Riko Muranaka

FCCJ

Q&A: Japanese physician snares prize for battling antivaccine campaigners

A Japanese physician and writer who is under fire from antivaccination groups for defending a cervical cancer vaccine won an international award today for her perseverance. She hopes the recognition will lead to a reevaluation of the vaccine's safety in Japan.      

Riko Muranaka, a lecturer at the Kyoto University School of Medicine in Japan who writes about women's health issues, found herself in the crosshairs of antivaccination campaigners after publishing articles explaining how clinical trials and extensive reviews had demonstrated the safety of several human papillomavirus (HPV) vaccines. HPV is the leading cause of cervical cancer and also causes genital warts, as well as oropharyngeal and other cancers in men. International trials have shown that the vaccines prevent HPV infections in most individuals, and the World Health Organization in Geneva, Switzerland, recommends including HPV vaccination in national immunization programs.

The HPV vaccine became available in Japan at a reduced cost or for free in 2010, and the vaccination rate rose to about 70%. In April 2013, the Ministry of Health, Labour and Welfare made the vaccine part of the free national immunization program and recommended it for girls in their early teens. But soon afterward, antivaccine campaigners started claiming the shot causes debilitating side effects. TV programs repeatedly broadcast a video of a young woman having seizures supposedly after receiving the HPV vaccine. The ministry suspended its vaccination recommendation and vaccination rates have since plummeted to less than 1% of eligible girls. (The HPV vaccine remains freely available.)

In the fall of 2015, Muranaka started writing articles hoping to reopen public discussion about the vaccine’s safety. In a June 2016 article, she raised questions about data from animal experiments conducted as part of a Ministry of Health, Labour and Welfare investigation purporting to show that the vaccine caused brain damage in mice. The ministry later posted a message on its website explaining that the group’s experiments did not establish a link between the vaccine and such brain damage. The principal investigator, Shuichi Ikeda, a neurologist at Shinshu University in Matsumoto, Japan, then sued Muranaka for defamation. The lawsuit is making its way through the courts. But the possibility of legal action and harassment by antivaccine activists led magazines to decline her articles and a deal for a book on the HPV vaccine was canceled. (She later found another publisher.) She has continued advocating for the vaccine through her Facebook page and website.

Muranaka received the 2017 John Maddox Prize today in London "for promoting science and evidence on a matter of public interest, despite facing difficulty or hostility in doing so." ScienceInsider spoke with her about her efforts to raise awareness about the HPV vaccine and the personal toll that has taken. 

Questions and answers have been edited for clarity and brevity.

Q: What effect has the antivaccination campaign had on women’s health in Japan?

A: Each year in Japan, 27,000 to 28,000 women are diagnosed with cervical cancer and around 3000 die. HPV vaccines can prevent this disease. Yet because of the campaigners' videos and the government's decision to suspend recommending the vaccine, many mothers and children do not know this vaccine is safe. The long-term impact will be preventable suffering and death.

Q: Are there any signs the ministry will reinstate its recommendation that girls receive the vaccine?

A: I don't think so. Already, data have been published showing that the symptoms allegedly due to the vaccine occur at similar rates in both vaccinated and unvaccinated boys and girls. The government is trying to see what is going on with these young people and I don't see any end to their investigations. 

Q: Will the Maddox award help publicize the benefits of the vaccine?

A: I hope that Japanese media will see international coverage of my award and realize that those opposing vaccination have driven the public debate, influencing the government's position. To have the vaccination rate drop from 70% to almost zero is unusual. Even in the U.S. [where there has been negative publicity about the vaccine] the vaccination rate is still around 50%. The antivaccination people are very active, and the media doesn't want any trouble. It's a sad story.

Q: How are you coping with being sued?

A: Well, I've started to realize the lawsuit is not all negative. This hardship has brought me friends in the media and academia during this lonely battle.