Cities and towns face language barriers as they prepare to vaccinate Japan's foreign residents

As local governments ramp up preparations to inoculate their residents against COVID-19, one key task for officials is to make the vaccine program as widely accessible as possible to foreign residents, including by offering interpreters and translating documents into other languages.

But with their hands already full, some municipalities, many of them home to diverse populations, are less prepared than others and have been forced to put the issue on the back burner.

At the national level, lawmakers are aware of the problem and are discussing measures to mitigate communication problems. The ruling Liberal Democratic Party’s internal task force has compiled a proposal stating the need for the smooth inoculation of foreign residents.

The proposal, which was approved by the party’s policy council Thursday, calls on the administration of Prime Minister Yoshihide Suga to robustly fund efforts by municipalities to translate vaccination tickets into foreign languages and have multilingual vaccine hotlines in place.

“Implementing thorough anti-infection measures, such as the inoculation of people including foreign residents, will go a long way toward ensuring the safety of the entire nation,” read the proposal, a copy of which was obtained by The Japan Times. The task force, headed by LDP lawmaker Satsuki Katayama, intends to submit the petition to Suga soon.

All foreign nationals with registered addresses are eligible to receive vaccination tickets. Nearly 3 million foreign residents were living in Japan as of June last year, according to the latest statistics by immigration authorities.

The health ministry says they will be treated on a par with Japanese nationals in terms of when they will get access to shots, beginning with priority groups — such as those age 65 or above and those with pre-existing health conditions — and continuing with the general public.

Less certain is the fate of those without legitimate certificates of residence, including visa overstayers and detainees on provisional release, with their eligibility currently being vetted by the ministry.

To better cater to the needs of expats in Japan, the central government is preparing to translate its vaccine-related flyers into foreign languages, according to health ministry official Rio Matsumoto.

But the more practical and arduous task of reaching out to non-Japanese communities, and making sure they are sufficiently informed of the vaccination process, eventually falls on the shoulders of local governments.

The city of Yamato, Kanagawa Prefecture, for example, is adopting what it calls the “Yamato model.” It is aiming to deploy a team of medical professionals to vaccinate demographics that may struggle to access care on their own, including older people and foreign residents who don’t speak Japanese.

Like many municipalities, the city has laid out two main channels through which vaccinations will become available — local clinics where shots are administered on an individual basis, and community centers where visitors are inoculated en masse.

But what stands out about the strategy by Yamato, home to one of the prefecture’s highest concentrations of non-Japanese residents and sizeable communities of Chinese, Korean and Philippine nationals, is another measure it is employing: Having doctors and nurses enlisted by the city actively approach communities susceptible to alienation.

Under the current plan hatched by the city, a team of medical professionals from a local hospital will first visit a pair of apartment complexes home to a sizable number of older people once inoculations for that demographic kick off in mid-April and will administer shots there.

The idea is to prevent older residents in the neighborhood, which has no nearby medical institutions and has poor access to public transportation, from getting left behind, city official Mihoko Osawa said.

Then, when vaccinations begin for the general public, the team of doctors will shift gears and cater to foreign residents whose access to conventional vaccination channels may be hindered by language barriers, reaching out to them with the added help of interpreters.

To this end, the city is aiming to set up an ad hoc vaccination site near Yamato International Association — a hub of international communication in the city — with volunteer interpreters offering services in 20 languages including English, Spanish, Chinese and Tagalog on site to help facilitate communication between doctors and patients.

“Since we already had previous experience arranging interpreters for foreign residents, I think we had an inherent readiness to respond to their needs,” Osawa said.

Ayase, another city in Kanagawa with a large population of non-Japanese, is also among the most prepared. The city has attracted an increasing number of foreign nationals from Vietnam and Sri Lanka in recent years.

Ayase is planning to install tablet devices at local clinics and mass vaccination venues through which doctors and foreign patients will be connected with medical interpreters in a three-party call. Vaccination coupons and other related documents will also be published in simplified Japanese, according to municipal official Michiyo Imai.

Preparation in those cities aside, the mammoth scale of the nationwide vaccine program has swamped many municipal officials to the point that they barely have enough human resources left to be able to work on multilingual services.

One struggling local government is that of the city of Ota, Gunma Prefecture, which has communities of Brazilian, Vietnamese and Filipino people. “Truth be told, we are just too busy keeping up with instruction after instruction issued by the central government to really have time to think about what to do with our foreign residents” in terms of vaccination, said an Ota official in charge of health policies who declined to be named.

The best the city has planned so far, the official said, is to translate its flyers on the vaccine rollout into English, Chinese, Spanish and Portuguese and showcase them inside its office building in hopes of spreading awareness of what the process is going to look like.

Tokyo’s Shinjuku Ward, home to the largest number of foreign residents in the capital, is also underprepared.

Given the tight schedule of the program, the ward didn’t have time to translate the vaccination tickets it is currently preparing to mail to older people, although the tickets do include information regarding a multilingual hotline, said Hironori Kusuhara, a ward official in charge of the vaccine rollout program.

“It’s not just multilingual services we need to think about, but all sorts of other things dominate our attention now, including how to set up and operate the vaccination sites,” Kusuhara said.

“It’s true that we have a great number of foreign residents, so we recognize it is an issue we would need to address going forward.”