Editorials

HPV vaccine raises questions

On April 1, vaccinations against cervical cancer began being administered on a regular basis free of charge. But a series of reports have surfaced suggesting that the vaccinations have caused side effects.

Parents of children who are said to have suffered serious health damage have formed an association and called on the government to immediately stop the vaccinations. Usually junior high school first-grade girl students receive the vaccinations; they have to go through three rounds of vaccinations.

The health and welfare ministry should immediately carry out a thorough study of the health damage allegations. If the health risks from the vaccinations appear to exceed the benefits promised, the government should stop the vaccinations. Otherwise, it should fully explain both the benefits and any possible damage from the vaccinations to help people make decisions.

The government should extend sufficient relief if it is ascertained that the vaccinations have caused health damage.

Every year, about 20,000 women in Japan are diagnosed with cervical cancer and about 3,500 of them die. Cervical cancer cases are on the rise among women in their 20s and 30s. The cancer is caused by the commonplace human papillomavirus (HPV), which is transmitted usually through sexual intercourse.

There are more than 100 types of HPV; some 15 types have a high risk of causing cervical cancer. HPV types 16 and 18 are responsible for about 70 percent of all cervical cancers. It is thought that 80 percent of Japanese women become infected with HPV during their lifetime.

Two types of vaccines that are effective against HPV types 16 and 18 are used in Japan. Although they do not cover all of the high-risk types of HPV, combining the vaccinations and medical examinations is considered an effective preventive.

The regular vaccinations cover girls in the sixth year of elementary school through the first year of junior high school. The vaccinations against cervical cancer began in December 2009. A total of 8.29 million people had received them as of December 2012. According to a health and welfare ministry panel, 1,968 cases of side effects were reported through the end of March 2013. Of these, 106 were rated serious cases of pains or body convulsions, pains in joints or difficulty in walking.

This means about 12.8 serious cases of side effects per 1 million inoculations — higher than the 0.9 serious cases per million inoculations of influenza vaccine and the 2.1 serious cases per million inoculations of inactivated polio vaccine. The side-effect rate for the HPV vaccine is still lower than the 26.0 serious cases per million inoculations of Japanese encephalitis vaccine.

The panel’s view is that the side-effect danger from cervical cancer vaccinations is not particularly high compared with that from other vaccinations. If the vaccinations are stopped, many more women may fall victim to cervical cancer.

The health and welfare ministry has the duty to show convincingly that the benefit from the vaccinations is greater than the risks from the vaccinations. Hospitals and doctors need to provide sufficient information to people about the vaccinations so that they can make a rational decision.

[Correction: The original number of cases per 1 million — 12.3  per million — was incorrect. The correct number is 12.8. per million.]