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Effectiveness of prophylactic HPV vaccine for cervical abnormalities and HPV infection in Japan: the Japanese Human Papillomavirus Disease Education and Research Survey (J-HERS) 2021
  • +15
  • Toshiyuki Sasagawa,
  • Yoshihiko Saeki,
  • Takuya Irie,
  • Fujiko Itoh,
  • Akiko Enatsu,
  • Hiroko Komura,
  • Miho Fujii,
  • Ryota Fujii,
  • Natsuko Hidaka,
  • Toshiyuki Maehama,
  • Nobuhiko Shirasu,
  • Tomoo Waseda,
  • Takeo Shibata,
  • EMI TAKATA,
  • Kazuki Mibe,
  • Jinichi Sakamoto,
  • Sousuke Yamada,
  • Masahiro Takakura
Toshiyuki Sasagawa
Kanazawa Ika Daigaku Igakubu

Corresponding Author:tsasa@kanazawa-med.ac.jp

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Yoshihiko Saeki
Kanazawa Ika Daigaku Igakubu
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Takuya Irie
Ladies Clinic
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Fujiko Itoh
Kokusai Central Clinic
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Akiko Enatsu
Four Seasons Ladies Clinic
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Hiroko Komura
Koumura Women’s Clinic
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Miho Fujii
Caress Sapporo Tokeidai Memorial Hospital
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Ryota Fujii
Koyodai Clinic
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Natsuko Hidaka
Aoba Women’s Clinic
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Toshiyuki Maehama
Yuuai Medical Center
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Nobuhiko Shirasu
White Ladies Clinic
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Tomoo Waseda
Anju Ladies Clinic
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Takeo Shibata
Kanazawa Ika Daigaku Igakubu
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EMI TAKATA
Kanazawa Ika Daigaku Igakubu
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Kazuki Mibe
Kanazawa Ika Daigaku Igakubu
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Jinichi Sakamoto
Kanazawa Ika Daigaku Igakubu
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Sousuke Yamada
Kanazawa Ika Daigaku
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Masahiro Takakura
Kanazawa Ika Daigaku Igakubu
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Abstract

Objective: This study investigated the efficacy of the prophylactic human papillomavirus (HPV) vaccine started at 2009- 2013 in Japan. Materials and Methods: The study involved 1529 eligible women aged 16 to 39 years who visited 11 outpatient clinics for various reasons in Japan. All these patients underwent an examination of HPV genotype and a Pap test using cervical cell samples. Two hundred ninty-nine women (19.6%) received the prophylactic HPV vaccine (bivalent :quadrivalent vaccine ratio = 2:1). Of the 5062 participants in the Japanese Human Papillomavirus Disease Education and Research Survey (J-HERS 2011), which was conducted in the pre-vaccination era, 3236 eligible participants were included as controls. Results: In the present study (J-HERS 2021), highest rate for HPV vaccination (53%) was observed in 22- to 27-year-old patients. Vaccinated ones showed 49% protection against low-grade intraepithelial lesions (LSIL) and atypical squamous cells not excluding high-grade squamous intraepithelial lesions (ASCH) or worse (LSIL/ASCH+), and 100% protection against high-grade squamous intraepithelial lesions (HSIL) or worse (HSIL+). The prevalences of HPV16 and HPV18 infections also significantly decreased (HPV16; 95% and HPV18; 100%), but there were no differences in HPV6 and HPV11 infections by the vaccination. The prevalences of HPV51 and HPV59 increased with vaccination, although these changes were not confirmed in the comparative study with J-HERS 2011. Comparisons between the pre-vaccination period (J-HERS 2011) and post-vaccination period (J-HERS 2021) revealed reduction rates of 43%, 51%, 88%, and 62% were observed for HPV16, HPV18, HPV16/18, and HPV31/58 infections, respectively. Similarly, reduction rates of 62% and 71% for LSIL/ASCH+ and HSIL+, respectively. The reduction rate for LSIL/ASCH+ was 88% in 16- to 21-year-old patients, whereas the rate for HSIL+ was 87% in 28- to 33-year-old patients. C onclusion: Bivalent or quadrivalent vaccines provided 100% protection against high-grade squamous cell lesions (suggestive of CIN2 or CIN3) in young women aged < 39 years at 9 to 12 years after initiation of the first nationwide HPV vaccination program in Japan. Cross-protection against HPV31 and HPV58 is likely to occur, although some HPV type replacements are inconsistent across vaccination regimens. This demonstrates a high effectiveness of HPV vaccine. In contrast, we worry about no reduction of cervical cancer in younger generation (born in 1997-2007) who are rarely vaccinated due to long term suspension of this vaccine recommendation in Japan.
23 Oct 2023Submitted to Journal of Medical Virology
24 Oct 2023Submission Checks Completed
24 Oct 2023Assigned to Editor
24 Oct 2023Review(s) Completed, Editorial Evaluation Pending
25 Oct 2023Reviewer(s) Assigned
20 Nov 2023Editorial Decision: Revise Minor