20]. The incidence of solicited systemic symptoms was not different between HPV vaccines and placebo (RR: 1.04, 95% CI: 0.99 to 1.09). The incidence of unsolicited symptoms was significantly higher for 2vHPV vaccine compared to placebo (RR: 1.28, 95% CI: 1.01 to 1.63), but was not significantly different between 2vHPV and hepatitis B vaccines. CONCLUSIONS HPV vaccines had significantly higher risk of any injection site symptom compared to placebo or other vaccines (hepatitis A and B vaccines), and the incidence of solicited local symptoms was no difference between 2vHPV vaccination and 4vHPV vaccination. However, the most adverse reactions were transient.
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Affiliation(s)
- Yukari Ogawa
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Musashino University, 1-1-20 Shinmachi Nishitokyo-shi, Tokyo, 202-8585 Japan
| | - Hinako Takei
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Musashino University, 1-1-20 Shinmachi Nishitokyo-shi, Tokyo, 202-8585 Japan
| | - Ryuichi Ogawa
- Department of Pharmacotherapy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose-shi, Tokyo 204-8588 Japan
| | - Kiyoshi Mihara
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Musashino University, 1-1-20 Shinmachi Nishitokyo-shi, Tokyo, 202-8585 Japan
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Tanaka Y, Ueda Y, Kimura T. Struggles within Japan's national HPV vaccination: A proposal for future strategy. Hum Vaccin Immunother 2017; 13:1167-1168. [PMID: 28059676 PMCID: PMC5443375 DOI: 10.1080/21645515.2016.1267085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yusuke Tanaka
- a Department of Obstetrics and Gynecology , Osaka University Graduate School of Medicine , Suita , Osaka , Japan
| | - Yutaka Ueda
- a Department of Obstetrics and Gynecology , Osaka University Graduate School of Medicine , Suita , Osaka , Japan
| | - Tadashi Kimura
- a Department of Obstetrics and Gynecology , Osaka University Graduate School of Medicine , Suita , Osaka , Japan
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Okuhara T, Ishikawa H, Okada M, Kato M, Kiuchi T. Assertions of Japanese Websites for and Against Cancer Screening: a Text Mining Analysis. Asian Pac J Cancer Prev 2017; 18:1069-1075. [PMID: 28547943 PMCID: PMC5494218 DOI: 10.22034/apjcp.2017.18.4.1069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background: Cancer screening rates are lower in Japan than in Western countries such as the United States and the United Kingdom. While health professionals publish pro-cancer-screening messages online to encourage proactive seeking for screening, anti-screening activists use the same medium to warn readers against following guidelines. Contents of pro- and anti-cancer-screening sites may contribute to readers’ acceptance of one or the other position. We aimed to use a text-mining method to examine frequently appearing contents on sites for and against cancer screening. Methods: We conducted online searches in December 2016 using two major search engines in Japan (Google Japan and Yahoo! Japan). Targeted websites were classified as “pro”, “anti”, or “neutral” depending on their claims, with the author(s) classified as “health professional”, “mass media”, or “layperson”. Text-mining analyses were conducted, and statistical analysis was performed using the chi-square test. Results: Of the 169 websites analyzed, the top-three most frequently appearing content topics in pro sites were reducing mortality via cancer screening, benefits of early detection, and recommendations for obtaining detailed examination. The top three most frequent in anti-sites were harm from radiation exposure, non-efficacy of cancer screening, and lack of necessity of early detection. Anti-sites also frequently referred to a well-known Japanese radiologist, Makoto Kondo, who rejects the standard forms of cancer care. Conclusion: Our findings should enable authors of pro-cancer-screening sites to write to counter misleading anti-cancer-screening messages and facilitate dissemination of accurate information.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Japan.
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Kim CJ, Song R, Chen J, Tavares Da Silva F, Gopala KB, Kim JH, Bi D, Park JS. Six-year multi-centre, observational, post-marketing surveillance of the safety of the HPV-16/18 AS04-adjuvanted vaccine in women aged 10-25 years in Korea. Pharmacoepidemiol Drug Saf 2017; 26:837-842. [PMID: 28266092 PMCID: PMC5516175 DOI: 10.1002/pds.4175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 12/21/2016] [Accepted: 01/17/2017] [Indexed: 11/25/2022]
Abstract
Purpose To evaluate the safety of HPV‐16/18 AS04‐adjuvanted vaccine when administered as per the PI in Korea. Methods A total of 3084 women aged 10–25 years were enrolled in this post‐marketing surveillance from 2008 to 2014. Subjects were invited to receive three doses of the vaccine (0, 1 and 6 months), and participants who received at least one dose were included in the analysis. Adverse events (AEs), adverse drug reactions (ADRs) and serious AEs (SAEs) were recorded after each dose. All AEs, ADRs and SAEs were presented with exact 95% confidence intervals (CI) (NCT01101542). Results Injection‐site pain was the most frequent AE and ADR reported by 322 subjects (10.4% [95%CI: 9.4–11.6]); the local pain was transient and lasted 4–7 days in most cases. Dysmenorrhoea and vaginitis were the most common unexpected AEs reported by 30 (1.0% [95%CI: 0.7–1.4]) and 16 subjects (0.7% [95%CI: 0.3–0.8]), respectively. Pain (toe pain, leg pain and body pain [one case each]; foot pain [two cases]) was the most common unexpected ADR reported by five subjects (0.2% [95%CI: 0.1–0.4]). Four subjects reported a single SAE (one case each of exostosis, gastroenteritis, abortion and tonsillitis); none were fatal. All SAEs were assessed as unlikely to be related to vaccination; gastroenteritis, exostosis and tonsillitis resolved during the study period. Conclusions This is the first post‐marketing surveillance study in Korea that provides 6‐year safety data for HPV‐16/18 AS04‐adjuvanted vaccine. The vaccine showed an acceptable safety profile and favourable benefit/risk ratio when given to women aged 10–25 years in Korea. © 2017 The Authors. Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Chul-Jung Kim
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, Korea
| | | | | | | | | | | | - Dan Bi
- GSK Vaccines, Wavre, Belgium
| | - Jong Sup Park
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Shono A, Kondo M. Mothers' preferences regarding new combination vaccines for their children in Japan, 2014. Hum Vaccin Immunother 2016; 13:766-771. [PMID: 27905819 DOI: 10.1080/21645515.2016.1255387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
A number of new vaccines to prevent childhood diseases have been introduced globally over the last few decades. Only four combination vaccines are currently available in Japan, DTaP/sIPV, DTaP, DT, and MR, leading to complex infant vaccine scheduling. This study aims to investigate mothers' preferences with respect to combination vaccines for their children, should new combination vaccines become available that have not yet been launched in Japan or that will be developed in the future. We conducted a web-based, cross-sectional survey of 1,243 mothers who had at least one child between 2 months and 3 y of age. Mothers were recruited from an online survey panel of registered users. Their preferences were elicited using discrete choice experiments, the analyzed main effects model, and interactions using a mixed logit model. Mothers showed a preference for vaccines that prevented multiple diseases, had fewer injections per doctor visit, lower price, and lower risk of adverse events. Respondents valued a reduced risk of adverse events the most among all attributes in this study. The estimated monetary value of the willingness to pay for a 1% reduction in the risk of adverse events was ¥ 92,557 ($ 907). Therefore, if new combination vaccines are introduced, the risk of adverse events after vaccination is an especially important factor for mothers. While the safety of the vaccines themselves is required, health professionals should also inform mothers about the benefits and risks of vaccination, to allay mothers' concerns about vaccine safety.
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Affiliation(s)
- Aiko Shono
- a Department of Public Health and Epidemiology , Faculty of Pharmaceutical Sciences, Meiji Pharmaceutical University , Noshio, Kiyose, Tokyo , Japan
| | - Masahide Kondo
- b Department of Health Care Policy and Health Economics , Faculty of Medicine, University of Tsukuba, Tennoudai , Tsukuba, Ibaraki , Japan
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Okami K. Clinical features and treatment strategy for HPV-related oropharyngeal cancer. Int J Clin Oncol 2016; 21:827-835. [PMID: 27380170 DOI: 10.1007/s10147-016-1009-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/19/2016] [Indexed: 12/30/2022]
Abstract
Among head and neck squamous cell carcinoma (HNSCC), the incidence of oropharyngeal SCC (OPSCC) is increasing in contrast to carcinoma with origin in other subsites. Human papillomavirus (HPV) is now recognized as a significant risk factor of the carcinogenesis of OPSCC. The HPV-related OPSCC patients tend to be relatively young, less exposed to tobacco and alcohol, and have a relatively high socioeconomic status and education level, which is distinct from HPV-unrelated classical OPSCC. The neck metastases tend to be aggressive and cystic. The better response to treatment resulting in improved prognosis of HPV-related OPSCC led to reconsidering the clinical staging and treatment approaches. Clinical trials of treatment deintensification to reduce the acute and late toxicity without compromising efficacy have been conducted. This review of HPV-related OPSCC focuses on current and generally accepted facts regarding the biology, epidemiology, and therapeutic strategy of this new disease entity.
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Affiliation(s)
- Kenji Okami
- Department of Otolaryngology, Center of Head and Neck Surgery, Tokai University, 143 Shimokasuya, Isehara, 259-1193, Japan.
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Sauvaget C, Nishino Y, Konno R, Tase T, Morimoto T, Hisamichi S. Challenges in breast and cervical cancer control in Japan. Lancet Oncol 2016; 17:e305-e312. [PMID: 27396648 DOI: 10.1016/s1470-2045(16)30121-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
Since the mid-1990s, there has been an increasing incidence of, and mortality from, cervical and breast cancers in Japan. Such an increase has raised concerns over the efficiency of Japan's screening programmes for these cancers. Although citizens benefit from universal health coverage, the Japanese health insurance system mostly focuses on tertiary prevention and disease treatment, while secondary prevention (screening) is low priority. Citizens have multiple opportunities to be screened for cancer-either through programmes organised by municipalities, or individual or collective, opportunistic and comprehensive health check-ups on a voluntary basis. Despite this, however, participation is as low as 35% of the target population for both cancers. In this Policy Review, we discuss the challenges in the prevention of breast and cervical cancers in Japan, particularly focusing on the structure of the National Health Insurance system and the National Cancer Control Plan, reasons for low participation as a result of social and political attitudes, as well as providing recommendations to overcome these challenges. Japanese women would benefit from new measures to increase participation, a national data surveillance programme to monitor screening activities, and the implementation of a quality assurance system among all providers.
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Affiliation(s)
- Catherine Sauvaget
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France.
| | - Yoshikazu Nishino
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Ryo Konno
- Department of Obstetrics and Gynaecology, Jichi Medical University, Saitama Medical Centre, Saitama, Japan
| | - Toru Tase
- Department of Obstetrics and Gynaecology, Miyagi Cancer Centre, Natori City, Japan
| | - Tadaoki Morimoto
- Department of Health Science, School of Medicine, Tokushima University, Tokushima, Japan
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Forster AS, Waller J. Taking stock and looking ahead: Behavioural science lessons for implementing the nonavalent human papillomavirus vaccine. Eur J Cancer 2016; 62:96-102. [PMID: 27235782 PMCID: PMC4920641 DOI: 10.1016/j.ejca.2016.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/11/2016] [Accepted: 04/14/2016] [Indexed: 11/24/2022]
Abstract
The development and licensing of a nonavalent human papillomavirus (HPV) vaccine has the potential to reduce morbidity and mortality from HPV-related cancers beyond that of first generation HPV vaccines. However, this benefit can only be realised if the offer of vaccination is accepted. Uptake of first generation HPV vaccines is not complete and shows huge global variation. In addition to practical and financial challenges to optimising coverage, behavioural issues explain a large proportion of the variance in vaccine receipt. This commentary draws on the findings of over a decade of behavioural science research seeking to understand uptake of first generation HPV vaccines, in order to anticipate challenges to implement the nonavalent HPV vaccine. Challenges include distrust of combination vaccines, uncertainty about long-term efficacy, distrust of a new and (perceived to be) untested vaccine, cost and uncertainty regarding interchanging doses of first generation and nonavalent vaccines and the appropriateness of revaccination. We use behavioural science theory and existing evaluations of interventions to increase uptake of vaccines to identify evidence-based approaches that can be implemented by vaccine stakeholders to address parents' concerns and maximise uptake of the nonavalent HPV vaccine.
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Affiliation(s)
- Alice S Forster
- Health Behaviour Research Centre, UCL, Gower Street, London, WC1E 6BT, UK.
| | - Jo Waller
- Health Behaviour Research Centre, UCL, Gower Street, London, WC1E 6BT, UK
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The Effect of Guidance regarding Home Exercise and ADL on Adolescent Females Suffering from Adverse Effects after HPV Vaccination in Japanese Multidisciplinary Pain Centers. Pain Res Manag 2016; 2016:3689352. [PMID: 27445608 PMCID: PMC4904598 DOI: 10.1155/2016/3689352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 08/14/2015] [Indexed: 12/15/2022]
Abstract
Background. Two prophylactic papillomavirus (HPV) vaccines have been available for primary prevention of cervical cancer. Although serious adverse effects (AE) were rare, more than 230 women have been suffering from severe AEs such as persistent pain and headache in Japan. Our research group started to treat adolescent females suffering from the AEs. Objective. To survey the characteristics of and the effects of cognitive behavioral therapy on adolescent female suffering from the AEs in Japanese multidisciplinary pain centers. Methods. One hundred and forty-five patients suffering from the AEs were reviewed retrospectively and 105 patients of them were provided guidance on home exercise and activities of daily living based partially on a cognitive-behavioral approach. The intensity of pain was rated by the patients using a numerical rating scale (NRS). Furthermore, the Hospital Anxiety and Depression Scale (HADS) and the Pain Catastrophizing Scale (PCS) were used. Results. Eighty out of the 105 patients who received the guidance were followed up, 10 displayed a marked improvement, and 43 showed some improvement. Conclusions. Guidance on home exercise and activities of daily living based on a cognitive-behavioral approach alleviated the AEs that women suffered from after HPV vaccination in Japan.
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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. [DOI: 10.1016/j.canep.2015.08.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 07/25/2015] [Accepted: 08/03/2015] [Indexed: 11/22/2022]
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Egawa-Takata T, Ueda Y, Morimoto A, Yoshino K, Kimura T, Nishikawa N, Sekine M, Horikoshi Y, Takagi T, Enomoto T. 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. [DOI: 10.1111/jog.12822] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/28/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Tomomi Egawa-Takata
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Yutaka Ueda
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Akiko Morimoto
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Kiyoshi Yoshino
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Tadashi Kimura
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Nobumichi Nishikawa
- Department of Obstetrics and Gynecology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | | | - Tetsu Takagi
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
| | - Takayuki Enomoto
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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Tanaka Y, Ueda Y, Kishida H, Hosogai N, Morimoto A, Egawa-Takata T, Matsuzaki S, Kobayashi E, Yoshino K, Kimura T. Trends in the cervical cancer screening rates in a city in Japan between the years of 2004 and 2013. Int J Clin Oncol 2015; 20:1156-60. [PMID: 25990449 DOI: 10.1007/s10147-015-0842-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The objective of our study was to evaluate trends in the cervical cancer screening rate in a city in Japan between the years of 2004 and 2013. METHODS The cervical cancer screening rates for all female residents 20-49 years of age living in Toyonaka City for each year between 2004 and 2013 were analyzed and the effects of reminder letters and a free coupon program for cervical cancer screening on the subjects' behavior were evaluated. RESULTS The screening rate increased on a single-year basis from 8.9 % (2004) to 12.7 % (2009) as a result of the free coupon program. From 2009 onward, the screening rate on a single-year basis remained stable. Although the free coupon program increased the rate of screening participation, it did not achieve a continuous increase in the number of subjects undergoing screening. Furthermore, despite recommendations for biennial screening, some subjects participated in consecutive screening within the last 2 years after receiving visits for a regularly scheduled residential screening program 1 year before/after the current screening program with a free coupon. There was a peak in the rate of screening participation at the end of the fiscal year among females eligible for the free coupon program. CONCLUSIONS Excessive cervical cancer screening performed unnecessarily in the young is an unexpected limitation of free coupon programs. Further efforts to improve the screening rates are required, and the various factors leading young Japanese females to have a negative attitude toward cervical cancer screening should be identified.
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Affiliation(s)
- Yusuke Tanaka
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hisayo Kishida
- Community Health Division, Toyonaka City Public Health Center, Toyonaka, Osaka, Japan
| | - Noriko Hosogai
- Community Health Division, Toyonaka City Public Health Center, Toyonaka, Osaka, Japan
| | - Akiko Morimoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tomomi Egawa-Takata
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shinya Matsuzaki
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Eiji Kobayashi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kiyoshi Yoshino
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Abstract
INTRODUCTION Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. AREAS COVERED Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. EXPERT OPINION Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence.
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Affiliation(s)
- Michela Stillo
- Department of Public Health and Paediatric sciences, University of Turin
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Tanimoto T. A perspective on the benefit-risk assessment for new and emerging pharmaceuticals in Japan. Drug Des Devel Ther 2015; 9:1877-88. [PMID: 25848223 PMCID: PMC4386774 DOI: 10.2147/dddt.s62636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The universal health care system in Japan is facing a historical turning point as a result of the increasing fiscal burden, rapidly aging society, and a decreasing population. To understand the challenges and opportunities in the Japanese pharmaceutical market, which occupies one tenth of the global share, this review highlights several issues related to the benefit-risk assessment that is unique to the modern Japanese society: 1) regulatory system for new drug development; 2) health hazards related to pharmaceuticals ("Yakugai" in Japanese); 3) drug lag; 4) problems and controversies in the vaccination policy; and 5) clinical study misconduct. The regulatory process places a significant importance on Japanese data collection regardless of data accumulation from other countries. Because Yakugai has repeatedly caused tragedies and social disputes historically, the regulatory judgments generally tend to be more prudential when safety concerns are raised for new and emerging pharmaceuticals. Such a regulatory system has caused more than several years of approval delays compared to delays in other countries. The problem of drug lag still lingers on despite several regulatory system revisions, while the solution is incompatible with the elimination of Yakugai because the lag potentially reduces the risk of unpredictable adverse events. The Japanese vaccination policy has also received a lot of criticism, and needs improvements so that the decision-making process can be more transparent and scientifically based. Additionally, repeated clinical study misconduct damaged the reputation of Japanese clinical studies with unnecessary defrayment in health insurance; therefore, the medical community must change its inappropriate relationship with the industry. The problems surrounding pharmaceuticals are related to centralized, strict drug pricing control under the universal health coverage. Although the current government attempts to facilitate innovative research and development of novel therapeutics in Japan, further reforms should be explored for patients who need new and emerging pharmaceuticals.
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Affiliation(s)
- Tetsuya Tanimoto
- Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
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Larson HJ, Wilson R, Hanley S, Parys A, Paterson P. Tracking the global spread of vaccine sentiments: the global response to Japan's suspension of its HPV vaccine recommendation. Hum Vaccin Immunother 2014; 10:2543-50. [PMID: 25483472 PMCID: PMC4977439 DOI: 10.4161/21645515.2014.969618] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In June 2013 the Japanese Ministry of Health, Labor, and Welfare (MHLW) suspended its HPV vaccination recommendation after a series of highly publicized alleged adverse events following immunization stoked public doubts about the vaccine's safety. This paper examines the global spread of the news of Japan's HPV vaccine suspension through online media, and takes a retrospective look at non-Japanese media sources that were used to support those claiming HPV vaccine injury in Japan. Methods: Two searches were conducted. One searched relevant content in an archive of Google Alerts on vaccines and vaccine preventable diseases. The second search was conducted using Google Search on January 6th 2014 and on July 18th 2014, using the keywords, “HPV vaccine Japan” and “cervical cancer vaccine Japan.” Both searches were used as Google Searches render more (and some different) results than Google Alerts. Results: Online media collected and analyzed totalled 57. Sixty 3 percent were published in the USA, 23% in Japan, 5% in the UK, 2% in France, 2% in Switzerland, 2% in the Philippines, 2% in Kenya and 2% in Denmark. The majority took a negative view of the HPV vaccine, the primary concern being vaccine safety. Discussion: The news of Japan's suspension of the HPV vaccine recommendation has traveled globally through online media and social media networks, being applauded by anti-vaccination groups but not by the global scientific community. The longer the uncertainty around the Japanese HPV vaccine recommendation persists, the further the public concerns are likely to travel.
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Key Words
- AEFI, Adverse Event Following Vaccination
- BBC, British Broadcasting Corporation
- CBCD, Center for the Biology of Chronic Disease
- CDC, Centers for Disease Control and Prevention
- CRPS, complex regional pain syndrome
- FDA, Food and Drug Administration (US)
- GAVCS, Global Advisory Committee on Vaccine Safety
- HPV
- HPV, Human papillomavirus
- Japan
- MHLW, Ministry of Health, Labor and Welfare (Japan)
- MHRA, Medicines and Healthcare Products Regulatory Agency
- NCNP, National Center of Neurology and Psychiatry (Japan)
- NIP, National Immunization Program
- Q&A, Questions and Answers
- VARRC, Vaccine Adverse Reactions Review Committee
- WHO, World Health Organization
- cervical cancer
- social media
- vaccine
- vaccine hesitancy
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Affiliation(s)
- Heidi J Larson
- a London School of Hygiene & Tropical Medicine ; London , UK
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