The Washington PostDemocracy Dies in Darkness

The science doesn’t support them, but Japanese anti-vaxxers are winning on HPV

(Joe Raedle/Getty Images)

TOKYO — Vaccines are a highly politicized subject in many countries. Just look at Donald Trump’s repeated claims in the Republican presidential race that childhood vaccinations cause autism.

In Japan, a vigorous debate is underway over the safety of vaccinations against HPV, a virus that can lead to cervical cancer. Opponents say the vaccines — which have been given to more than 80 million girls and women around the world in the past nine years — are dangerous and cause mobility problems that can sometimes be severe.

Health experts say that the vaccines are safe and effective and that not vaccinating girls puts them at much greater risk of developing cervical cancer later in life. Global health authorities, including the World Health Organization and the Centers for Disease Control and Prevention, agree.

The Japanese government, which responded to concerns two years ago by withdrawing its recommendation that girls ages 12 to 16 have the HPV vaccine, is now having a tough time trying to reverse that decision.

That’s partly because of videos such as this, which anti-vaxxers say show girls with severe motor issues that developed after they were vaccinated. The videos are not pleasant viewing.

First, some background: There are two vaccines — Merck's Gardasil and GlaxoSmithKline's Cervarix — that protect against two strains of human papillomavirus that cause at least 70 percent of cervical cancers.

HPV is passed through sexual contact, and most people are thought to be exposed at some stage in their lives, which is why the medical industry recommends vaccinating girls before they become sexually active.

The WHO and the CDC, as well as health authorities in all other developed countries except Japan, recommend the vaccine, which comes in three shots over six months. Clinical trials show that both vaccines are safe and very effective in preventing infection of the two worst strains of HPV, the WHO says.

But in Japan, there have been reports of a small number of cases in which girls have suffered complex regional pain syndrome, a condition most often affecting a limb, after receiving the vaccine.

In 2013, the government withdrew its recommendation that girls have the vaccine. But those who had suffered side effects before that continue to lobby against the shots.

“I forever regret having my daughter get the vaccination. I wish I could suffer for her,” said Miyako Hagiwara, whose 15-year-old daughter, Hisui, began to develop symptoms such as severe headaches, nausea and numbness in the hands and legs after being vaccinated in 2013.

“I want many people to know what’s going on so that victims don’t feel isolated,” Hagiwara told the Mainichi newspaper this month. She is the representative in Shizuoka for the Japan Cervical Cancer Vaccination Sufferers' Organization, which has 400 members nationwide.

This month, Medwatcher Japan, a group set up to “monitor and prevent drug-induced disasters,” will host a conference titled "Problems with the HPV Vaccine.”

A spokesman for Japan’s Health Ministry said it "considers it appropriate to continue the suspension of active recommendation" at this point.

The ministry this year surveyed 1,739 patients who had received the vaccine and found that 186 were still experiencing side effects, including headaches, fatigue and muscle weakness.

In 135 of the cases, the problems were so severe that they interfered with daily activities, including school and work, Japanese news agencies reported. An unspecified number reportedly had lost their ability to walk.

The Health Ministry will begin paying benefits to those affected — but “only in cases where a clear link exists or cannot be denied,” Kyodo News reported.

The ministry recently declared that there was an “undeniable causal relationship” in the case of 11 girls who had been vaccinated and went on to suffer health issues. They now receive about $300 a month each in compensation from the government.

This week, the Health Ministry is designating a center in each of the country’s 47 prefectures for patients who suffer side effects after receiving the vaccine.

Doctors have been instructed to check for physical pain and mental health issues, while at consultation counters girls suffering from side effects can talk about problems at school — more than 70 percent of the worst affected have not been able to go back to school or have to repeat a year, the ministry said – and find out about relief for medical costs.

But the Japan Society of Obstetrics and Gynecology is urging the government to start recommending the vaccination again.

“If the suspension of recommendations for vaccination continues without improving the current situation, young generations will be deprived of the benefits of vaccines for cancer prevention,” Tomoyuki Fujii, chairman of the society, said in a statement. “And, consequently, Japan will become the only country continuing to show a marked increase of cervical cancer in the future.”

Almost 9 million girls and women were vaccinated after the government recommended it, but the total number who suffered chronic pain or motor impairment was 176 — or 2 per 100,000 vaccinations, the society said.

Although there is no scientific evidence to suggest a causal link, the vaccination rate has fallen to close to zero since the government withdrew its recommendation.

“The JSOG strongly demands the early resumption of recommendations for HPV vaccination, with the aim of eradicating cervical cancer,” Fujii said.

In Europe, regulators have found no evidence to support a link between the vaccine and impaired movement.

After media in Denmark reported similar concerns about side effects, the European Medicines Agency’s Pharmacovigilance Risk Assessment Committee conducted a review. The vaccination rate in some European countries was 90 percent.

In its report, published this month, the committee concluded that there was no evidence that the vaccine caused chronic pain syndrome or an abnormal increase in heart rate on sitting or standing up.

It noted that symptoms might overlap with other conditions, making diagnosis difficult. But the number of teenage girls experiencing chronic limb pain or dizziness after vaccination was not higher than the general population.

“Therefore, there is no reason to change the way the vaccines are used or amend the current product information,” the committee found.

Melissa Brower, a spokeswoman for the CDC, said the organization was aware of Japan’s concerns about a possible association between the vaccine and motor movement.

“HPV vaccines have an excellent safety record,” she said, adding that about 86 million doses of the vaccine had been distributed for use in the United States. The CDC continues to recommend its use, she said.

Yuki Oda contributed to this report.