Tag: Japan

Who is Riko Muranaka?

It’s a shame that you are probably very familiar with Andy Wakefield, Bob Sears, and Del Bigtree, but have never heard of Riko Muranaka.

Do you know any vaccine advocates?

Who is Riko Muranaka?

Riko Muranaka is a doctor and a journalist and was one of the few to push back against all of the negative articles in the Japanese media following the decision of Japanese Ministry of Health, Labour and Welfare to stop formally recommending that girls get vaccinated and protected with the HPV vaccine.

“We can’t afford to sit back and allow a similar situation to develop in which unscientific claims jeopardize lives around the world. The Japanese government should reinstate its proactive recommendation for the HPV vaccine and set a positive example before irrational fear of the vaccine gains further momentum in other countries.”

Riko Muranaka on Stopping the Spread of Japan’s Antivaccine Panic

Not only that, it was her investigation that led to the discovery that the initial report that led to the HPV scare by neurologist Shuichi Ikeda was misleading and inappropriate.

“Evidence she used against Japanese neurologist Shuichi Ikeda revealed that only a single mouse had been vaccinated and the brain section showing damage did not belong to this mouse.”

The EU battle strategy against fake news, fighting the 4Ds that lead to doubt: CORDIS attends the 11th World Conference of Science Journalists

So where does that leave Riko Muranaka?

In 2017, she received the John Maddox Prize for Standing up for Science “for promoting science and evidence on a matter of public interest, despite facing difficulty or hostility in doing so.” 

What kind of difficulty and hostility has she faced?

“Because of her science-based reporting on this topic, Dr. Muranaka experienced massive hostility. Unlike before, she became unable to publish in Japanese media. Her family was threatened, and she was sued by an anti-vaccination doctor.”

How Japan was taken by an anti-vax tsunami

Unbelievably, Ikeda sued Dr. Muranaka for defamation and won, even though the Japanese Ministry of Health, Labour and Welfare censured Ikeda for misrepresenting his research. The case is currently on appeal.

And tragically, although HPV vaccines are still available in Japan, after all, they were never banned, they still don’t have a proactive recommendation.

Riko Muranaka still has work to do to get HPV vaccination rates back up in Japan, but she did help to make sure that “Japan’s antivaccine panic” didn’t spread anywhere else.

More on Riko Muranaka

Did Japan Ban the HPV Vaccine?

Why do some folks think that Japan banned the HPV vaccine?

Looking at an immunization schedule from Japan, it is easy to see that none of this is true.
Looking at an immunization schedule from Japan, it is easy to see that none of this is true.

The usual suspects…

Did Japan Ban the HPV Vaccine?

But no, Japan never did ban the HPV vaccine.

The HPV vaccine is still on the immunization schedule in Japan and it is actively recommended by the Japan Pediatric Society.
The HPV vaccine is still on the immunization schedule in Japan and it is actively recommended by the Japan Pediatric Society.

What did happen is that the Japanese Ministry of Health, Labour and Welfare stopped formally recommending that everyone get vaccinated and protected with the HPV vaccine.

They removed their proactive recommendation for girls to get vaccinated against HPV infections.

Why?

“In Japan, coverage rates for the HPV vaccine have plummeted from 70 percent in 2013 to less than 1 percent today. This happened after a preliminary (and allegedly fraudulent) mouse study showing the vaccine caused brain damage was spread by the media, along with unconfirmed video reports of girls in wheelchairs and having seizures after getting immunized.”

Why Japan’s HPV vaccine rates dropped from 70% to near zero

Sounds like they got Wakefielded

But they quickly reinstated the recommendation though, right?

“To better understand the significance and health impact of the purported adverse symptoms from the HPV vaccine, a national epidemiological study of the general population in Japan was conducted by a research arm of the MHLW. In the research, similar numbers of girls with the same symptoms were reported in both vaccinated and unvaccinated girls.”

Ikeda et al on HPV vaccination in Japan: what is happening in Japan?

After all, all of their investigations found no merit to the initial reports that led to the “ban.”

“In January, 2014, the Vaccine Adverse Reactions Review Committee investigating these adverse events concluded that there was no evidence to suggest a causal association between the HPV vaccine and the reported adverse events after vaccination, but they still did not reinstate proactive recommendations for its use.”

JB Hanley et al on HPV vaccination crisis in Japan

Tragically, they didn’t.

“Suspension of the recommendation for vaccination has continued to the present, despite no scientific or epidemiologic evidence showing a causal link between postvaccination symptoms and HPV vaccines. This situation is unique to Japan.”

Matsumoto et al on Reduction in HPV16/18 prevalence among young women with high‐grade cervical lesions following the Japanese HPV vaccination program

What was the effect?

We have long known that their policy led to much lower HPV vaccination rates in Japan.

And not surprisingly, lower HPV vaccination rates will once again led to higher rates of HPV infections, after years of declines among those who were vaccinated and protected.

Ueda et al showed the Dynamic Changes in Japan's Prevalence of Abnormal Findings in Cervical Cervical Cytology Depending on Birth Year
Ueda et al showed the Dynamic Changes in Japan’s Prevalence of Abnormal Findings in Cervical Cervical Cytology Depending on Birth Year (CC BY 4.0)

And this is all happening in a country that is already seeing increasing rates of cervical cancer, “despite a decreasing trend in most developed countries.”

“We can’t afford to sit back and allow a similar situation to develop in which unscientific claims jeopardize lives around the world. The Japanese government should reinstate its proactive recommendation for the HPV vaccine and set a positive example before irrational fear of the vaccine gains further momentum in other countries.”

Riko Muranaka on Stopping the Spread of Japan’s Antivaccine Panic

The only real questions now are why are they still waiting to reinstate a proactive recommendation in Japan?

“In Japan, the percentage of women getting a cervical cancer screening is low, while the incidence of cervical cancer is increasing. Therefore, the nationwide introduction of HPV vaccination was expected to bring cervical cancer under control.”

Ikeda et al on HPV vaccination in Japan: what is happening in Japan?

And how many people will unnecessarily get HPV infections and cervical cancer until they do?

More on Banned Vaccines

When Was the Last Case of Rubella in the United States?

While we rarely hear about rubella anymore, like most other vaccine-preventable diseases, the last case of rubella in the United States was a lot more recent than you probably imagine.

Austin recently had its first case of rubella in twenty years.

Although endemic rubella and congenital rubella syndrome were declared eliminated in 2004, like measles, we still have cases each year.

When Was the Last Case of Rubella in the United States?

To be sure, rubella is far less common that it used to be.

Remember the rubella epidemics of the 1960s, when rubella caused 2,100 neonatal deaths and 20,000 infants to be born with congenital rubella syndrome?

If natural herd immunity really works, how do you explain congenital rubella syndrome in the pre-vaccine era and in countries that don't use the rubella vaccine?
If natural herd immunity really works, how do you explain congenital rubella syndrome in the pre-vaccine era and in countries that don’t use the rubella vaccine? Why doesn’t everyone get natural immunity when they are younger and rubella is milder, avoiding the chance of getting sick when they are pregnant?

How about the rubella outbreaks in the early 1990s, when rubella caused 13 deaths and 77 cases of congenital rubella syndrome?

“Rubella is a leading cause of vaccine-preventable birth defects. Although rubella virus infection usually causes a mild febrile rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects known as congenital rubella syndrome (CRS).”

Grant et al on Progress Toward Rubella and Congenital Rubella Syndrome Control and Elimination — Worldwide, 2000–2018

One of our problems today is that most people don’t remember these epidemics and outbreaks, so they don’t understand how important it is for everyone to be vaccinated and protected.

They have no idea how fortunate they are that these diseases no longer make routine headlines.

But what happens if too many people skip or delay their vaccines?

Japan is still dealing with a large outbreak of rubella, with resulting cases of congenital rubella syndrome.

We will see more rubella and congenital rubella syndrome.

There were five cases of congenital rubella syndrome in the United States in 2017, all import related.
All five cases of congenital rubella syndrome in the United States in 2017 were import related.

While we do see some congenital rubella cases now, they are all women who were exposed to rubella outside the United States when they were pregnant.

“During 2001–2004, four CRS cases were reported to CDC; the mothers of three of the children were born outside the United States.”

Achievements in Public Health: Elimination of Rubella and Congenital Rubella Syndrome — United States, 1969–2004

Again, since the endemic spread of rubella was declared eliminated in 2004, cases since then are import related. People who aren’t immune get exposed to rubella when they are traveling to areas of the world where rubella is more common and return. Fortunately, since rubella isn’t as contagious as measles, these cases don’t usually cause big outbreaks.

So when was the last case of rubella and congenital rubella syndrome in the United States that wasn’t imported from outside the United States?

It was just before 2004.

Let’s get everyone vaccinated and protected before we see the next case.

More on Rubella and Congenital Rubella Syndrome

Does Measles Protection from the MMR Vaccine Wane Over Time?

Why do some parents think that measles protection from the MMR vaccine might wane over time?

Yup – misinformation from the usual suspects.

Does Measles Protection from the MMR Vaccine Wane Over Time?

Wait, how can this be misinformation if they are citing a source and it is a study published by the CDC?

“The results, published in Archives of Pediatrics and Adolescent Medicine, show that even after being previously vaccinated twice for measles, about 35% of vaccinated 7-year-olds and 60% of vaccinated 15-year-olds are susceptible to subclinical infection with measles virus.”

Physicians for Informed Consent: CDC Data Shows Immunity from the MMR Vaccine Wanes Over Time

While that doesn’t sound good, that’s not what the study really says!

“A rise in the proportion of persons with low antibody levels suggests an increase in potential susceptibility, but low titers are unlikely to represent the same risk of illness or viral transmission as absent antibodies.”

LeBaron et al on Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a Postelimination Environment

They are clearly misinterpreting what the study does say and mean.

“In summary, we found that, in a population of children who had received 2 doses of measles vaccine at ages and intervals consistent with US policy and who were unlikely to have been exposed to wild-type measles, potential susceptibility rates were low for as long as 10 years after the second dose.”

LeBaron et al on Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a Postelimination Environment

The funny thing is that the study is about what happens to vaccine induced immunity in the absence of exogenous boosting.

In other words, what happens when vaccines get diseases under good control so that we are no longer exposed to wild disease which can give our antibody levels a little boost.

So they are highlighting a study that proves that vaccines work and fortunately, it concludes that “measles antibody persists,” even without exogenous boosting.

The other study they cite discusses a measles outbreak in Japan.

In the 2018 outbreak, 99 people got measles.

“A recent outbreak of measles in Okinawa Prefecture, Japan ended with 33 measles cases whose symptoms were masked because of insufficient protection against the disease (modified measles).”

Mizumoto et al on Transmission potential of modified measles during an outbreak, Japan, March‒May 2018

Only 10 were fully vaccinated with two doses of measles vaccine. An additional 20 had one dose.

“Symptoms in modified measles cases are masked, so they do not present with the full (typical) symptoms of measles (fever, maculo-papular rash and catarrhal symptoms such as cough, coryza or conjunctivitis) and their transmission risk is reported to be lower.”

Mizumoto et al on Transmission potential of modified measles during an outbreak, Japan, March‒May 2018

While many vaccines do lead to milder disease, even if the vaccine doesn’t provide full protection, we don’t typically see that with measles, except for rare case reports.

So instead of modified measles, it is possible that many of these folks were simply very recently vaccinated, likely in response to the outbreak, and were having a vaccine reaction.

Remember, measles containing vaccines do commonly cause a fever and rash as a side effect. That’s why we sometimes see vaccine strain measles in outbreak reports. These aren’t typically people with measles or modified measles.

“This case report adds further evidence for lower infectivity of modified measles with no secondary cases and highlights the potential requirement for updated contact tracing recommendations in this scenario. Other case reports have shown that individuals with modified measles and history of prior vaccination have more robust levels of plaque reduction neutralisation (PRN) titre, reflecting an immunity booster response. These case studies also identified no secondary cases. In measles outbreak reports in healthcare workers with two documented MMR vaccines, no onward transmission of measles has been reported.”

Uren et al on Modified measles with an atypical presentation

Still, although it would be better if vaccines prevented disease and you would get sick at all, when they don’t, isn’t a modified case better than getting full blown measles?

And the bottom line is that the so-called Physicians for Informed Consent is once again misleading people if they are trying to make them think that the MMR vaccine will wane and that “Nearly 50% of Vaccinated U.S. Schoolchildren Can Become Infected With and Spread Measles.”

The only school where you will find that nearly 50% of the kids are susceptible to measles is likely a Waldorf school. But that’s only because they won’t be vaccinated and protected.

More on Waning Immunity