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Japan's COVID-19 inoculation campaign is moving at a glacial pace, hampered by a lack of supply and a shortage of specialty syringes — issues that underscore the enormous challenge it faces in its mission to vaccinate every adult by the year's end.

Just under 46,500 doses had been administered to front-line medical workers as of Friday, three weeks since the campaign began.

By contrast, South Korea, which began its vaccinations a week later than Japan, had administered nearly seven times more shots as of Sunday.

At the current rate, it would take 126 years for Japan to vaccinate its population of 126 million — although supplies are expected to increase in the coming months.

Unlike many other countries, Japan requires clinical trials for new medicines, including vaccines, to be conducted on Japanese patients, slowing the approval process.

So far, only the vaccine developed by Pfizer and BioNTech has been approved. Clinical trials in Japan for AstraZeneca and Moderna's vaccines have been conducted and the vaccines are now awaiting regulatory approval.

"The sense of urgency among the government is not, I think, similar to other G7 (Group of Seven) countries," said Haruka Sakamoto, a physician and researcher at Keio University, noting Japan's comparatively low case numbers and death toll.

The nation has recorded about 438,000 confirmed cases of COVID-19 with 8,251 deaths. Cases in Tokyo, which is still under a state of emergency, have subsided from a daily peak of 2,520 on Jan. 7 to 237 on Sunday.

Sakamoto said the health ministry's conservative stance stems from previous examples of a new medicine gaining approval relatively quickly only for the ministry to be criticized by the public and media for moving too fast and endangering safety.

The health ministry did not immediately respond to a request for comment on the pace of the inoculation rollout.

Japan is focusing on vaccinating about 4.8 million medical workers first before moving on to its population of 36 million older people. Vaccine czar Taro Kono has said that while shots for those over 65 will start next month, supplies will be extremely limited.

South Korea has been using low dead space syringes to extract six or even seven doses of Pfizer vaccine from a vial instead of five, and 12 doses of AstraZeneca vaccine per vial instead of 10, but Japan has been unable to ready sufficient supply of the specialty syringes.

That shortage will mean that some doses will go to waste when shots for older people start, Kono said Friday.

Japan is continuing to negotiate with Pfizer on supplies, Kono said, and imports are expected to increase fourfold in April from March to about 1.7 million vials. Each shipment must be approved by the European Union, which introduced a mechanism in late January to monitor vaccine exports after drugmakers announced delays in their supplies to the bloc.

Japan has secured rights to at least 564 million doses of COVID-19 vaccines, the largest volume in Asia, and Prime Minister Yoshihide Suga has pledged to have enough for the whole population by June, before the July 23 start of the Tokyo Olympics.

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