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.
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.
A self-administered questionnaire was distributed to parents with daughters attending secondary schools or high schools in two remote areas of the country.
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.
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.
The authors a grateful to the teachers at Tomioka Nishi High School and Tomioka Higashi High School in Anan City, the teachers at the secondary schools in Nachikatuura Town, and the staff at the education board in Nachikatsuura Town, for their help in collecting the data for this study.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: This study was reviewed and approved in advance by the Ethics Review Committee for Human Research in the Faculty of Public Health at Mahidol University.
1. Ferlay, J, Soerjomataram, I, Dikshit, R, Eser, S, Mathers, C, Rebelo, M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:e359–86. https://doi.org/10.1002/ijc.29210. Search in Google Scholar
2. Center for Cancer Control and Information Services. N.C.C. cancer statistics in Japan. Avairable at: https://ganjoho.jp/en/professional/statistics/table_download.html. Search in Google Scholar
3. Motoki, Y, Mizushima, S, Taguri, M, Takahashi, K, Asano, R, Kato, H, et al. 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. https://doi.org/10.1016/j.canep.2015.08.001. Search in Google Scholar
4. World Health Organization. Human papillomavirus (HPV) and cervical cancer: Media centre Fact sheet; 2016 June 2016. Available at: www.who.int/mediacentre/factsheets/fs380/en/. Search in Google Scholar
5. Harper, DM, Franco, EL, Wheeler, C, Ferris, DG, Jenkins, D, Schuind, A, et al. Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet 2004;364:1757–65. https://doi.org/10.1016/s0140-6736(04)17398-4. Search in Google Scholar
8. Croyle, R. Theory at a glance: a guide for health promotion practice. Health Educ Q 2005;15:351–77. Search in Google Scholar
9. Donadiki, EM, Jimenez-Garcia, R, Hernandez-Barrera, V, Sourtzi, P, Carrasco-Garrido, P, de Andres, L, et al. Health belief model applied to non-compliance with HPV vaccine among female university students. Public Health 2014;128:268–73. https://doi.org/10.1016/j.puhe.2013.12.004. Search in Google Scholar
10. Kessels, SJ, Marshall, HS, Watson, M, Braunack-Mayer, AJ, Reuzel, R, Tooher, RL, et al. Factors associated with HPV vaccine uptake in teenage girls: a systematic review. Vaccine 2012;30:3546–56. https://doi.org/10.1016/j.vaccine.2012.03.063. Search in Google Scholar
11. Hanley, SJ, Yoshioka, E, Ito, Y, Konno, R, Hayashi, Y, Kishi, R, et al. Acceptance of and attitudes towards human papillomavirus vaccination in Japanese mothers of adolescent girls. Vaccine 2012;30:5740–7. https://doi.org/10.1016/j.vaccine.2012.07.003. Search in Google Scholar
12. Yagi, A, Ueda, Y, Egawa-Takata, T, Tanaka, Y, Morimoto, A, Terai, Y, et al. Development of an efficient strategy to improve HPV immunization coverage in Japan. BMC Public Health 2016;16:1013. https://doi.org/10.1186/s12889-016-3676-7. Search in Google Scholar
13. Zhang, SK, Pan, XF, Wang, SM, Yang, CX, Gao, XH, Wang, ZZ, et al. Perceptions and acceptability of HPV vaccination among parents of young adolescents: a multicenter national survey in China. Vaccine 2013;31:3244–49. https://doi.org/10.1016/j.vaccine.2013.05.046. Search in Google Scholar
14. Matsuhisa, Y, Hirose, H, Gotoh, T, GP-COMERnet Group. A survey of awareness and knowledge of human papillomavirus vaccination in schoolgirls and their parents. Off J Jpn Prim Care Assoc 2013;36:297–301. https://doi.org/10.14442/generalist.36.297. Search in Google Scholar
15. Egawa-Takata, T, Ueda, Y, Morimoto, A, Yoshino, K, Kimura, T, Nishikawa, N, et al. 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 Gynecol Res 2015;41:1965–71. https://doi.org/10.1111/jog.12822. Search in Google Scholar
16. Brewer, NT, Gottlieb, SL, Reiter, PL, McRee, AL, Liddon, N, Markowitz, L, et al. Longitudinal predictors of HPV vaccine initiation among adolescent girls in a high-risk geographic area. Sex Transm Dis 2011;38:197–204. https://doi.org/10.1097/olq.0b013e3181f12dbf. Search in Google Scholar
17. Davis, K, Dickman, ED, Ferris, D, Dias, JK. Human papillomavirus vaccine acceptability among parents of 10-to 15-year-old adolescents. J Low Genit Tract Dis 2004;8:188–94. https://doi.org/10.1097/00128360-200407000-00005. Search in Google Scholar
18. Morimoto, A, Ueda, Y, Egawa-Takata, T, Yagi, A, Terai, Y, Ohmichi, M, et al. Effect on HPV vaccination in Japan resulting from news report of adverse events and suspension of governmental recommendation for HPV vaccination. Int J Clin Oncol 2015;20:549–55. https://doi.org/10.1007/s10147-014-0723-1. Search in Google Scholar
19. Egawa-Takata, T, Ueda, Y, Morimoto, A, Tanaka, Y, Matsuzaki, S, Kobayashi, E, et al. Human papillomavirus vaccination of the daughters of obstetricians and gynecologists in Japan. Int J Clin Oncol 2016;21:53–8. https://doi.org/10.1007/s10147-015-0869-5. Search in Google Scholar
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