The sceptical attitude pre-dates the more recent Western “anti-vax” sentiment that has thrived on social media, with its roots instead in past vaccine-linked events and legal rulings that encouraged the government to take a passive stance on vaccination.
And ironically, Japan’s relative success in handling the pandemic – until the recent winters surge tipped daily case numbers into the thousands – means an urgent rollout of the shot is less of a priority. The country has avoided a second state of emergency, even as cases have increased to record levels.
As a result, Japan’s rollout is set to be slower than some other nations, which has led to frustration among those counting on vaccines to eradicate the virus. Only Pfizer has so far applied for local approval of its coronavirus shot, even as the UK and the US have both administered more than half a million doses, mostly to the elderly and health-care workers.
Local media have reported that vaccines will be rolled out in Japan from late February, when the government aims to inoculate about 10,000 frontline health-care workers. The ministry is then preparing to vaccinate general medical staff, after which it will be gradually administered to the wider population. Japan hasn’t stated when it aims to complete its vaccination program.
While figures such as US Vice President Mike Pence and President-elect Joe Biden have received the dose, and leaders such as Indonesian President Joko Widodo are volunteering to be the first to receive it in their countries, Japan’s Prime Minister Yoshihide Suga has said he will wait his turn.
Japan’s Health Minister Norihisa Tamura said Friday that he has asked relevant bodies to prioritise the review of Pfizer’s application, but didn’t give a timeline for approval. A health ministry spokesman also declined to comment on the reported timeline.
Japan’s modern vaccine unease has its roots in a measles, mumps and rubella inoculation that studies in the 1990s suggested led to higher rates of aseptic meningitis in the early 1990s. Though no link was ever established, the shots were discontinued, and to this day Japan doesn’t recommend a combined MMR shot.
Another catalyst was a 1992 court ruling that made the government responsible for any adverse reactions related to vaccines, said Tetsuo Nakayama, a professor at the Kitasato Institute for Life Sciences. Two years later, the government revised a vaccination law, scrapping mandatory vaccinations.
These events helped send a message that inoculations should be taken at one’s own risk, and diluted the awareness of vaccination as a greater public benefit, said Mikihito Tanaka, a professor at Waseda University.
“Japan has a strong health insurance scheme and an accessible medical system,” he said. “Compared to places like the US, that makes the incentive to gamble one’s health with a new vaccine very low.”
The handling of the human papillomavirus (HPV) vaccine also looms large in public memory. After media coverage on claims the vaccine’s side effects included severe headaches and seizures, the health ministry in 2013 withdrew its recommendation for the shot, which has proven safe and effective in preventing cervical cancer. While it remained available on request, the vaccination rate plummeted from 70 per cent to less than 1 per cent currently. That may have led to an additional 5,700 deaths, according to one study.
Japan’s drug approvals require clinical trials involving Japanese people, but an emergency authorisation based on data from other countries is allowed. Vaccines for the 2009 H1N1 flu pandemic were given emergency approval after about three months review.
Still, the government will have to carefully manage how the public perceives a speedy approval process. The economic impact of the pandemic and the forthcoming Tokyo Olympics could prompt a faster approval, but also arouse suspicion over whether the shots have been thoroughly vetted.