Department of Reproductive Endocrinology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Vaccine. 2012 Aug 24;30(39):5740-7. doi: 10.1016/j.vaccine.2012.07.003. Epub 2012 Jul 13.
To better understand how to achieve high uptake rates of human papillomavirus (HPV) vaccination in Japan, we investigated acceptance of and attitudes towards HPV vaccination in 2192 mothers of girls aged 11-14 yrs. A school-based survey was conducted in five elementary and fourteen junior high schools in Sapporo, Japan. Responses from 862 participants were analyzed. Ninety-three percent of mothers would accept the vaccine for their daughter if free, but only 1.5% was willing to pay the minimum recommended price of ¥ 40,000. Vaccine acceptance was higher in mothers who had heard of HPV vaccine (adjusted odds ratio, aOR=2.58, confidence interval, CI=1.47-4.53), and who believed susceptibility to (aOR=2.30, CI=1.34-3.92) and severity of (aOR=3.73, CI=1.41-9.88) HPV to be high. Recommendations from a doctor (aOR=12.60, CI=7.06-21.48) and local health board (aOR=27.80, CI=13.88-55.86) were also positively associated with increased HPV vaccine acceptance. Concerns about side effects of both the HPV vaccine (aOR=0.03, CI=0.01-0.08) and routine childhood vaccines in general (aOR=0.11, CI=0.02-0.78) emerged as barriers to vaccination. Not participating in routine cervical screening also emerged as a deterrent (aOR=0.49, CI=0.27-0.91). While most mothers (66.8%) agreed that 10-14 yr was an appropriate age for vaccination, a further 30.6% believed >15 yr to be more appropriate. In conclusion, attitudes of Japanese mothers toward HPV vaccination are encouraging. While lower vaccine acceptance in mothers who do not undergo regular cervical screening needs further investigation, this study indicates that high uptake may be possible in a publically funded HPV vaccination program if physicians actively address safety concerns and justify why the vaccine is needed at a particular age.
为了更好地了解日本如何实现人乳头瘤病毒（HPV）疫苗接种率的提高，我们调查了 2192 名 11-14 岁女孩的母亲对 HPV 疫苗接种的接受程度和态度。在日本札幌的五所小学和十四所初中进行了一项基于学校的调查。对 862 名参与者的回答进行了分析。如果免费，93%的母亲会接受为女儿接种疫苗，但只有 1.5%的母亲愿意支付建议的最低价格 40000 日元。听说过 HPV 疫苗的母亲（调整后的优势比，aOR=2.58，置信区间，CI=1.47-4.53），以及认为 HPV 易感性（aOR=2.30，CI=1.34-3.92）和严重性（aOR=3.73，CI=1.41-9.88）高的母亲，对疫苗的接受程度更高。医生（aOR=12.60，CI=7.06-21.48）和地方卫生委员会（aOR=27.80，CI=13.88-55.86）的推荐也与 HPV 疫苗接种率的增加呈正相关。对 HPV 疫苗（aOR=0.03，CI=0.01-0.08）和一般常规儿童疫苗（aOR=0.11，CI=0.02-0.78）的副作用的担忧也成为接种疫苗的障碍。不参与常规宫颈癌筛查也成为一种威慑（aOR=0.49，CI=0.27-0.91）。虽然大多数母亲（66.8%）认为 10-14 岁是接种疫苗的合适年龄，但还有 30.6%的母亲认为 15 岁以上更合适。总之，日本母亲对 HPV 疫苗接种的态度是令人鼓舞的。虽然不进行常规宫颈癌筛查的母亲的疫苗接种接受率较低，但进一步的研究表明，如果医生积极解决安全性问题，并说明为什么需要在特定年龄接种疫苗，那么在公共资助的 HPV 疫苗接种计划中，高接种率是有可能实现的。
