Why did Japan take so long to start vaccination against Covid-19 despite the impending Olympics?

With Olympic competition Launched in Tokyo in July, Japan had every reason to approve the Covid-19 vaccine and act swiftly to start vaccination.

But the country has only begun to inoculate a population of 126 million with Pfizer-BioNTech shots. last week, More than 2 months after the vaccine was deployed Other major countries, United States and United Kingdom included.

According to the United States, the United States has given more than 68 million doses since the vaccination program was launched in December. Johns Hopkins University..

According to the Japanese government, it is administered only about 18,000 times in Japan.

The case load in Japan is not as high as in the US and UK, but in the last few months Medical system Since the start of the pandemic last year, we have been overwhelmed by the worst wave of infection. Hundreds of new cases It is still reported daily. And Prime Minister Yoshihide Suga is under pressure to reduce infections before Japan welcomes the world for the Summer Olympics.

Like the United States, Japan uses the Pfizer-BioNTech vaccine as part of its program. However, Japanese regulators took another two months to approve its use.

The government says it is deliberately cautious. After a series of vaccine scandals dating back 50 years, it is important to beat the skeptical people as Japan is one of the least reliable countries in the world for vaccines.

However, the decision to act slowly has been criticized by some medical professionals, including Professor Kenji Shibuya of King’s College London, and Japan’s delay in deployment and lack of vaccination strategy will ultimately kill It says it will drop it.

Careful approval process

Pfizer-BioNTech conducted an extensive Phase 3 clinical trial of the vaccine at the end of last year for nearly several months. 150 clinical trials Sites in the US, Germany, Turkey, South Africa, Brazil and Argentina.

On November 19, both companies announced that the vaccine had shown 95% effectiveness For prevention of Covid-19 infection. 2 weeks later, Britain became the first Western country Approved vaccine for emergency use, followed by the United States December 11th.

December 31, World Health Organization (WHO) has also approved the Pfizer-BioNTech vaccine for emergency use.

Japan’s approval came six weeks later, on February 14, after a small national test with 160 participants showed results consistent with the international test. By Japanese standards, approval was immediate. This process can typically take a year or two. But critics say the delay has spent valuable time on the government.

“With a sample size of 160 people, we don’t have any scientific evidence of efficacy or safety (of the vaccine),” said Shibuya of King’s College.

Minister Taro Kono, who is in charge of deploying the coronavirus vaccine in Japan, said that national clinical trials were conducted to build public confidence in the program.

“I think it is more important for the Japanese government to show the Japanese that they have done everything possible to prove the effectiveness and safety of the vaccine and to encourage them to get the vaccine,” Kono said. He said. “In the end, we may have started slowly, but I thought it would be more effective.”

Scandal and skepticism

According to a study published in a medical journal Lancet When we mapped vaccine confidence in 149 countries between 2015 and 2019, 30% strongly agreed with the safety, importance and efficacy of Japanese vaccines, compared to 50% in the United States. It was less than.

Vaccine resistance in Japan dates back to the 1970s Two babies died within 24 hours After combining diphtheria, tetanus, whooping cough (whooping cough) vaccination. The vaccine was temporarily discontinued, but confidence was already shaken. Over the years, infant vaccination rates have declined and cases of whooping cough have increased.

In the late 1980s, there was another fear of the introduction of the Japanese-made measles, mumps, and rubella (MMR) vaccines. Early versions of the vaccine were associated with aseptic meningitis, or swelling of the membranes around the brain and spinal cord. This issue dates back to the mumps component of the MMR vaccine, leading to lawsuits and heavy damages payments.

The National Institute of Health Sciences discontinued the combined injection in 1993 and replaced it with a separate vaccine.

After the MMR scandal, Shibuya says the Japanese government has “recognized the risks” and the national vaccination program has become voluntary.

Dr. Yuho Horikoshi, an infectious disease expert, said the proceedings led to a “vaccine gap” and that the vaccine was not approved in Japan for about 15 years.

More recently, in 2013, Japan added the human papillomavirus (HPV) vaccine to its national schedule to protect girls from the sexually transmitted disease virus known to cause cervical cancer. However, videos of girls allegedly suffering from side effects began to circulate on YouTube, and the government removed it from the national schedule.

The· Vaccine Side Effect Review Committee Examination of the case found no evidence of a causal link between adverse events and the HPV vaccine. However, due to reports and withdrawal of the vaccine from the Japanese government program, the number of girls vaccinated has dropped sharply. 70% in 2010 Now it is less than 1%.

Most of its low rates 11,000 preventable deaths According to a study by The Lancet, from cervical cancer in Japan over the next 50 years.

WHO recommends vaccination of girls aged 9 to 14 years to prevent cervical cancer. 311,000 Women all over the world every year. According to a study published in the Journal of Infectious Diseases British cervical cancer Fallen because of the vaccine.And Australia is on track Eliminate cervical cancer By 2028, this is also due to the vaccine, according to another recent study.

Professor Shoji Tsuchida, an expert in social psychology at Kansai University, states that despite Japan’s vaccine resistance, the “anti-taxer” movement is not widespread in Japan.

“Most people who don’t want to get vaccinated are afraid of possible side effects and don’t believe in” pseudo “science (they think),” Tsuchida said. “Past vaccination side effects in Japan, especially HPV cases, have primarily affected the minds of these people.”

Efforts to reassure the skeptical masses

Japan’s resistance to vaccination has become a problem for the government regarding the deployment of the coronavirus vaccine.

The first Covid-19 vaccination in Japan has been given to 3.7 million front-line healthcare professionals with the goal of vaccination of the elderly in April.

The Government of Japan has requested that half of the doctors and nurses in the first round keep an “observation diary” to monitor side effects for seven weeks after receiving both vaccines.

Vaccine deployment is currently underway, but the medical community is concerned about vaccine resistance. That’s why a group of doctors, including New York-based Yuji Yamada, has launched a promotional campaign to encourage Japanese people to get Covid-19 shots. They do it with a cartoon dog.

In a lab coat, Koshien is a Shiba Inu-inspired chatbot tasked with reassuring skeptics by answering vaccine questions. The name Korawa comes from the Japanese word for “coronavirus” and “vaccine”.

To date, more than 55,000 people have signed up for the app, 70% of whom are women. According to Yamada, the Japanese media initially reported on the potential side effects of the vaccine. “These could have triggered women who tend to take the risk of vaccines more seriously, so women used more (apps),” he said.

Vaccination Minister Kono has cast his support behind the app, but the government has not yet released its own public message.

Shibuya says the government needs to focus on asserting to the public that the Covid-19 vaccine is safe, important and essential for the Olympics. He also says the government has to do more to control the virus.

“Suppress, suppress, suppress and eliminate local infections, or the vaccines will be deployed so slowly that Japan will have to repeat the emergency many times,” says Shibuya.

“Their basic motivation and incentive is to refresh the economy. If they really want to host the Olympics, they really need to curb transmissions, so it’s potentially near zero.”