This article is from the public number:Occasional Healing ( ID: to-cure-sometimes) , author: Zhang Ping, from the title figure: vision China
On March 26, 2019, a Japanese court announced the verdict of the vaccine against the vaccine of the village of Nakazumi (Riko Muranaka) anti-HPV vaccine neuroscientist Sumitomo Ikeda was found guilty and was sentenced to a fine of 3.3 million yen (about 210,000 RMB).
“Oriental” judgment
The Science magazine reported on the case, in the photo is Murakami
Before losing the lawsuit, Murakami Murakami received the John Maddox Prize, a scientific contribution award established by Nature magazine. The first winner of this award was Fang Zhouzi, a Chinese science writer.
The focus of this three-year case is a “research” by Ikeda.
Ikeda was the head of the Department of Medicine at Shinshu University in Matsumoto, Japan. In March 2016, Ikeda verbally announced a research report on the TV broadcast that HPV vaccine was found to cause brain damage in mice. Three months later, Murakami criticized Ikeda’s research as a medical journalist in the Japanese business magazine Wedge, saying that only one mouse was not vaccinated by Ikeda’s own experiment, and it was shown on TV. A damaged image of the brain was not from the mouse.
Although Shinshu University and Japan’s Ministry of Health, Labor and Welfare for Health and Social Security believe that Ikeda did mislead the public with inappropriate statements, the court evaded doubts about the study itself and still ruled that the village did not provide convincing The evidence was therefore blamed for the crime.
After the court announced the verdict, the top scientific journals Nature and Science (Science) published the results of the review. Expressing deep concern, the former pointed out: “The distortion of the HPV vaccine facts may expose a generation to danger.”
After four days after the court announced the verdict, the popular science writer Fang Zhouzi issued a text on his personal tweet to support Murakami. Fang Zhouzi believes that the verdict “has oriental characteristics,” he said: “Because of rumors, the Japanese girl’s HPV vaccination rate has dropped from 70% to 1%. The price is that many cervical cancer and other cancer patients will be added in the future.” /p>
from “70%” to “1%”
In 2009, the first HPV vaccine was licensed in Japan, but it was expensive because of the high price. A year later, the Japanese government began to promote the HPV vaccine and subsidized the vaccinators. The number of vaccinations has exploded. It is estimated that the 2011-2012 girls in Japan from 12 to 16 years old have a HPV vaccination rate of 70%.
However, in early spring of 2013, suspected HPV post-injection adverse events were published on television, newspapers, and online media. Although the Japanese government introduced the HPV vaccine to the national population for free in April 2013, the vaccination rate began to plummet and the public panic increased as the suspected adverse events continued to ferment in the media.
As of June 14, 2013, the second day of the WHO Global Vaccine Safety Advisory Committee affirming the safety of HPV vaccines, the Japanese Ministry of Health, Labor and Welfare decided to suspend the recommendation for HPV vaccine. After 2013, the HPV vaccine was smashed into the cold in Japan, and the vaccination rate for girls aged 12 and over plummeted to less than 1%.
Image Source: Station Cool Heroo
However, is the risk of HPV vaccine worthy of such panic?
Since the FDA first approved the HPV vaccine in 2006, more than 100 countries have included it in the national immunization program. In addition to the WHO, the United States, Canada, Australia, the United Kingdom, Norway, Denmark and other countries are independent. Vaccine safety regulators have conducted extensive vaccine safety assessments of this vaccine, including dozens of studies from more than one million participants in different countries.
The results of these studies indicate that the incidence of suspected adverse events in the vaccinated population has not increased compared to the incidence of unvaccinated populations.
In short, the HPV vaccine is safe.
So, is the adverse event reported in Japan just an independent event in the crowd here?
In January 2014, a year after the media exposed suspected adverse events, the Japanese Vaccine Adverse Reactions Review Committee investigated these adverse events and concluded that there is no evidence of HPV vaccine and reported adverse events. There is a causal relationship between them.
Therefore, the review committee conducted a nationwide epidemiological study of Japanese adolescents in 2015 and 2016, respectively, reporting similar rates of suspected HPV vaccine adverse events among unvaccinated peers. . The results of safety monitoring are strikingly consistent across countries and populations across the globe.
In this case, what happened during the year, which led to a jump comparison of 70% to 1%?
Media loves bad news
In June 2019, a survey was published at BMC Public Health, where researchers compared four daily newspapers with the highest circulation in Japan – “Asahi Shimbun”, “Yomiuri Shimbun”, “Daily News” and “Day By the news. Analysis of the article before and after the outbreak of the HPV vaccine crisisChanges in the content of the chapter.
In about 20 million paper articles collected, after the suspected “adverse events” in March 2013 were exposed in the media, the content related to HPV vaccine adverse events, as well as “vaccine-induced damage” and “ Terms such as “victims” have been increased by (see below).
Blue line: “vaccine adverse reactions”, black line: “vaccine-induced damage”, gray part: vaccination rate
On the other hand, after the news of the vaccine adverse events in 2013, the proportion of paragraphs that issued safety statements to WHO and major academic groups, as well as the proportions of references to adverse events, have always been small.
This also led to the consequences of the vaccination rate.
Blue Line: Safety Statement issued by relevant groups, Yellow Line: Adverse Reaction Survey Results, Gray Section: Vaccination Rate
For this result, the researchers commented that these newspapers did not choose a neutral descriptive language (eg “symptoms may be a side effect of HPV vaccines”), and terms such as “vaccine-induced damage” and “victims” should be criticized, such words strongly suggest the vaccine The causal relationship between vaccination and symptoms may provoke readers’ fear of adverse events.
In contrast, during the same period, they rarely convey positive aspects of the HPV vaccine. For example, the vaccine’s positive role in preventing cervical cancer, the WHO’s safety statement, and the findings of the review committee. This selective report forms a reader’s misunderstanding of the vaccine and uses the invisible hand to push the reader to vaccinate.
In 2018, Kyoto University professor Ben Youyou (Tasuku Honjo) at the first press conference after winning the Nobel Prize in Physiology or Medicine, Commenting on the HPV vaccine crisis in Japan, he said: “The media is obviously responsible for this.” He pointed out that the media still has a lot of information to be conveyed to the society to resolve prejudice and misunderstanding of new scientific knowledge and to promote the public to make the right choice.
At the beginning of this year, network technology giants such as Facebook, YouTube, Pinterest and Instagram announced that they would use powerful measures to remove or reduce any error messages related to vaccine safety on their platforms. This is undoubtedly The media has made tremendous progress in the anti-vaccine campaign.
Professional “reversal”
In 2015, a survey in the Lancet (The Lancet) magazine showed that in the face of Japan’s early expensive HPV vaccine The reason why parents are willing to vaccinate at their own expense is the doctor’s recommendation. However, the role of many doctors in this HPV vaccine debate is not so positive.
A pediatric, obstetrics and gynaecologist and neurologist in Japan participated in an “anti-HPV vaccine” seminar in March 2013. They stood on the united front with patients and threw doubts about the vaccine.
The former president of the Japanese Academy of Pediatrics and the pediatrician Yokota Yokota said, “As a physician, you should not only look at the data, rely on epidemiological studies, but should study the symptoms of girls who have had adverse events after each vaccination.Look for answers.”
To make matters worse, some doctors began to propose a new syndrome and suggested a serious adverse reaction to the HPV vaccine.
In such statements at the time, these doctors’ recommendations were based entirely on patient complaints and their limited clinical impressions, but were not more scientific and objective.
There is no doubt that the attitude of some doctors has made the situation more complicated and the public’s panic over the vaccine has become more serious. In February of this year, in an interview with a German medical fact check website (61.0 %); The proportion of recommended HPV vaccines to adolescents has also increased from 65.2% to 70%.
In fact, the Japanese medical community, scientists and public health experts have tried to influence the government with a positive attitude. 15 Japanese academic organizations such as the Japanese Academy of Pediatrics, the Japanese Obstetrics and Gynecology Association, and the Japan Infectious Diseases Association began a joint call for the government to quickly resume active recommendation for vaccines.
Despite the efforts of the experts, the Japanese government has not resumed recognition of the HPV vaccine, and the public’s bad impression of the HPV vaccine has also been difficult to recover.
Government that does not welcome vaccines from Baibai to HPV
The HPV vaccine, considered to be one of the most controversial vaccines in the world, has caused a huge storm in the entire Japanese society. However, this is not the first time that Japan has had problems with vaccine safety. The whole process is like history. repeat.
In 1974, Japanese media reported a number of news reports of neurological damage after vaccination with white-cell whole cell vaccine, resulting in a vaccination rate for Japanese children from 80% to 10% in 1976.
At that time, WHO’s findings were: There is no evidence that pertussis whole-cell vaccine can induce brain damage or severe neurological disorders.
In 1993, due to reports of severe aseptic meninges after measles, mumps and rubella (MMR) mixed vaccination Inflammation, the Japanese government decided to withdraw the vaccination proposal for its MMR vaccine. Ironically, the survey showed that the incidence of severe aseptic meningitis was 1.24% in unvaccinated patients and only 0.05% in those who were vaccinated.
From 1976 to 1987, more than 10 million school children were vaccinated each year, but seasonal flu continued to occur, which led to fierce resistance from anti-vaccine individuals who claimed that the flu vaccine was ineffective. The flu vaccine coverage among schoolchildren dropped sharply from 80% at the peak to 18% in 1992. In 1994, Japan excluded the flu vaccine from the national immunization program. Although in 2001 the government revised immunization schedule, recalled to the flu vaccine, it’s vaccination rates remain low.
7-valent vaccine pneumonia, Haemophilus influenza vaccine, rotavirus vaccine, hepatitis B vaccine …… War of the list of this vaccine can still continue.
The policy formulation of Japanese vaccination can be said to be a complete failure.
A Japanese medical professor said in an interview with Japan Times that Japan’s vaccination policy is lagging behind Europe and North America for more than a decade.
In 2015, WHO clearly stated to Japan: “There is a lack of solid evidence to make a (suspension of recommended HPV vaccine) policy decision, resulting in Safe and effective vaccines are not accepted and may cause real harm.”
After a national vaccination program is stopped for any reason, in an unfortunate year of birth, unprotected susceptible populations will emerge, and rubella and measles are the best precedents.
A large number of susceptible individuals lacking immunity were born during this decade before the recovery of rubella and measles. There were a total of 17,050 cases of rubella outbreaks between 2012 and 2014. From 2001 to the present, measles has accumulated about 170 cases, and this number has risen to the highest level in the same period in ten years. Vaccination is by far the most indisputable and effective way to avoid measles.
In February of this year, 167 cases were reported in 20 states in Japan during the week. Image source: National Institute of Infectious Diseases, Japan
In view of these past failures and the current confusion about HPV vaccination, what is the reform of the Japanese vaccination system? Is it going to repeat the ridiculous sway of the vaccine, or is it timely to sway the horses, weaken the anti-vaccine interests to control the media and exert political pressure on the government? Is the decision to be made by an independent advisory committee based on verifiable scientific evidence, or is it determined by government officials?
On October 30, 2019, Nakamura Nominee’s appeal against the crime was rejected by the court. Nakamura wrote on her personal blog: “In the Japanese judicial system, individuals who have made false statements affecting the lives of most people are more important than scientifically pointing out their wrong social welfare?” /strong>
The road is long and the line is approaching. Nakamura will continue to appeal “lonely”.
References:
[1] Okuhara, T., Ishikawa, H., Okada, M. et al. Newspaper coverage before and after the HPV vaccination crisis began in Japan: a text mining analysis BMC Public Health 2019;19,770.
[2] Hanley SJ, Yoshioka E, Ito Y, et al. HPV vaccination crisis in Japan. Lancet. 2015;385(9987):2571. < /p>
[3] Court ruling highlights the threat of vaccine misinformation.Nature. 2019 Apr;568(7750):5. https://www.nature.com/articles/d41586 -019-01031-x.
[4] Ueda, Y., Yagi, A., Nakayama, T. et al. Dynamic changes in Japan’s prevalence of abnormal findings in cervical cytology depending on birth year. Sci Rep. 2018; 8, 5612 .
[5] “Expenditure and Financial Burden of Common Cancer in China: A Hospital-Based Multicenter Cross-Section Study”, National Cancer Center.
[6] The price of drugs for CML is a reflection of the unsustainable preices of cancer drugs: from perspective of a large group of CML experts. 2013, Blood.
[7] Bending the cost curve in Cancer Care. 2011, NEMJ.
[8] In Cancer Care, Cost Matters. 2012, Newyork Times.
This article is from the public number: occasionally cure (ID: to-cure-sometimes) , author: Zhang Ping, editor: Li Shanshan