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Japan’s vaccination drive finally kicked into gear Monday around four months after the start of inoculations in the United States and the United Kingdom, a slow rollout that has generated further criticism of Prime Minister Yoshihide Suga’s handling of the pandemic.

The doses for people 65 and over are the first vaccinations for members of the public in Japan after priority was given to inoculating front-line medical staff first.

Japan has so far weathered the coronavirus pandemic relatively well, with infection numbers and deaths just a fraction of many Western countries. But the slow vaccination plan means struggling businesses and fearful shoppers will have to hold out for longer as the recovery of the economy is delayed by as much as two years compared with global peers.

The tardy start comes as stricter measures were reinstated today to quell an uptick in virus cases in the capital, fueling discontent with Suga in an election year, as the government, like many around the world, lurches between tightening and loosening guidelines on activity. It also adds to smoldering doubts over Tokyo’s readiness to host the Olympics in July with no timeline for when most people will be inoculated.

“More than anything we need to get on with these vaccinations quickly,” said Kazutaka Sato, the 70-year-old owner of a restaurant in Osaka — the current center of the pandemic in Japan. “Without vaccinations, it’s going to be extremely tough for businesses like ours to keep going.”

COVID-19 vaccinations for people age 65 or over start Monday at the Hachioji Municipal Government building in Tokyo. | POOL / VIA KYODO
COVID-19 vaccinations for people age 65 or over start Monday at the Hachioji Municipal Government building in Tokyo. | POOL / VIA KYODO

Osaka recorded a record 918 new cases over the weekend, and Tokyo’s seven-day average has also crept up in recent weeks.

With no domestically developed COVID-19 vaccine of its own, Japan’s late rollout stems from a dependence on imported shots that were initially in limited supply. Another factor was a strict approval process that required local clinical trials for foreign vaccines. So far, Japan has only given the green light to Pfizer-BioNTech’s jabs.

Especially given Japan’s history of public skepticism over vaccine safety, a take-it-slow approach may have also been needed to get the country on board. In Europe, reports that AstraZeneca PLC’s vaccine may cause blood clots in rare instances have made some scared to get shots. “Naturally, the general public would feel reluctant to take the vaccine after seeing this news,” Haruka Sakamoto, a public health researcher at the University of Tokyo, wrote in an email to Bloomberg.

Lost time

Still, Suga’s government is showing little appetite to make up for lost time. The first batches of vaccines for people aged 65 or over will be limited to 1,000 doses for most areas of the country, with additional doses sent weekly.

Taro Kono, Japan’s vaccine point man and a possible successor to Suga, told Bloomberg that the rate of COVID-19 inoculations is unlikely to pick up speed until May. And the government has so far declined to set any schedule or long-term targets for getting shots into arms.

Meanwhile, a third of the U.S. and half the U.K. population have already gotten at least one jab and those countries are expected to hit the 75% mark within four months, according to Bloomberg projections.

Health care workers reach for a box of the Pfizer-BioNTech COVID-19 vaccine at Kanto Rosai Hospital in Kawasaki. Japan’s vaccination drive finally kicked into gear Monday around four months after the start of inoculations in the United States and the United Kingdom. | BLOOMBERG
Health care workers reach for a box of the Pfizer-BioNTech COVID-19 vaccine at Kanto Rosai Hospital in Kawasaki. Japan’s vaccination drive finally kicked into gear Monday around four months after the start of inoculations in the United States and the United Kingdom. | BLOOMBERG

“The preparations for vaccinations have been slow,” said Tetsuo Nakayama, a professor at the Kitasato Institute for Life Sciences, whose research focuses on vaccines. “And we’re going to have regional differences between places like Tokyo and provincial areas because local governments are in charge of administering the vaccinations, not the central government.”

Currently, Japan, a country of some 126 million people, likely has around 8 million doses of the Pfizer jab, according to figures provided by the government in March. The government estimates it could receive another 43 million doses in May, followed by 45 million in June. Its deal with Pfizer is for 144 million doses.

Japan also has deals for 120 million doses of AstraZeneca’s jab and 50 million doses of Moderna Inc.’s. Both of those shots are being considered for emergency approval, but no decisions are expected until next month at the earliest.

Vaccine hesitancy

While vaccine hesitancy has been a key issue in Japan and other Asian countries where people are more wary of side effects, there are signs more residents are becoming willing. A survey in late March by the Jiji news agency showed 79% of respondents wanted to take the COVID-19 jab. Another poll showed about two-thirds of people are getting impatient with the speed of the rollout.

Japan will prioritize its 36 million seniors aged 65 or over before opening up vaccinations to people with pre-existing health conditions and then younger age groups.

Taro Kono, Japan’s vaccine point man, has said the rate of COVID-19 inoculations is unlikely to pick up speed until May. | BLOOMBERG
Taro Kono, Japan’s vaccine point man, has said the rate of COVID-19 inoculations is unlikely to pick up speed until May. | BLOOMBERG

Progress is also likely to be patchy because of Japan’s approach to delivering the vaccines to municipalities. Even Kono, the vaccine czar, acknowledges that residents of small villages may end up having an easier time getting their shots at first, just because a single shipment of doses might be enough to cover the population, while supply in big cities falls short of people’s needs.

“It’s staggering,” said economist Takahide Kiuchi at Nomura Research Institute. “The gap with other nations is only widening. The vaccine drive has been so slow, putting the economy at risk.”

The hit to consumer spending, which makes up more than half of gross domestic product, will hold back growth and make Japan an economic laggard this year, he says.

Not everyone agrees.

“The benefits of vaccination are bigger for countries that failed to control the virus infection as well as Japan,” said Yuki Masujima at Bloomberg Economics. “Thanks to the relatively low number of confirmed COVID-19 cases in Japan, the negative impact from the Japan’s delay in vaccination should only shave at most 0.3 percentage point off GDP in 2021.”

Still, that will leave Japan recovering at a slower pace than its peers and it will still take until 2023 before Japan’s annual output regains its 2019 pre-pandemic level, compared with this year for the U.S. and 2022 for the euro-zone, Masujima said.

For Sato, the restaurant owner, it’s all about getting diners back into his shop, where customers are down by 70%.

“Everyone will feel safer if they get vaccinated,” he said. “Until then, we can’t see a light at the end of the tunnel.”

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