The Japanese are not so keen on vaccinations, with the result that only 6 percent of the population has had a corona jab. And that with the Olympics coming up. “Japanese experts are just too cautious.”
With two months to go until the start of the Olympics, Japan finally has its first mass vaccination center. In Tokyo, where the tournament will be held from July 23, people over 65 can register for a corona jab since last week. The center is open twelve hours a day and has to vaccinate about ten thousand elderly people every day.
It should give the slow vaccination campaign in Japan a boost. Less than 6 percent of Japanese have so far had a shot against the corona virus. In the Netherlands that percentage is 30 percent, in the United Kingdom half of all adults have already been vaccinated. The low vaccination coverage is striking, if only because Japan has a very aging population: more than a quarter of the Japanese are over 65.
At the same time, there has been great skepticism for months about the feasibility of the largest sporting event in the world. Polls show time and again that most Japanese would rather lose the Olympics than be rich, partly because they are afraid that the tournament will cause a new corona wave.
High vaccination coverage could remove some of that fear. But why is vaccination so slow? According to Riko Muranaka, a Japanese vaccination expert, the slow campaign is partly due to the mild start of the virus in Japan. For a long time, the country (127 million inhabitants) had relatively few corona deaths. Only last winter did the number of infections and victims increase rapidly. Most of the 12,500 casualties occurred in the past six months. Until then, the government hadn’t given any serious thought to the vaccination campaign. They were too optimistic about the course of the pandemic in Japan,” said Muranaka, who is a physician and researcher at Kyoto University.
In addition, once the government wanted to make haste, it ran into a number of blockages. For example, the rules dictate that vaccines from abroad must first be tested on Japanese soil before they can be approved. As a result, Moderna and AstraZeneca only received the green light last week. Japanese Prime Minister Yoshihide Suga recently said that this must change in the future. “I am convinced that we need to change the laws to better respond to these kinds of emergencies.”
But according to Muranaka and other experts, the main reason for the vaccination delay is another. Remarkably many Japanese are afraid of side effects. In the last three decades of the last century, activist groups in Japan successfully brought lawsuits against the government and doctors for alleged side effects of vaccines. In 1993, a vaccine against measles, mumps and rubella was withdrawn after it caused meningitis in 11 children, three of whom died. The cause was most likely a contaminated mumps vaccine. Partly because of this, the government abolished the vaccination obligation in 1994.
In 2013, there was a fuss about the vaccine against cervical cancer (HPV), after teenage girls were said to have developed neurological complaints after the vaccination. A scientific committee dismissed the reports as nonsense, but the government decided to stop actively offering the HPV vaccine. As a result, only one in a hundred girls is now vaccinated.
According to Muranaka, who is fighting to get the HPV vaccine widely accepted again, vaccination fears remain dormant because the government no longer presents itself as a strong defender of vaccination. On the day that Anthony Fauci, the head of the US Institute of Infectious Diseases, called for a mass vaccination campaign, his Japanese counterpart emphasized that the long-term effects of the vaccine are not yet fully understood. ‘Although that is medically theoretically correct, the message is of course completely wrong,’ says Muranaka. ‘Japanese experts are just too cautious. They don’t want to be held legally responsible.’
Other Japanese experts think it wise that the country took its time. So it could quietly wait and see how the vaccine worked out in other countries, a strategy that South Korea also used – and for which it is now receiving a lot of criticism. “I don’t think the vaccination program is too slow,” Immunology professor emeritus Masayuki Miyasaka told Reuters earlier this year. ‘This way we can look closely at which and how many reactions the vaccine causes. Since mRNA vaccinations are new to us, we have to look extra closely at the possible health risks.’
That cautious attitude was also reflected in the distribution policy, according to Muranaka. The vaccines have been distributed via local governments to more than ten thousand clinics and general practitioners. Only doctors and certified nurses were allowed to administer the injections. That may have been intended to allay mistrust of the vaccine, but it caused a lot of delay.
Now a different wind is blowing. In addition to establishing the major vaccination centers, the government decided to give clinics a bonus per corona injection. Additional healthcare workers have been made available to administer the injections. The governor of Tokyo personally visited the prime minister to ask for more doses for the Olympic city.
It doesn’t mean that all caution is gone. Despite formal approval, the tens of millions of AstraZeneca doses remain on the shelf for now. The concerns about thrombosis symptoms and other possible side effects are too great.