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      Intentions for catch-up HPV vaccination in Japan: an internet survey

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          Abstract

          Purpose

          In Japan, Japan’s Ministry of Health, Labor, and Welfare decided to suspend govermental recommendation for HPV vaccination in FY 2013. The HPV vaccination rate for those born in FY 2000 or thereafter declined dramatically. In 2021, the “suspension of recommendation” ended. The catch-up vaccinations for the unvaccinated have been offered nationwide from FY 2022 to FY 2024. We aimed to quantify the vaccination intentions and characteristics of those young women now eligible for catch-up vaccination. 

          Methods

          In February of 2022, we conducted an internet survey targeted women who were born in 1997–2004 but who had not yet been HPV vaccinated.

          Results

          We received 1,648 valid responses. 41.6% of the respondents wanted to uptake the catch-up HPV vaccination, 29.7% were undecided, and 28.7% did not want to be vaccinated. The intention to uptake catch-up HPV vaccination was associated with a good history of gynecological visits, intention to receive cervical cancer screening, sexual activity, degree of anxiety about cervical cancer, familiarity with problems associated with cervical cancer, experience with vaccination recommendations, and knowledge about cervical cancer ( p < 0.05, respectively). In the vaccinated generation, the proportion of the group that did not want to be vaccinated was significantly higher ( p < 0.05). In the vaccine-suspended generation, the proportion of the group that wanted to be vaccinated was significantly higher ( p < 0.05).

          Conclusion

          Our survey revealed that catch-up vaccination intentions differed depending on the vaccination environment. It is necessary for all organizations involved with HPV vaccination, such as government, medical institutions, and educational institutions, to make recommendations based on an understanding of the characteristics of the “vaccinated generation” and the “vaccine-suspended generation”.

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          Most cited references21

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          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            Worldwide burden of cancer attributable to HPV by site, country and HPV type

            HPV is the cause of almost all cervical cancer and is responsible for a substantial fraction of other anogenital cancers and oropharyngeal cancers. Understanding the HPV‐attributable cancer burden can boost programs of HPV vaccination and HPV‐based cervical screening. Attributable fractions (AFs) and the relative contributions of different HPV types were derived from published studies reporting on the prevalence of transforming HPV infection in cancer tissue. Maps of age‐standardized incidence rates of HPV‐attributable cancers by country from GLOBOCAN 2012 data are shown separately for the cervix, other anogenital tract and head and neck cancers. The relative contribution of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 was also estimated. 4.5% of all cancers worldwide (630,000 new cancer cases per year) are attributable to HPV: 8.6% in women and 0.8% in men. AF in women ranges from 20% in India and sub‐Saharan Africa. Cervix accounts for 83% of HPV‐attributable cancer, two‐thirds of which occur in less developed countries. Other HPV‐attributable anogenital cancer includes 8,500 vulva; 12,000 vagina; 35,000 anus (half occurring in men) and 13,000 penis. In the head and neck, HPV‐attributable cancers represent 38,000 cases of which 21,000 are oropharyngeal cancers occurring in more developed countries. The relative contributions of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 are 73% and 90%, respectively. Universal access to vaccination is the key to avoiding most cases of HPV‐attributable cancer. The preponderant burden of HPV16/18 and the possibility of cross‐protection emphasize the importance of the introduction of more affordable vaccines in less developed countries.
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              Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

              Summary Background There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. Methods In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Findings Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. Interpretation To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. Funding European Commission, Wellcome, and Engineering and Physical Sciences Research Council.
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                Author and article information

                Contributors
                a.yagi@gyne.med.osaka-u.ac.jp
                Journal
                Int J Clin Oncol
                Int J Clin Oncol
                International Journal of Clinical Oncology
                Springer Nature Singapore (Singapore )
                1341-9625
                1437-7772
                30 September 2023
                30 September 2023
                2023
                : 28
                : 12
                : 1667-1679
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, ( https://ror.org/035t8zc32) 2-2, Yamadaoka, Suita, Osaka, 565-0871 Japan
                [2 ]Clinical Psychology, Graduate School of Human Sciences, Osaka University, ( https://ror.org/035t8zc32) 1-2, Yamadaoka, Suita, Osaka, 565-0871 Japan
                [3 ]GRID grid.260975.f, ISNI 0000 0001 0671 5144, Department of Obstetrics and Gynecology, , Niigata University Graduate School of Medical and Dental Sciences, ; 1-757 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8510 Japan
                [4 ]GRID grid.272242.3, ISNI 0000 0001 2168 5385, Center for Public Health Sciences, , National Cancer Center, ; 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
                [5 ]Department of Obstetrics and Gynecology, Oita University Graduate School of Medicine, ( https://ror.org/01nyv7k26) 1-1, Hasamamachiidaigaoka, Yufu, Oita 879-5593 Japan
                [6 ]Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, ( https://ror.org/0135d1r83) 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa 236-0004 Japan
                Author information
                http://orcid.org/0000-0002-3222-5963
                Article
                2411
                10.1007/s10147-023-02411-0
                10687105
                37776388
                5b7a42d4-9891-42c5-9e75-e60f67d10cad
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 9 April 2023
                : 30 August 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003478, Ministry of Health, Labour and Welfare;
                Award ID: A Health
                Award ID: Labour Sciences Research Grant
                Award Recipient :
                Funded by: Osaka University
                Categories
                Original Article
                Custom metadata
                © Japan Society of Clinical Oncology 2023

                japan,hpv vaccine,catch-up vaccination,cervical cancer,suspension of recommendation,health communication

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