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Japan: Stopping the spread of Japan’s antivaccine panic

25 Nov, 2016
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Japanese women’s health is increasingly at risk as public-health policy is driven by conspiracy theories, misguided political interference and bureaucratic caution. This is particularly evident in the government’s handling of the human papillomavirus (HPV) vaccine to protect against cervical cancer.

In June 2013, just two months after the HPV vaccine was included in the National Immunization Program, the Japanese government made the unusual and perplexing decision to keep the vaccine in the NIP but suspend “proactive” recommendations for it. This was evidently in response to highly publicized accounts of alleged adverse reactions.

The result was that girls in the target age group, from the 6th grade of primary school to the third grade of high school, stopped receiving the vaccine. Vaccination rates dropped to below 1% from about 70%.

Cervical cancer is a threat to women’s health globally. There are approximately 528,000 new cases and 266,000 deaths annually; in Japan there are roughly 9,300 cases of invasive cervical cancer and 3,000 deaths.

Most of these tragedies could be prevented by the HPV vaccine. The efficacy, effectiveness and safety of the HPV vaccine has been proved time and again. Its use is unequivocally supported and recommended by the World Health Organization as well as by Japanese medical societies.

The Vaccine Adverse Reactions Review Committee, a task force established by the Japanese Ministry of Health, Labor, and Welfare’s Health Science Council, has repeatedly concluded that no causal link exists between HPV vaccines and professed symptoms, and that most reported cases were likely psychosomatic. A study of 70,960 vaccinated and nonvaccinated adolescent girls from Nagoya also found no significant association between 24 alleged vaccine-induced symptoms and the HPV vaccines.

Despite this, on March 16 Dr. Shuichi Ikeda, one of the principal investigators commissioned by the government to investigate alleged adverse events, presented highly misleading genetic and mouse experiment data at the MHLW’s Sciences Research Grant Meeting. He appeared on television the same day stating, “Without a doubt, there are signs of brain disorder. The results clearly reflect the objective findings which are common among the patients claiming such brain disorders.” The following day, major Japanese newspapers ran alarmist headlines.

As I reported in the Japanese business magazine “Wedge,” it turned out that there was no statistically significant genetic type for the vaccinated patients. The brain section of green fluorescence presented as evidence of “auto-antibody deposition” was not of the vaccinated mouse, and only one mouse was used in the experiment.

One month later, the MHLW took the unprecedented step of publishing a statement to refute the claims of Dr. Ikeda. Shinshu University, where he worked as vice chancellor and dean of the medical department, established an investigation committee.

On Nov. 15, the university held a press conference agreeing with most of the issues I pointed out, but concluded it was not tantamount to data fabrication. Dr. Ikeda was required to demonstrate the reproducibility of the experiment and given a strong warning. He issued a statement saying, “I am relieved that University proved it was not fabrication or manipulation. I will do my best for the girls suffering from adverse reactions to HPV vaccine as before.”

 

The MHLW then published a new, unprecedented statement saying, “We provided a national research grant to Ikeda’s group in order for people to lead safe and secure lives based on science. We are truly sorry his inappropriate presentation caused misunderstanding to society. Ikeda’s social responsibility is big. We found no evidence to suggest reported symptoms are related to the HPV vaccine.”

Aside from the government statement on Dr. Ikeda’s study, Tokyo’s indecisiveness in the face of this controversy has allowed unfounded doubts about the safety of the HPV vaccine to spread. Not only has Japan isolated itself from the global health community, its example has helped vaccine opponents dismantle efforts to protect women world-wide.

In Denmark, Kusuki Nishioka, the Japanese doctor who first suggested the HPV vaccine caused brain injuries, appeared on television. The vaccination rate there has since dropped to about 20% from 80%.

The antivaccination movement is gaining traction in Japan. On July 27, 63 young women filed lawsuits against the Japanese government and vaccine manufacturers in the district courts of Tokyo, Nagoya, Osaka and Fukuoka, demanding compensation for alleged side effects from HPV vaccines.

Japan’s media has covered these lawsuits but ignored the medical evidence. This has lent disproportionate credibility to the plaintiffs’ claims.

These events are reminiscent of the biggest vaccine scandal in history. In 1998, Andrew Wakefield published “scientific data” in the Lancet as evidence that the MMR vaccine for measles, mumps and rubella caused autism.

Mr. Wakefield’s data was later found to be manipulated, but it was not until 2010 that his paper was retracted and his medical license revoked. Earlier this year, Mr. Wakefield released a movie called “Vaxxed: From Cover-Up to Catastrophe.” Robert De Niro, whose son is autistic, tried to premiere this movie at the Tribeca Film Festival. This once again fueled antivaccine sentiment in the U.S.

We can’t afford to sit back and allow a similar situation to develop in which unscientific claims jeopardize lives around the world. The Japanese government should reinstate its proactive recommendation for the HPV vaccine and set a positive example before irrational fear of the vaccine gains further momentum in other countries.

This entry was posted on Friday, November 25th, 2016 at 11:21 am and is filed under Latest News.

Literature Literature archive

MJ Bayefsky, LOGostin 2018 JAMA Pediatr. online Dec 28, 2018. doi:10.1001/jamapediatrics.2018.4283
K I Hammanyero, S Bawa, F Braka, et al. 2018 BMC Public Health Vol 18 (Suppl 4) :1306 https://doi.org/10.1186/s12889-018-6193-z

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Drs. Heidi Larson and Pauline Paterson of the Vaccine Confidence Project join episode 50 of the Public Health United podcast with Nina Martin, November 2017.

Drs. Larson and Paterson join a discussion on vaccine confidence at Hong Kong University.  September, 2015.

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