Japan’s slow Covid vaccine rollout casts cloud over Olympics

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More than two months after it began its vaccine rollout, Japan still lags behind the rest of the developed world, raising questions about its preparedness and doubts about the wisdom of holding the Olympics in Tokyo in less than three months’ time.

To date, 1.3% of Japan’s population have received at least one of two doses, compared with 40% in the US, 49% in the UK and 20% in France, according to Our World in Data. Neighbouring South Korea, which has also been criticised for a slow vaccine uptake, has inoculated more than 4% of its people.

The health ministry has so far approved only the Pfizer/BioNTech vaccine, leaving Japan dependent on imports from theEU until the AstraZeneca and Moderna vaccines are given the green light, possibly next month.

As of 23 April, just over 1.74 million frontline medical staff had received their first dose, with 878,000 fully vaccinated. About 74,000 people aged 65 and over had been given their first jab as of Sunday, according to the Prime Minister’s Office.

Japan’s cautious approach was in place long before export bottlenecks appeared, and reports have cast doubt on claims that supply issues are behind the lag. On Monday, Bloomberg said the EU had exported 52.3m doses to Japan between 30 January and 19 April. An EU source in Tokyo confirmed the figures were correct.

Japan chose to start vaccinating its population months after the US and some European countries, beginning in mid-February, with 4.8 million health workers, most of whom have yet to be immunised.

Inoculations for 36 million people aged 65 and over began in mid-April, with the 60-64 age group, nursing care workers and people with pre-existing conditions to follow, possibly by the end of July. Those aged 16-59 have yet to be told when they will be eligible.

After its initial success in preventing the catastrophic caseloads and death tolls experienced in other countries, Japan continued to put its faith in preventative measures, including widespread mask-wearing and avoidance of the “three Cs” – closed spaces, crowded places and close-contact settings.

Circuit-breaking “soft lockdowns” called in April last year and earlier this year depended on bars and restaurant observing voluntary restrictions on opening hours and people heeding requests to avoid non-essential outings.

Japan, so the official reasoning went, had bought itself time to wait and observe the progress of inoculations in countries that had rushed out vaccines after suffering high death tolls during the pandemic.

“The government is paying a lot of attention to the safety of vaccines,” said Haruka Sakamoto, a public health researcher at Tokyo University graduate school of medicine. “The health ministry first observed vaccines that are widely used in other countries before conducting additional trials and distributing them in Japan.”

But extreme caution and red tape are causing frustration among the public. A Kyodo news agency poll this month found more than 60% of people were dissatisfied with Japan’s vaccine rollout, while more than 90% were worried about another wave of infections.

Infections driven by new variants soared in Osaka and neighbouring Hyogo prefecture in the month since the prime minister, Yoshihide Suga, fully lifted a targeted state of emergency days before the Olympic torch relay began in late March.

Quasi-emergency measures failed to stem the rise, with cumulative infections now at well over half a million and deaths approaching 10,000 – among the worst in Asia.

On Sunday, Tokyo, Osaka and two other virus hotspot regions entered a third state of emergency that includes business closures and fines for non-compliance.

By delaying vaccinations, Japan has left itself vulnerable to new variant outbreaks, with less than 90 days to go before the opening ceremony of the Tokyo 2020 Olympics.

“Experts are aware that it is too late now to stop the spread of variants with vaccines,” said Riko Muranaka, a lecturer at Kyoto University school of medicine. On Monday, the chief cabinet secretary, Katsunobu Kato, said 21 cases of the Indian “double mutant” variant had been found in Japan, all but one in airport quarantine.

Muranaka, who has led high-profile campaigns against vaccine misinformation, traced Japan’s hesitancy to successful lawsuits brought against the health ministry by a small number of parents who claimed their children had suffered serious side-effects from the measles, mumps and rubella (MMR) vaccine in the 1980s and 90s.

Media-fuelled controversies linked to the MMR jab and later the human papillomavirus (HPV) vaccine – both of which are recommended by the World Health Organization – had made the health ministry nervous about encouraging people to have the Covid jab, Muranaka said, adding that the inefficient distribution of doses, including the absence of a centrally managed booking system, had magnified Japan’s problems.

“The government takes only limited responsibility for recommending vaccines,” she said. “That is partly to blame for the situation Japan finds itself in now. I’m very pessimistic about the vaccination forecasts. I’m not sure if we will be able to reach herd immunity by the winter. If we continue as we are then variants will spread – the only way to stop that is to vaccinate as quickly as possible.”

In preparation for expected high demand in huge urban centres, large vaccination centres will open in Tokyo and Osaka in the coming weeks in an attempt to speed up the immunisation drive, according to local media reports, with one site in the capital able to administer 10,000 shots a day.

Officials in Tokyo insist the rollout is about to pick up speed, with its vaccination chief, Taro Kono, promising the arrival of 10m doses a week after the Golden Week public holidays in early May.

But the slow pace of immunisation among health workers does not bode well for the rest of the population. Most have yet to receive their first jab, and in some areas unvaccinated medical staff are reluctant to administer shots to older residents.

The rollout is now too far behind to have any impact on the Olympics, with much of Japan’s population unlikely to be protected by the time tens of thousands of athletes, media, officials and other Games-related staff begin arriving in Tokyo ahead of the 23 July opening ceremony.

Writing in the BMJ this month, four health experts cited Japan’s “sluggish vaccine rollout” among other factors in urging plans to hold the Games to be “reconsidered as a matter of urgency”.

Suga and the Tokyo 2020 organisers, however, have said the progress of domestic vaccinations is unconnected to what they say will be a “safe and secure” Games.

“I don’t understand why the government has shown such a lack of urgency,” Sakamoto said. “Hosting the Olympics is a top priority for the current administration, and the most effective way to achieve this is through vaccination.

“In Israel and the UK, people are gradually getting back to their daily lives. But it will be a long time before that happens in Japan.”

Hafta Ichi
Source: The Guardian
Keyword: Japan’s slow Covid vaccine rollout casts cloud over Olympics

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