Disparities among Japanese municipalities in recommendations for routine and catch-up HPV vaccinations.

In November of 2021, the government of Japan announced a reversal of its decision, in 2013, to suspend the previous proactive recommendation for HPV vaccination. However, the intention of young girls to receive routine and catch-up vaccinations has not necessarily increased as expected. We conducted a nationwide questionnaire survey by mail in September 2022. The survey was mailed to 133 municipalities, consisting of all cities/wards of the Tokyo and Osaka Prefectures and all other prefectural capital cities. Responses were received from 82 municipalities (61.6%). Notification of routine HPV vaccinations had already been sent to 76 (92.7%) of the municipalities; 70 (85.4%) had been sent encouragement for catch-up vaccinations. The questionnaire forms for registration and pre-vaccination screening for routine immunization had been sent to 74.1% (60/81) of the municipalities and 68.8% (55/80) for catch-up immunizations. Regarding catch-up vaccination, only 54 municipalities (65.9%) had detailed vaccination records for those eligible. Ten municipalities (12.2%) had virtually no vaccination records because they had already been discarded. Sixty-one of the municipalities (74.4%) had notified only those females eligible for a catch-up vaccination based on their vaccination record, whereas 25.6% (21/82) of the municipalities reported that they had sent, or would send, the notification to all females within the targeted grades, including those who had already been vaccinated with three shots. The survey revealed disparities among the municipalities in their HPV vaccine notification processes. Future research monitoring HPV vaccination rates and incidence rates of cervical cancer and precancerous lesions in each municipality will be desirable.