• Chunichi Shimbun

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It has been eight years since the central government stopped calling for people to get vaccinations against the human papillomavirus, or HPV — the main cause of cervical cancer.

In a significant policy change, a health ministry panel decided on Oct. 1 that it would resume promoting the vaccination, which is basically free of charge for girls between the sixth grade and their first year of high school.

For girls currently in their first year of high school, the deadline for the free inoculation is the end of March. And since they need to get vaccinated three times in the course of six months, time is limited for them to get the shots.

In Japan, about 11,000 women mainly in their 20s through 40s suffer from cervical cancer every year, of which about 2,800 die from the disease. A majority of them contract the illness from sexual intercourse, and getting vaccinated before starting to have intimate relationships with a partner is key to preventing the disease. Outside Japan, more than 100 countries are inoculating their populations through public vaccination programs.

In April 2013, the country launched a free HPV vaccination program targeting those eligible. But the ministry stopped recommending the vaccinations in June the same year after a number of recipients developed aches and other side effects, which led to a number of lawsuits against the government nationwide. The government has not acknowledged that there is a causal relationship between the two.

Nonetheless, with the government no longer actively promoting the inoculation, vaccination rates plunged from over 70% to less than 1%, despite the vaccination being free of charge.

A 44-year-old woman in Nagoya remembers rushing to a clinic two years ago for her daughter to get the HPV vaccine, who was a first year high school student at the time.

She had been planning to have her daughter vaccinated, but since she didn’t get a notification from her municipality about the free vaccine program she had assumed she had to pay.

If she missed the deadline, she would have had to pay about ¥50,000 for the three doses required. In the end, her daughter got the first shot in October and had the third shot at the end of March, just before the deadline.

A brochure explaining the pros and cons of HPV vaccination | CHUNICHI SHIMBUN
A brochure explaining the pros and cons of HPV vaccination | CHUNICHI SHIMBUN

Having gone through that, her younger daughter, who is in junior high school, had her last shot in September.

“The problem is that people eligible for the shots don’t know that they can get vaccinated (for free) even though there is a limited time frame in which to get inoculated,” said Hideshi Eguchi, 66, chairman of Nagoya’s pediatricians organization.

The policy to actively promote the vaccine program was reinstated by the Health, Labor and Welfare Ministry after data proving the HPV vaccine’s efficacy began to be published.

Part of this data was Swedish research compiled in the autumn of last year involving about 1.67 million people from age 10 to 30. The research showed that the risk of getting cancer was 63% lower for vaccinated individuals. For ages 10 to 16, the risk of getting cancer was 88% lower — proof that the efficacy is higher if people get vaccinated at a younger age.

The health ministry has been preparing for the move, making updates to the free vaccine program’s brochures explaining the pros and cons of the HPV vaccine, and has instructed municipalities to send it to eligible residents.

Kanako Inaba, an obstetrician and gynecologist promoting the vaccine, says it’s not too late for first year high school students to get the shots.

“If push comes to shove, you can finish getting the shots in about four months,” said Inaba. “Don’t give up because you’ve run out of time, and seek advice from municipalities and your home doctor.”

The city of Tsu, Mie Prefecture, sent the health ministry’s brochure to all girls from first year junior high school students through first year high school students in October 2020.

As a result, the vaccination rate jumped from 1.2% in fiscal 2019 to 5% in the following year. In addition, the number of vaccinations rose from 22 individuals in April 2020 to 209 in August this year.

Upper House lawmaker Junko Mihara, who had cervical cancer, speaks in an online interview. | CHUNICHI SHIMBUN
Upper House lawmaker Junko Mihara, who had cervical cancer, speaks in an online interview. | CHUNICHI SHIMBUN

Meanwhile, Nagoya began sending the brochure to junior and high school girls in July.

However, some municipalities, including the town of Anpachi, Gifu Prefecture, are not planning to promote the vaccination.

“It’s because the central government has not actively promoted the vaccination, and we are currently too busy with the coronavirus pandemic,” said a town official in charge.

The Anpachi town, which is charging ¥1,000 per shot based on the vaccination law which stipulates municipalities can charge the fee if they want, said no one got the shot in fiscal year 2019 and just two people received it in fiscal year 2020.

Other municipalities are extending the deadline for the shot amid the pandemic. Minato Ward and Koto Ward in Tokyo are allowing first grade and second grade high school girls to get the shot for free through the end of March 2023.

Upper House lawmaker Junko Mihara, who served as deputy health minister under Prime Minister Yoshihide Suga, called on people to get the HPV vaccination.

“Because the central government has not been clear that they are now actively promoting the vaccination, many municipalities are perplexed, which is why some people know about the inoculation while some don’t,” said Mihara in an online interview.

Mihara, who had her uterus surgically removed after she got cervical cancer, pointed out that the government has been looking for the right timing to resume its promotion given that many local governments have been too busy with the COVID-19 vaccination.

“When I found out I had cervical cancer, it was in 2008 before the HPV vaccine was approved in Japan,” she said. “I had to give up having a child because I had to have my uterus removed.

“I don’t ever want any woman to go through the same experience.”

This section features topics and issues from the Chubu region covered by the Chunichi Shimbun. The original articles were published Oct. 5.

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