TOKYO – Japan’s largest cities are in a state of emergency with increased deaths from coronavirus, even as the country tries to convince the world that it can safely hold the summer Olympics. South Korea is banning meetings of five or more people to keep a recent increase in cases under control. Hong Kong imposed severe restrictions on some of its poorest neighborhoods to prevent the increase.
And yet, none of these places has begun to carry out the only solution with any hope of overcoming the pandemic: vaccination.
While the United States and most European nations, as well as Asian giants China and India began to inoculate their populations, Japan, South Korea and Hong Kong stood out for proceeding much more slowly.
Japan won’t even start vaccinating medical professionals – those at the front of the line – by the end of February. The same is true in South Korea, and those over 65 will not start receiving vaccines until May. Hong Kong, a semi-autonomous territory in China, will start vaccinating “high-risk” groups in mid-February.
To some extent, the three East Asian economic powers have the luxury of time. Despite the recent rise in infections, they have not experienced the types of outbreaks that have devastated the United States or Britain. The three governments say they will approve the vaccines after standard regulatory reviews and are preparing the logistics base for a smooth rollout.
“Japan, South Korea and Hong Kong are in the enviable position that their strong application of public health controls and prevention has enabled them to strongly control the burden of disease,” said Dr. Krishna Udayakumar, director of the Duke Global Health Innovation Center. “So it’s not vaccination or anything. The countries that feel the most urgent need to speed up vaccinations are the ones that suffer the most ”.
The delays, which come as the most contagious and perhaps deadliest variants of the virus, are emerging all over the world, could hamper the efforts of these governments to protect the public and restore normality to their tired populations.
But the postponement also offers opportunities. Latecomers can take some time to learn from problematic implementations in the United States and Europe, where supply problems, refrigeration challenges and debates about who should be inoculated first have affected vaccination campaigns.
By acting more deliberately, East Asian governments may also be able to alleviate some public concerns about the remarkable speed with which vaccines were created. In Japan and South Korea, research shows that many people are reluctant to get vaccinated immediately.
“Bottlenecks will really be on the demand side,” said Dr. Udayakumar. “Can we really convince people to accept the vaccine and implement the implementation quickly enough to achieve collective immunity through vaccination?”
Delivery can also restrict the speed of deployment. Although Hong Kong approved the Pfizer vaccine in January, neither Japan nor South Korea has yet approved it. Both countries have contracts with several vaccine manufacturers for doses sufficient to cover more than all of their populations. Manufacturers are struggling to fulfill these requests and many others.
“If vaccines are guaranteed, South Korea will continue vaccination faster than any other country in the world, and that is what South Korea is good at,” said Kim Woo-joo, an infectious disease specialist at the University of Korea . “The problem is that it is uncertain and there is no guarantee that vaccines will arrive on time.”
In theory, Japan has a more urgent deadline. The government insists it will continue with the Olympics, despite intensifying questions about the feasibility of doing so. The Games, originally scheduled for 2020 in Tokyo, but postponed until this summer, are scheduled to start on July 23.
In January, Thomas Bach, president of the International Olympic Committee, encouraged athletes, Olympic officials and others who were supposed to travel to Tokyo for the Games “to get vaccinated in their home countries, according to national immunization guidelines, before they go. to Japan. ”
But vaccination will not be necessary, officials said. In comments on the Olympics to the Japanese Parliament in January, Prime Minister Yoshihide Suga said that “by taking the appropriate measures against the infection, we are preparing to hold a safe and secure tournament without having a vaccine as a prerequisite”.
This has raised concerns in Japan that a large number of unvaccinated people may be arriving this summer. In turn, those who travel to Japan to compete can feel more confident if local residents have been vaccinated in large numbers.
Even as these pressures increase, there are signs that the government is reducing expectations for a faster distribution schedule. Last week, Taro Kono, a minister appointed to administer coronavirus vaccination, said residents over 65 would not begin receiving vaccines until at least April. Herd immunity would probably not occur until months after the Olympics.
Another major potential complication for the Japanese government is an audience that has shown one of the highest levels of vaccine skepticism in the world. Disinformation, fueled by the media, frustrated previous campaigns.
After the vaccine against human papillomavirus to prevent cervical cancer was introduced in Japan in 2010, local media widely reported that some girls who had been inoculated were suffering from side effects that experts later found to be unrelated to the vaccine.
Even so, memories of these media reports – although vague – still influence public opinion.
Kazuo Inoue, 68, a semi-retired consultant in Tokyo, said his attitude was “wait and see”.
“Generally, any new vaccine or new drug has side effects,” he said. “And we’ve had several cases before. I forgot the name of the vaccine, but it was a HPV vaccine for girls, a new vaccine and it had many side effects for many people ”.
Erika Yamao, 33, a hairdresser and mother of three young children in Tokyo, said she watched talk shows in the middle of the day, where famous presenters warned about the possible side effects of vaccines. She said she was not inclined to receive an injection when it was available.
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Answers to your vaccine questions
Currently, more than 150 million people – almost half the population – can be vaccinated. But each state makes the final decision about who goes first. The country’s 21 million health workers and three million residents in long-term care facilities were the first to qualify. In mid-January, federal authorities urged all states to open eligibility for all people aged 65 and over and adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. . Adults in the general population are at the rear of the line. If federal and state health officials can resolve bottlenecks in vaccine distribution, all 16 years and older will be eligible as early as this spring or early summer. The vaccine has not been approved in children, although studies are ongoing. It may take months before a vaccine is available to anyone under the age of 16. Go to your state’s health website for up-to-date information on vaccination policies in your area
You should not have to pay anything out of your pocket to get the vaccine, although insurance information is requested. Even if you do not have insurance, you should receive the vaccine free of charge. Congress passed legislation this spring that prohibits insurers from applying any cost sharing, such as copayment or deductibles. He imposed additional protections, preventing pharmacies, doctors and hospitals from charging patients, including those without insurance. Even so, health experts fear that patients may run into loopholes that leave them vulnerable to unexpected bills. This can happen for those who are charged a medical consultation fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get the vaccine at a doctor’s office or urgent care clinic, talk to them about possible hidden costs. To make sure you don’t get a surprise bill, the best bet is to get your vaccine at a vaccination post in the health department or at a local pharmacy as soon as the vaccines are more widely available.
This must be determined. It is possible that Covid-19 vaccines will become an annual event, as well as the flu vaccine. Or it may be that the benefits of the vaccine last for more than a year. We have to wait to see how durable vaccine protection is. To determine this, the researchers will screen vaccinated people for “innovative cases” – those who fall ill with Covid-19 despite the vaccination. This is a sign of weakened protection and will give researchers clues as to how long the vaccine lasts. They will also monitor the levels of antibodies and T cells in the blood of vaccinated people to determine if and when a booster injection may be needed. It is conceivable that people need reinforcements every few months, once a year or just every few years. It is just a matter of waiting for the data.
“I don’t know how much it can really protect me,” said Yamao. “And there are a lot of risks associated with that.”
Government aides say they will have to be careful about public health campaigns promoting vaccines.
“I think just asking people to get the vaccine will be a source of more adverse reactions,” said Takashi Nakano, a professor at Kawasaki Medical School and a member of the health ministry’s vaccine advisory board. “People might think, ‘Why is he suggesting that I get the vaccine unsafe along with the government effort?'”
Partly to alleviate domestic concerns, Pfizer, Moderna and AstraZeneca have been conducting small clinical trials in Japan before obtaining regulatory approval for their vaccines. Japan has contracts with the three companies and recently announced plans to manufacture the doses of the injection developed by AstraZeneca internally.
Given the government’s drive to host the Olympics, officials are particularly concerned with linking an immunization campaign to the success of the Games.
“Vaccination and the Olympics must be separated,” said Shunichi Shinkawa, an official in the Office of the Japanese New Coronavirus Disease Control Office, in an interview. “Vaccination is for people and to protect human life in Japan.”
Even some athletes are suspicious. Mei Ichinose, a Paralympic swimmer who is competing for Japan and currently training near Brisbane, Australia, said she was asked if she feared the vaccine could affect her performance.
“Performance aside, I don’t know if I feel 100 percent safe to get it just as a human being,” she said. “Usually, vaccines take a long time to create,” he added. “But this time, the vaccines were made so quickly, that I care about their safety.”
In other cases, decisions about getting the vaccine can be made only if it allows people to do something they really want.
Yamao, the Tokyo hairdresser, said she would be vaccinated if it meant she could visit her parents in Osaka.
“If I couldn’t travel on the bullet train without the vaccine, then I would consider that,” she said. “It is a last resort.”
The report was contributed by Youmi Kim from Seoul, South Korea, Tiffany May from Hong Kong and Makiko Inoue from Tokyo.