With Japan lagging behind other wealthy nations in its COVID-19 vaccine rollout and the pandemic-delayed Tokyo Olympics just two months away, the government of Prime Minister Yoshihide Suga is intent on accelerating the nation’s inoculation campaign. It has set for itself the rather ambitious goal of giving the nation’s population of older residents 1 million shots per day and give all 36 million of them a chance to get vaccinated by the end of July.

The 1 million shots a day goal, and the extent to which the central government has cracked the whip on municipalities, are the latest manifestations of Suga’s apparent frustration with the nation’s slow-starting vaccination campaign.

Local governments will be vital in Japan’s endeavor to accomplish the target.

While a recent health ministry survey showed that about 85% of municipalities expect to meet the July deadline, some are less sanguine than others that they can achieve it. Some municipalities say they responded optimistically to the poll amid pressure from the central government to speed up the rollout.

And then there are some local officials who are not confident at all. They dismiss the proposed timeline as out of touch with the reality of their rollout efforts, which are already fraught with a host of logistical challenges, including the difficulty of procuring doctors and nurses to administer the jabs.

Municipal challenges

Suga said the government will start aiming for 1 million daily shots after the planned Monday launch of mass vaccination sites in Tokyo and Osaka, which will leave about 70 days until the end of July.

The idea is to use those 70 days to give an estimated 36 million older people nationwide the full two-dose course of a vaccine, which amounts to roughly 72 million shots — hence 1 million shots per day. Since the start of vaccinations of older people on April 12, a total of 1.8 million shots have been administered so far. The daily tally, based on preliminary figures, amounted to just 144,620 for older people on Thursday, along with 190,533 shots given to medical workers.

Asked about the rationale behind the target, Suga cited a daily average of 600,000 shots given for the flu in Japan, which he said can be surpassed with the kind of wherewithal now in place to vaccinate people against COVID-19.

Although Suga’s target is predicated on an expected ramp-up in shots coming from the launch of the mass vaccination centers in Tokyo and Osaka, those sites have a combined capacity of just 15,000 shots per day. That means that, in large part, the goal of 1 million shots a day still hinges on the speed of municipal rollouts.

Local governments like the city of Hiroshima have made no secret of their pessimism regarding the July goal.

“There is a limit as to how many local clinics or mass vaccination sites we can arrange. It’s simply impossible to go beyond that limit and work toward whatever deadline is imposed on us,” Yukiharu Sakaya, head of the city’s health and medicine department, told a news conference last week.

A city employee shows a man how to make a reservation for a vaccination in Okazaki, Aichi Prefecture, on May 13. | KYODO
A city employee shows a man how to make a reservation for a vaccination in Okazaki, Aichi Prefecture, on May 13. | KYODO

The official estimated it won’t be until early October, more than two months later than the time frame announced by Suga, that the city will be able to finish inoculating all of its 300,000 residents age 65 or older.

The poll showed that in prefectures like Akita, Shizuoka and Chiba, the percentage of municipalities with an optimistic attitude toward the July deadline was particularly low, with Akita placing last at 56%.

One of the biggest hurdles bedeviling these municipalities is a dearth of medical professionals eligible to administer shots.

In Abiko, Chiba Prefecture, for example, it may not be until September that more than 40,000 residents 65 and over can be fully immunized, due partly to difficulties finding doctors willing to contribute to the rollout when they themselves are not vaccinated yet, according to Kumiko Nemoto, an official of the city’s health promotion department.

“In our city, even the vaccination of health care workers isn’t done yet, and many doctors who are supposed to serve as vaccinators remain unable to get the jabs, so it’s been difficult for us to seek their cooperation,” Nemoto said. “This delay in the inoculation of medical professionals is a big issue for us. We can’t just speed things up just because there are some doses on the way,” she said.

Similar challenges plague the city of Yurihonjo in Akita Prefecture, where a large chunk of health care workers are still left without access to jabs.

A man reads a vaccine invitation letter from Tokyo's Adachi Ward on April 28. | KYODO
A man reads a vaccine invitation letter from Tokyo’s Adachi Ward on April 28. | KYODO

“We were originally expecting to get them inoculated in April, but the delay in vaccine supply has resultedin doctors still working to get them vaccinated, said an official from the city’s COVID-19 vaccination team who asked not to be named.

“This delay in the initial phase is now turning into a major bottleneck, and we’re now in a situation where we just don’t have the resources to process the increased amount of vaccine supply that’s coming our way,” the official said. Yurihonjo expects to inoculate about 60% of its 28,000 residents over 65 — equivalent to the percentage of older people that usually opt to be vaccinated against the seasonal flu — by the end of August.

Saving face?

Even some of the municipalities that told the survey of their intention to finish vaccinations of older people before August may be facing a tough road ahead.

In fact, some of them allege they felt pressured by central ministry officials into moving up their vaccination schedules by weeks to meet the July deadline, with some unsure about their ability to follow through on it.

In a monthly publication issued Saturday by the city of Ota, Gunma Prefecture, Mayor Masayoshi Shimizu detailed a recent phone conversation he had with an internal ministry official, who asked him to bring forward the city’s vaccination timeline for older people by a month and “just finish the inoculation of older people by the end of July.”

“Since Prime Minister Suga vowed to complete the inoculation of older people by the end of July, I wonder if the Cabinet Office has been asking other ministries to urge (local governments) to speed up their rollout,” the mayor wrote.

In fact, the internal affairs ministry set up an internal task force last month designed to strengthen networks with, and boost support for, municipalities grappling with the vaccine rollout, with minister Ryota Takeda serving as its head.

Prime Minister Yoshihide Suga speaks during a news conference in Tokyo on May 14. | POOL / VIA AFP-JIJI
Prime Minister Yoshihide Suga speaks during a news conference in Tokyo on May 14. | POOL / VIA AFP-JIJI

Recalling a similar experience of being pressured by such calls from “various” entities of the central government, Akita Gov. Norihisa Satake put it more bluntly as he spoke to reporters last week: “They were essentially asking me to help save face for the prime minister.”

The city of Inzai in Chiba Prefecture also answered the poll by saying full vaccinations of people over 65 can be completed by the end of July, but only after it had been pressured by the prefecture and the central government to move up the schedule by a month, according to a city official who asked not to be named.

“We’re not really confident that we’ll be able to make it by the end of July,” said the official from the city’s coronavirus response team.

The biggest bottleneck, he said, is the lack of manpower, which makes it a daunting task for the city to set up and staff an additional mass vaccination site.

“We were originally aiming for August, but the (1 million shot target) came out of the blue and we suddenly had to change course. I’m sure there were other municipalities, like us, who are struggling to make adjustments,” the official said.

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