Browsing by Author "Tamakoshi, Mio"

Background: Human papillomavirus (HPV) is responsible for most cervical cancer cases. In Japan, the HPV vaccination coverage has dramatically fallen since the government suspended proactive recommendations for the vaccines in 2013, following sensational media reports on alleged adverse reactions. The suspension has not been lifted till today. The government has been criticized by medical establishment for lacking evidence-based policymaking. Grounded on the constructivist approach to scientific knowledge, the study examines how scientific knowledge has been enacted, interpreted, translated into policies by the government and the pro-vaccine institutions throughout the HPV vaccine crisis in Japan. Method: The study analyses the minutes of the governmental expert committee, as well as the proceedings, statements, and publications of three pro-vaccine and pro-resumption institutions. The analysis is conducted using the qualitative content analysis method. Results: The study shows that the government suspended recommendations based on an etiological uncertainty instead of epidemiological calculations and has prolonged the suspension based on the framing of HPV vaccination as an individual’s protection by choice in contrast to seeing it as a public health issue to be promoted in a national effort. It also shows that there is ample heterogeneity among the pro-vaccine and pro-resumption institutions in terms of grounds of arguments and scientific evidence they use to call for an early resumption of governmental recommendations for the HPV vaccines. Conclusions: The study shows a way to understand the Japanese government’s HPV vaccination policy over the past eight years, beyond criticizing it as lacking evidence that supports their policy. This analysis highlights the complexity of scientific knowledge, thus how contingently scientific knowledge come to be enacted as a basis for policy decisions, depending on the values and purposes the decision makers believes in.