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Health minister Norihisa Tamura gave his final approval Friday for emergency use of two more COVID-19 vaccines — developed by Moderna and AstraZeneca, respectively — in hopes of giving the developed world’s slowest vaccine rollout a much-needed shot in the arm.

However, British-Swedish drugmaker AstraZeneca PLC’s shots will not initially be used while the government weighs whether to place age restrictions on the jabs following reports of very rare blood clots overseas.

The addition of vaccines comes as Japan aims to finish inoculating the country’s 36 million people age 65 and over by the end of July.

With the approval of the two shots, vaccine supplies are set to increase sharply. Japan has contracts for the three manufacturers to provide a total of 364 million doses, more than enough to cover two shots for all of the country’s 126 million residents.

The number of doses ordered are as follows:

  • AstraZeneca: 120 million shots
  • Moderna: 50 million shots by the end of September; in talks to acquire an additional 50 million shots for next year
  • Pfizer: 194 million shots by the end of the year

A health ministry panel approved Moderna’s vaccines Friday for people age 18 and over, deciding not to use AstraZeneca’s shots for public vaccinations until the government has carefully considered introducing age limits. About two dozen countries are halting or restricting use of the jab due to concerns over the rare clots. Pfizer’s shots have been used for people age 16 and over in many parts of the world.

For now, Pfizer’s vaccines, which need to be stored in deep freezers at minus 75 degrees Celsius, will continue to be used across the country at hospitals or venues set up by municipal governments. Moderna’s vaccines, which need to be kept at minus 20 degrees, will be given at state-run mass inoculation centers to be launched on Monday in Tokyo and Osaka, both of which will be staffed primarily by doctors and nurses from the Self-Defense Forces.

Dozens of large sites to be set up by several prefectural and municipal governments will also use the Moderna shot. AstraZeneca plans to have domestic pharmaceutical firms such as Daiichi Sankyo Co. produce at least 90 million of the 120 million contracted vaccines, which can be stored in regular refrigerators.

Health minister Norihisa Tamura on Thursday | KYODO
Health minister Norihisa Tamura on Thursday | KYODO

The mRNA vaccines developed by Pfizer and Moderna were both about 95% effective in late-stage trials overseas, while AstraZeneca’s viral vector vaccine was 70.4% effective, according to the health ministry. All three vaccines need to be administered twice for full protection, and the government is asking people not to mix vaccines from one dose to the next.

“Data has shown that people who get a different vaccine the second time would have higher chances of developing a fever,” said Dr. Tetsuo Nakayama, a project professor at Kitasato Institute for Life Sciences and director of the Japanese Society of Clinical Virology.

The intervals for shots by Pfizer, Moderna and AstraZeneca are three weeks, four weeks, and four to 12 weeks, respectively.

The pace of vaccinations is on the rise as the government has vastly increased vaccine allocations to the local municipalities since the end of Golden Week. The number of shots given daily averaged 322,000 over the past week, up 54% from the previous week, but that’s still about a third of Prime Minister Yoshihide Suga’s goal of 1 million shots a day.

The nation’s rollout of Pfizer’s vaccines started on Feb. 17 with a total of 7,990,398 shots administered to health care workers and older people as of Thursday, Cabinet Office data showed. That means that only about 4.4% of the nation’s 126 million residents have received at least one dose. That’s far behind other Group of Seven countries, with rates of around 48% in the U.S. and Canada and 33% in Italy, according to Our World in Data.

One of the reasons for the slow rollout is the lack of personnel who can handle the inoculation drive. The government last month decided to enlist the help of dentists for the vaccination campaign and is considering adding pharmacists into the mix as well.

The fast-track approvals of all three vaccines by Tokyo came despite the lack of large clinical trials in Japan, as the lower number of COVID-19 cases compared to other countries made it difficult to secure trial candidates. The approvals of the Moderna and AstraZeneca vaccines come more than four months behind their approval in the U.K.

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