HPV vaccine hesitancy crisis predicted to result in over 5,000 cervical cancer deaths

A new study by Cancer Council NSW and Hokkaido University has found that the human papillomavirus (HPV) vaccine hesitancy crisis in Japan could result in 5,000-5,700 additional deaths which would not have occurred if young girls had been vaccinated against HPV. However, if vaccine coverage can be restored this year, including catch-up vaccination for those who missed out, more than 3000-3400 of these additional deaths could be prevented.

The study used a microsimulation model to predict the number of deaths that would occur over the lifetime of cohorts who missed the HPV vaccine due to the hesitancy crisis.

In 2010, Japan began funding for the HPV vaccine for girls aged 12-16 years, with coverage initially reaching greater than 70% across the country. However, in June 2013, two months after formal inclusion in the National Immunization Programme, promotion for the HPV vaccine was suspended. This was due to some reported adverse events of the vaccine that have since been found to be unrelated to vaccination. The news, however, was extensively covered in the media and resulted in vaccine coverage dropping to less than 1% thereafter.

Sharon Hanley, Assistant Professor at Hokkaido University is calling on the government to act now and save the lives being needlessly lost to this preventable disease.

“Despite the overwhelming scientific evidence supporting the safety of HPV vaccination, the Japanese government has continued suspension of proactive recommendations for over six years now,” said Sharon Hanley. “and if the suspension continues into 2020, this will lead to an additional 700-800 Japanese women dying from cervical cancer.”

“In January 2019, WHO listed vaccine hesitancy as one of the top ten threats to global health. Not only is this leading to women’s lives being lost in Japan but also may have influenced perceptions in other countries such as Denmark, Ireland and Colombia. However, the good news is that the vaccine is extremely safe and if the government were to resume promoting the HPV vaccine, we could avoid most of this loss of life”. Sharon Hanley added.

Co-author of the paper Kate Simms, Senior Research Fellow at Cancer Council NSW is encouraged by other examples around the world that indicate it’s not too late for Japan.

“Despite negative media coverage, the Danish and Irish governments continued to proactively promote HPV vaccination. This was complemented by various medical and non-medical organizations coming together to form an alliance to actively advocate for HPV vaccination,” said Kate Simms. “Forming these powerful cross-sectoral alliances has led to a rapid improvement in vaccine uptake in both countries.”

“Our research illustrates the significant intermediate and long-term cost of the crisis continuing in Japan, but also shows that much of the damage could be mitigated if high-level political support for HPV vaccination was restored and proactive recommendations reinstated.”

Professor Karen Canfell, the senior researcher on the study, also stresses the importance of screening “In addition to vaccinating adolescent females, adult women should ensure they attend regular screening. In Japan, it is recommended that women screen every two years.” She said. “Screening coverage rates in Japan are around 30-40%, which is lower than coverage rates seen in other high-income countries like Australia. Encouraging unscreened and under-screened women to attend screening could play a critical role in reducing the burden of cervical cancer in Japan. Furthermore, considering a transition to using HPV as the primary screening test is an important step forward for all countries including Japan.”

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