Vaccine-associated paralytic poliomyelitis in Japan

Paper entitled "Vaccine-associated paralytic poliomyelitis in Japan" has been published in Lancet.

Despite WHO's recommendation to switch the poliomyelitis vaccine from oral polio vaccine (OPV) to inactivated polio vaccine (IPV) in countries where polio elimination has been achieved, Japan has continued to use OPV. In Japan, OPV is given twice to children aged from 3 to 18 months.1 More than 10 years after the elimination of wild polio virus, tragic cases of vaccine-associated paralytic poliomyelitis (VAPP) continue to be reported every year—most recently in May, 2011. The Ministry of Health, Labour and Welfare claims that IPV is still being developed by Japanese vaccine companies and that it will not be available until the end of 2012 at the earliest. The growing tension between the Government, which persists with domestically produced OPV, and the parents, who request IPV to avoid VAPP, has evoked huge media attention.


To understand OPV perceptions and practices among parents, we did a survey of 260 parents whose children attend day care or one of two nursery schools in Kanagawa Prefecture. 50 parents (19%) thought that OPV was dangerous and 81 (31%) wanted their children to take IPV. Because of the growing fear of OPV, the coverage of OPV has been decreasing. According to the Ministry, OPV coverage from April to June, 2011, was 17·5% lower than in the previous year.2 A paediatrician in the urban area of Tokyo has said that the inoculation rate is only about 50% there, which indicates an increased risk of retransmission of poliovirus once it is imported.3


Despite such concerns, the Japan Pediatric Society recommends that people should take OPV until domestically produced IPV becomes available.4 However, some paediatricians have begun to import IPV and administer it if parents are willing to pay out-of-pocket expenses of US$160—240. The Governor of Kanagawa Prefecture also announced the establishment of a system to provide IPV to respond to the needs of residents, despite strong opposition from the Government.


Japan has been a major driver of the Global Polio Eradication Initiative,5 but the lack of consistency between its domestic and global health policies is harming its own people. How long will the Japanese people need to wait for safe IPV to become available?


This study was reviewed by the Office of Human Research Administration of the Harvard School of Public Health. Protocol number 21402-101: “Polio vaccination status and parents' perception on polio vaccine.” We declare that we have no conflicts of interest.


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Comment by Piya Hanvoravongchai on March 20, 2012 at 10:09am
Thanks for sharing. It is interesting to know that even in Japan there are difficulties getting polio vaccination covered
Comment by HealthSpace.Asia on March 19, 2012 at 9:22am

Hi Miwako. Thanks for sharing this information with us.

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