Differential misclassification between self-reported status and official HPV vaccination records in Japan: Implications for evaluating vaccine safety and effectiveness.

Manako Yamaguchi, Masayuki Sekine* (Corresponding Author), Risa Kudo, Sosuke Adachi, Yutaka Ueda, Etsuko Miyagi, Megumi Hara, Sharon J. B. Hanley, Takayuki Enomoto

*Corresponding author for this work

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29 Citations (Scopus)
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Japan has no national vaccine registry and approximately 1700 municipalities manage the immunization records independently. In June 2013, proactive recommendations for the human papillomavirus (HPV) vaccine were suspended after unconfirmed reports of adverse events following immunization in the media, despite no vaccine safety signal having been raised. Furthermore, studies assessing HPV vaccine safety and effectiveness published post suspension are predominantly based on self-reported information. Our aim was to examine the accuracy of self-reported vaccination status compared with official municipal records. Participants were women aged 20-22 yrs, who were attending for cervical screening in Niigata city. Among the 1230 eligible registrants, vaccine uptake, defined as any dose, was 75.0% and 77.2% according to a self-reported questionnaire and municipal records, respectively. The accuracy rate of self-reported information was as follows: positive predictive value (PPV) was 87.7%; negative predictive value (NPV) was 54.5%; sensitivity was 85.2%; and specificity was 59.8%. The validity of self-reported information was only moderate (Kappa statistic = 0.44, 95% confidence interval 0.37-0.50). This combined with the low NPV may lead to reduced estimation of effectiveness and safety. A more reliable method, such as a national HPV vaccine registry, needs to be established for assessing HPV immunization status in Japan.
Original languageEnglish
Pages (from-to)6-10
Number of pages5
JournalPapillomavirus Res
Early online date7 Jun 2018
Publication statusPublished - 1 Dec 2018

Bibliographical note

Papillomavirus research (Amsterdam, Netherlands)

This work was supported by a grant from the Japan Agency for Medical Research and Development to Takayuki Enomoto et al, Grant Number 16ck0106103h0003.

We thank Ms. Asami Yagi, Ms. Yuka Watanabe, Ms. Sachiko Ono and Ms. Anna Ishida for their support in conducting the survey.


  • Female
  • Humans
  • Young Adult
  • Japan
  • *Medical Records
  • *Self Report
  • *Vaccination Coverage
  • Drug-Related Side Effects and Adverse Reactions/epidemiology/pathology
  • Epidemiologic Methods
  • Papillomavirus Vaccines/*administration & dosage/*adverse effects
  • Registries
  • Sensitivity and Specificity


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