A Nationwide Epidemiological Survey of Adolescent Patients With Diverse Symptoms Similar to Those Following Human Papillomavirus Vaccination: Background Prevalence and Incidence for Considering Vaccine Safety in Japan

Abstract

Background Since June 2013, Japan has suspended proactive recommendation of human papillomavirus (HPV) vaccination due to self-reported diverse symptoms, including pain and motor dysfunction, as possible serious adverse events following immunization. Although these symptoms may be seen in adolescents without HPV vaccination, their frequency, taking into account disease severity, has not been examined. Methods A two-stage, descriptive, nationwide epidemiological survey was conducted in 2016, with a 6-month target period from July 1 to December 31, 2015, to estimate the prevalence and incidence of diverse symptoms among Japanese adolescents without HPV vaccination. Participants were 11,037 medical departments in hospitals selected nationwide by stratified random sampling. Eligible patients had to satisfy four criteria: (1) aged 12–18 years upon visiting hospital; (2) having at least one of four symptoms/disorders (pain or sensory dysfunction, motor dysfunction, autonomic dysfunction, or cognitive impairment); (3) symptoms/disorders persisting for at least 3 months; and (4) both criteria (2) and (3) influence attendance at school or work. We then extracted data of patients with diverse symptoms similar to those after HPV vaccination while considering opinions of doctors in charge. Results Estimated 6-month period prevalence of diverse symptoms among girls aged 12–18 years without HPV vaccination was 20.2 per 100,000. Annual incidence was estimated to be 7.3 per 100,000. Conclusion Adolescent Japanese girls without HPV vaccination also visited hospitals with diverse symptoms similar to those following HPV vaccination. Our findings predict the medical demands for coincident diverse symptoms, which are temporally associated with but not caused by HPV vaccination of Japanese adolescents.

Effect of Different Educational Interventions on Knowledge of HPV Vaccination and Cervical Cancer among Young Women: A Preliminary Report

“…Consequently, the MHLW's Adverse Effects Review Committee confirmed that the various symptoms reported after vaccination were functional physical symptoms [23,24]. A nationwide epidemiological survey conducted by the Sobue Group of the MHLW reported that a few symptoms similar to those reported as post-vaccination symptoms existed among people without a history of HPV vaccination [25]. In a questionnaire survey of women born between 1994 and 2000 in Nagoya, there was no significant difference in the age-adjusted incidence of 24 symptoms between vaccinated and unvaccinated women and no evidence of a causal relationship between the symptoms and HPV vaccination [26].…”

Parental gender influences their intention to HPV vaccinate their children, and the association between HPV and COVID-19 vaccination intentions

“…On the other hand, the estimated case-fatality ratio of COVID-19 infection ranges from 0.001 % (5–9 years old) to 8.29 % (>80 years old) [20] . The efficacy of HPV and COVID-19 vaccines is as high as 95 % or more, and their relative safety is also high [21] , [22] , [23] . Nevertheless, our survey found that people were more afraid of a COVID-19 infection than an HPV infection and more willing to inoculate their children with the COVID-19 vaccine than with the HPV vaccine.…”

Epidemiology of Upper Limb Complex Regional Pain Syndrome in a Retrospective Cohort of Persons Aged 9–30 Years, 2002–2017

“…In June 2013—7 years after the first licensed vaccine for the prevention of cervical cancer and other diseases caused by human papillomavirus (HPV) 7–10 —concerns about a potential link between HPV vaccination and self-reported CRPS stemming from case reports in the media led to the suspension of the HPV vaccination program in Japan 11–13 ; this suspension was not lifted until November 2021. 14–16 In 2015 and again in 2017, in analyses of data from over 270 million doses of HPV vaccines administered in multiple countries, the Global Advisory Committee on Vaccine Safety found no causal association between HPV vaccination and a range of symptoms and diagnoses that included chronic pain, motor dysfunction, CRPS, and postural tachycardia syndrome.…”