子宮頸がん ワクチン接種の勧奨は慎重に

The Yomiuri Shimbun
Health ministry should be cautious in promoting cervical cancer vaccine
子宮頸がん　ワクチン接種の勧奨は慎重に

Should the government proactively recommend that girls be vaccinated for cervical cancer? The Health, Labor and Welfare Ministry must exercise a careful judgment on this question.
　国が子宮頸けいがんワクチンの接種を積極的に勧めるべきかどうか。厚生労働省には慎重な判断が求められる。

Cervical cancer is caused mainly by viruses transmitted through sexual intercourse. The vaccine is effective against two such viruses that cause 50 to 70 percent of cases of cervical cancer. Japan began using it in 2009.
　子宮頸がんは主に性交渉で感染するウイルスが原因だ。ワクチンは、子宮頸がんの原因の５～７割を占める２種類のウイルスを防ぐ効果がある。国内では２００９年に使用が始まった。

In April last year, the health ministry set the age range for this vaccination from girls in the sixth grade of primary school through girls in the first year of high school. The girls are obliged to try to receive the vaccination, but the fee of ¥50,000 per person is subsidized by public funds.
This means all those who wish to be vaccinated can undergo the procedure for free, in principle.
　厚労省は昨年４月に小学６年から高校１年までの女子を定期接種の対象とした。接種を「努力義務」とする一方、約５万円の接種料は公費で補助し、希望者は原則無料で受けられるようになった。

So far, more than 3 million women are estimated to have been inoculated against cervical cancer.
　これまでに推計３００万人以上が接種を受けている。

However, a series of side effects have been reported. The number of serious cases, including those involving fainting or convulsions, has exceeded 500. There are also many people who have found it difficult to pursue their daily lives due to chronic pain after vaccination. These facts must be seriously considered.
　ところが、副作用の報告が相次いだ。失神やけいれんなどの重い症例だけでも５００件を超える。慢性的な痛みにより、日常生活が困難になった人もいることは、深刻に受け止めねばならない。

Only two months after the vaccination was made routine, the ministry took the unusual step of suspending the program encouraging girls to receive it. At present, the number of girls receiving the vaccine has declined drastically.
　定期接種開始から２か月後に、厚労省は積極勧奨を一時中止する異例の措置を講じた。現在、接種者は大幅に減っている。

More studies needed

A ministry panel of experts studying the side effects presented a opinion in January that the symptoms that occurred after vaccination were not caused by components of the vaccine, believing they were physical and mental reactions triggered by strong pain and anxieties felt at the time of inoculation.
　厚労省の有識者検討会は今年１月、症状はワクチンの成分が原因ではなく、「接種時の強い痛みや不安が引き起こした心身の反応」との見解を示した。

However, the conditions that trigger the side effects are not completely understood. There is no surefire treatment for the symptoms, which naturally makes many people harbor reservations about the vaccination.
　ただ、どういう場合に副作用が起きるのか、完全には分かっていない。治療を受けても、症状は必ずしも改善しない。接種に不安を抱く人が多いのは当然だろう。

The panel is to decide soon whether the ministry should resume actively recommending girls in the age group to receive the vaccine. However, opinions on the issue are divided among members of the ruling coalition parties. We think an environment in which girls can be vaccinated without concern must be created as soon as possible by advancing research on the vaccine, including methods to treat the side effects.
　検討会は近く、積極勧奨を再開するかどうかを決める見通しだ。だが、与党内でも意見が割れている。副作用の治療方法などの研究を進め、安心して接種を受けられる環境整備を急ぐ必要がある。

The original and key aim of a routine vaccination is so-called social defense, to prevent measles, rubella, tuberculosis and other transmittable diseases from spreading.
　そもそも、定期接種は、はしかや風疹、結核などの感染を拡大させないための「社会防衛」を主眼に行われる。

In contrast, the vaccination against cervical cancer aims at so-called personal defense to protect individuals from the risk of cancer. We doubt it has the same nature as vaccines the government should actively recommend to the public get, like the vaccines against infectious diseases.
　これに対し、子宮頸がんワクチンの接種は、がんの危険から自らを守る「個人防衛」が目的だ。他の感染症のワクチンのように、政府が積極的に勧奨すべきものとは性格が異なるのではないか。

Also, ¥30 billion in public money is spent every year on the routine vaccination but it still cannot completely prevent cervical cancer.
　定期接種には年間３００億円の公費が投じられるが、子宮頸がんを完全に防ぐことはできない。

We think it is more important for women to have regular checkups for cervical cancer. If it is found at an early stage, the cancer could be cured by surgery, such as removal of the diseased section. The ministry recommends that women aged 20 and older be tested for cervical cancer once every two years, but only 30 percent of women in that age group are tested in Japan, a rate far lower that that in the United States and some European countries.
　重要なのは定期的に検診を受けることだ。早期に発見できれば、患部切除などの手術で治癒する。厚労省は２０歳以上の女性に２年に１度の検診を推奨しているが、日本の受診率は約３割にとどまり、欧米と比べて極めて低い。

The ministry must try to offer more information on the positive and negative effects of the vaccine, and improve the current system to check for cervical cancer.
　ワクチンの効果とリスクの情報提供に努め、検診体制の充実を図ることが、厚労省の課題だ。

(From The Yomiuri Shimbun, June 8, 2014)