Why Japan took so long to start vaccinations with Covid-19, even as the Olympics approach

Why Japan took so long to start vaccinations with Covid-19, even as the Olympics approach

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In Japan, only about 18,000 doses have been administered, according to the Japanese government.

Like the US, Japan is using the Pfizer-BioNTech vaccine as part of its program. Even so, Japanese regulators took another two months to approve its use.

The government says it was deliberately cautious. After a series of vaccine scandals dating back 50 years, Japan has one of the lowest vaccine confidence rates in the world – so winning over a skeptical audience is crucial.

However, the decision to move slowly has been criticized by some medical professionals, including Dr. Kenji Shibuya, a professor at King’s College in London, who says that the delay in Japan’s launch and its lack of vaccination strategy will cost lives.

Medical officials await consultations after receiving a dose of the Covid-19 vaccine in Tokyo on February 17, 2021.

Careful approval process

Pfizer-BioNTech conducted extensive Phase 3 clinical trials of its vaccine over several months at the end of last year at around 150 clinical test sites in the United States, Germany, Turkey, South Africa, Brazil and Argentina.
On November 19, companies announced that the vaccine was 95% effective in preventing Covid-19 infections. Two weeks later, the United Kingdom became the first western country to approve the vaccine for emergency use, followed by the United States on December 11.
On December 31, the World Health Organization (WHO) also approved the Pfizer-BioNTech vaccine for emergency use.

Japan’s approval came six weeks later, on February 14, after a minor test in the country with 160 participants showed results consistent with international tests. By Japanese standards, this approval came quickly – typically, the process can take one to two years. But critics say the delay cost the government valuable time.

“With a sample of 160 people, this gives no scientific evidence about the efficacy or safety (of a vaccine),” said Shibuya of King’s College.

Taro Kono, the minister in charge of launching the coronavirus vaccine in Japan, said the country’s clinical trial was conducted to build public confidence in the program.

“I think it is more important for the Japanese government to show the Japanese people that we have done everything possible to prove the vaccine’s effectiveness and safety – to encourage the Japanese people to get the vaccine,” said Kono. “At the end of the day, we may have started more slowly, but we think it would be more effective.”

Scandal and skepticism

According to a study published in the medical journal The Lancet that mapped confidence in the vaccine in 149 countries between 2015 and 2019, less than 30% of people in Japan strongly agreed that vaccines were safe, important and effective – compared to 50% In the USA.
Japan’s vaccine resistance dates back to the 1970s, when two children died within 24 hours after receiving the combined vaccine against diphtheria, tetanus and whooping cough (whooping cough). The vaccine was temporarily suspended, but confidence had already been shaken. For several years, childhood vaccination rates have fallen, leading to an increase in whooping cough.

In the late 1980s, there was another scare with the introduction of the measles, mumps and rubella (MMR) vaccine produced in Japan. The first versions of the vaccine were associated with aseptic meningitis, or swelling of the membranes around the brain and spinal cord . The problem was traced back to the mumps component of the MMR vaccine, which led to a lawsuit and heavy damages.

The National Institute of Health Sciences stopped the combined injection in 1993 and replaced it with individual vaccines.

After the MMR scandal, Shibuya said the Japanese government had become “aware of the risks” and its national vaccination program had become voluntary.

Dr. Yuho Horikoshi, an infectious disease specialist, says the lawsuits have led to a “vaccination gap” in which no vaccine has been approved in Japan for about 15 years.

More recently, in 2013, Japan added the human papillomavirus (HPV) vaccine to the national calendar to protect girls from the sexually transmitted virus, which is known to cause cervical cancer. However, videos of girls allegedly suffering from adverse reactions began to circulate on YouTube, prompting the government to withdraw them from national programming.

The Vaccine Adverse Reaction Review Committee investigated the incidents and found no evidence to suggest a causal relationship between adverse events and the HPV vaccine. But the reports, and the withdrawal of the vaccine from the Japanese government’s program, caused a sharp drop in the number of vaccinated girls – from more than 70% in 2010 to now less than 1%.
That low rate could result in nearly 11,000 preventable cervical cancer deaths in Japan over the next 50 years, according to a study published in The Lancet.
WHO recommends giving the vaccine to girls aged nine to 14 years to prevent cervical cancer, which kills 311,000 women worldwide each year. According to a study published in the Journal of Infectious Diseases, rates of cervical cancer in England are falling due to the vaccine. And Australia is on track to eliminate cervical cancer by 2028, according to another recent study, also due to the vaccine.

Professor Shoji Tsuchida, a specialist in social psychology at Kansai University, says that despite Japan’s resistance to vaccines, there is no widespread “antivaxxer” movement in the country.

“Most people who do not want to be vaccinated are afraid of possible side effects and do not believe what they consider to be a ‘false’ science,” said Tsuchida. “Previous cases of side effects from vaccination in Japan, especially the case of HPV, are mainly affecting the minds of these people.”

Efforts to reassure a skeptical audience

Japan’s resistance to vaccines poses a problem for the government when it comes to launching the coronavirus vaccine.

The first Covid-19 vaccinations in Japan are being given to 3.7 million frontline health workers, with the goal of vaccinating the elderly in April.

The Japanese government asked half of the first round of doctors and nurses to keep an “observation diary” to monitor any side effects for seven weeks after receiving both doses of the vaccine.

Although the vaccine is already underway, the medical community remains concerned about resistance to the vaccine. This prompted a group of doctors, including Yuji Yamada, from New York, to launch a promotional campaign encouraging people in Japan to take Covid-19 injections – and they are using a cartoon dog to do this.

Dressed in a white medical coat, Corowa-kun is a chatbot inspired by Shiba Inu, with the task of reassuring a skeptical audience by answering questions about the vaccine. The name Corowa-kun comes from the Japanese words for “coronavirus” and “vaccine”.

So far, more than 55,000 people have signed up for the app – 70% of them women – said its creators. According to Yamada, Japanese media initially reported the possible side effects of the vaccine. “These may have been the triggers for women who tend to think about the risk of the vaccine more seriously, and therefore women have been using (the app) more,” he said.

Vaccination Minister Kono gave his support to the application, but the government has yet to announce its own public messages.

In preparation for the Olympics, Shibuya says the government needs to focus on defending the public that the Covid-19 vaccine is safe, important and essential. He says the government must also do more to suppress the virus.

“Suppress, suppress and suppress to eliminate transmission from the community – otherwise, Japan will repeat the state of emergency over and over again, given a very slow release of the vaccine, Shibuya said.

“Their fundamental motivation and incentive is to renew the economy. If they really want to host the Olympics, they really need to suppress the broadcast, so there is potentially almost zero.”

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