HPV Vaccination in Japan: Challenges and the Need for Gender-Neutral Immunization

Abstract

　Human papillomavirus (HPV) is responsible not only for cervical cancer but also for a wide range of malignancies, including vulvar, anal, penile, and oropharyngeal cancers. Therefore, prevention of HPV infection is important for both women and men. In many Western countries, gender-neutral vaccination (GNV) has been adopted as a standard public health strategy, and its effectiveness in reducing HPV infections has been well documented. In Japan, however, routine HPV vaccination is currently limited to females.

　This article reviews the epidemiology and pathogenesis of HPV infection, as well as the efficacy and safety of HPV vaccination. In addition, economic and policy-related aspects-including social and ethical considerations and cost-effectiveness are examined in an integrated manner to explore the background behind the lack of approval for routine HPV vaccination in males in Japan. A substantial body of scientific evidence supporting the effectiveness of gender-neutral vaccination has accumulated worldwide. When considering its implementation, regulatory frameworks and social acceptance should also be taken into account. A comprehensive HPV infection prevention strategy that transcends gender differences may play an important role as a foundation for cancer supportive care.