Peter Bach states in his Comment1 that poorer states in the USA with higher mortality from cervical cancer have lower coverage with the human papillomavirus (HPV) vaccine than do wealthier states; however, he does not indicate the disparities in vaccination policies and financial coverage within each state. We would like to know how the vaccine legislative proposals and vaccination charges differ between states.
A bivalent HPV vaccine was approved in Japan in December, 2009. This vaccine is expected to be beneficial for Japanese people, whose coverage for cervical cancer screening is extremely low (24%) compared with other Western countries.2 This vaccine is not insurance-covered, and no national financial support is currently planned. Recipients have to pay US$350—500 for the full vaccine dose. Several local governments decided to fund the HPV vaccine in April, 2010, but the number is extremely low (only 32 of 1747 local governments in Japan).3 The factor that influenced the funding decision seems to be the activity of the New Komeito Party, Japan’s third largest political party, which led a campaign to promote female cancer prevention and submitted 1 544 087 signatures to the Ministry of Labor, Health, and Welfare on March 29, 2010.4
The biggest impediment to vaccine implementation is its cost.5 In Japan, vaccine financing policies and recipients’ charges differ between local governments. We fear that funding inequalities could result in local disparities in cervical cancer incidence and mortality.
The underlying research reported in this letter was funded by Health and Labor Sciences Research Grants (Clinical Cancer Research) in Japan. We declare that we have no conflicts of interest.
Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.