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For Tokyo-based university student Takuya Haseyama, nailing job interviews is more important than getting a COVID-19 vaccine.

The 21-year-old is currently in the final phase of job hunting, and the last thing he wants is for a hard-won appointment with a potential employer to be derailed by side effects from the shots.

“My parents got the shots, and they told me they both experienced fever and suffered from a sense of fatigue afterwards,” Haseyama said. “So I think I’ll hold off on getting vaccinated until after I’m done with my job interviews.”

The student is one of many vaccine-hesitant young people in Japan, a group that authorities and scientists are trying to steer toward immunization amid a delta-driven surge in COVID-19 cases.

They are unleashing a flurry of incentives and awareness campaigns to break through the wall of hesitancy, complacency and apathy that has kept a good portion of the nation’s young people from being vaccinated. On Friday, a vaccination center opened in Tokyo’s Shibuya district — a mecca of youth fashion and pop culture — that will cater exclusively to younger generations.

But complicating the picture is the fact that low vaccination coverage among younger people is not just a matter of hesitancy. It also has to do with recent limits on the supply of vaccines that have derailed vaccination schedules for some young people keen to get their shots.

Lack of urgency

Like other parts of the world, Japan has a relatively high rate of vaccine reluctance among younger generations.

A poll released by the Tokyo Metropolitan Infectious Disease Surveillance Center on Thursday showed that the percentage of those in their 20s who said they are either “definitely” or “probably” not going to get vaccinated stood at 19.0% and 18.8% for men and women, respectively. The survey also indicated that the percentage of those disinclined to get a shot tended to drop the older the respondents got, with 12.1% and 8.7% of men and women in their 50s, respectively, expressing such reluctance.

A separate survey conducted earlier this month by Jiji Press, meanwhile, suggested that the share of those fully vaccinated in different demographics was lowest among younger people, standing at 16.9% for those in their 30s and further dipping to 12.9% among those age 18 through 29. The figures compared with 20.6% and 25.6% for those in their 40s and 50s, respectively.

A vaccination center for younger people in Tokyo's Shibuya district on Friday | RYUSEI TAKAHASHI
A vaccination center for younger people in Tokyo’s Shibuya district on Friday | RYUSEI TAKAHASHI

“Studies have shown that vaccine-hesitant individuals are more common among the youth than other generations,” said Dr. Takahiro Kinoshita, who also serves as vice-chair of Cov-Navi, a group of doctors fighting disinformation about coronavirus vaccines. “I think much of whether Japan can restore normalcy hinges on how many out of this demographic will be persuaded to get a shot.”

There are believed to be multiple factors behind youth vaccine hesitancy in Japan.

Among them are concerns about long-term side effects from the shots. The relatively lower risk young people face of experiencing complications from the virus means many see little benefit in getting immunized too.

Their heavy use of social media can also make them susceptible to the anti-vaccine disinformation and conspiracy theories, including on altered DNA and female infertility, that inundate such platforms.

“I know vaccines are probably safe, but it wasn’t long ago that they were developed, so I kind of want to wait and see how they go,” said Haseyama, the university student.

Haseyama takes mask-wearing seriously and avoids drinking parties, but part of him isn’t fully convinced of the danger of COVID-19.

“I’ve heard many COVID-19 patients get away with just being asymptomatic and not having a fever at all, so to me, side effects from the vaccines might be scarier than the virus,” he said.

Takahiro Kinoshita, doctor and vice-chair of Cov-Navi, a group of doctors fighting disinformation about coronavirus vaccines | KYODO
Takahiro Kinoshita, doctor and vice-chair of Cov-Navi, a group of doctors fighting disinformation about coronavirus vaccines | KYODO

Incentive blitz

It perhaps makes sense then that officials are eager to encourage young people to roll up their sleeves.

In June, state minister and vaccine rollout czar Taro Kono collaborated with Hajime Syacho, a popular YouTuber with nearly 10 million subscribers, to assure his viewers of the safety and effectiveness of COVID-19 vaccines.

Meanwhile, the youth-oriented vaccine center in Shibuya is touted by officials as being highly accessible because it allows eligible visitors — vaccine coupon holders age 16 through 39 who live, work or study in Tokyo — to just swing by without having to go through the hassle of booking an appointment.

In a related move, the Tokyo Metropolitan Assembly last week approved a ¥1 billion supplementary budget as part of a campaign to sway vaccine-hesitant youths. Envisaged measures include rolling out online adverts and awarding shopping coupons to vaccinated people in their 20s and 30s through a collaboration with smartphone app operators.

In Gunma Prefecture, officials unveiled a Subaru XV as a lottery prize for residents in their 20s and 30s who have received their second dose by the end of September. The automobile is worth about ¥3 million, Gov. Ichita Yamamoto told a news conference earlier this month.

“There are some younger folks who are dead-set against getting vaccinated, but there are also those who are just hesitant because of what they read on social media,” said Kunihiro Yanagi, an official at the prefecture’s vaccination promotion office.

“Our aim is to help reduce their hesitancy — first by providing them with accurate information about vaccines and then telling them that if they do get the shots, they might get a car too.”

People line up to get a shot at a new vaccination center in Tokyo's Shibuya district on Friday. | KYODO
People line up to get a shot at a new vaccination center in Tokyo’s Shibuya district on Friday. | KYODO

It remains to be seen how effective these incentives will be in improving vaccination uptake. Precedent overseas suggests the impact may be limited: In the U.S., where states such as Ohio, Maryland and New York went ahead with cash giveaways and lotteries, the resulting increase in vaccine uptake was reportedly small and short-lived.

Effective messaging

Equally important is to invest in effective communication with the hesitant, or even apathetic, people in this demographic. One way to get through to them is to drive home the severity of COVID-19, and consequently the importance of getting vaccinated against it, Cov-Navi doctor Kinoshita said.

A good example of this strategy, he said, is a viral infographic recently posted by his fellow Cov-Navi doctor Kosuke Yasukawa on Twitter. Featuring cartoon illustrations likely to resonate with young people, the graphic demonstrates the gap in perceptions between the general public and medical experts of what “mild,” “moderate” and “serious” COVID-19 symptoms each look like. The post had garnered over 144,000 likes as of Friday.

While many people tend to brush off a mild COVID-19 illness as no different from an ordinary cold, doctors are of the opinion that it’s actually fairly serious — only that patients don’t need help breathing just yet, according to the graphic. Likewise, doctors’ perception of a moderate case is that pneumonia has spread to the point where it represents the “most difficult time in their life” for many of those patients, despite the more complacent view among the public that moderate symptoms are merely “likely to involve some difficulty breathing.”

Another key approach, Kinoshita said, is to frame the virus and vaccines in terms of things that are closer to home for young people.

For example, emphasizing the fact that the virus can not only temporarily damage their health but cause lingering aftereffects such as loss of taste or loss of hair — thereby curtailing their enjoyment of food and fashion — could be an effective messaging strategy, the doctor said.

“Telling them that they might be able to resume grabbing drinks with their friends, cheering loudly at concerts or making a trip back home to their family — telling them they would be able to do all these again if they are vaccinated, I think, would be a powerful message too,” Kinoshita said.

A new vaccination site for younger people in Shibuya, Tokyo, on Friday | KYODO
A new vaccination site for younger people in Shibuya, Tokyo, on Friday | KYODO

Kinoshita, however, cautions that it’s not fair to lump together all members of younger generations as hesitant or apathetic — rather, their low vaccination coverage can partly be blamed on reduced vaccine access. There are some, he said, who are simply unable to book slots due to the shortage of doses, even if they want to.

Many young people are now eligible to get a shot at their university — an initiative that the government began in late June — but a subsequent supply crunch caused some institutions to delay or suspend their vaccination programs.

One of them is Meiji University, which is slated to launch its vaccination program next week after months of delay, which it attributes to a lack of vaccines from the central government.

Another example is the Tokyo University of Foreign Studies, which, in a collaboration with three other institutions, originally went ahead with the inoculation of about 1,000 students in early July. But the university was later notified by the education ministry that supplies were running short, resulting in the cancellation of a second vaccination program earlier this month that would have inoculated up to 2,000 students, according to a TUFS spokeswoman.

The prestigious foreign language university is home to many students aspiring to study abroad, which has led to their relatively high appetite for vaccinations, which are regarded as a prerequisite by some partner universities. “They were desperate (to get the shots) to go on their exchange program,” the spokeswoman said.

For these students, the debut of the vaccination center in Shibuya may be a welcome development.

There is a catch, however: The venue, located within a public facility, has a daily capacity of just 200. Keiji Aoyama, an official at Tokyo’s public health bureau, said that figure is simply the most the site can handle given its size, and that the possibility “cannot be ruled out” that visitors might be told upon arrival that doses had run out.

In fact, that was almost exactly what happened Friday morning: A long queue of young people eager to get vaccinated had formed outside the Shibuya center hours before its opening, forcing officials to announce as early as 7:30 a.m. that capacity had been reached.

“A daily capacity of 200 is just too small — I was expecting it to be more like 20,000 a day, if the site really wants to be effective,” Kinoshita said. Being assured that they can get the shots without reservations, only to be told there are, after all, no vaccines left for them, would be a huge turn-off that “risks alienating young people even further,” he said.

“There are young people who are serious about vaccines. … So to imply the pandemic isn’t coming to an end or older folks are dying because young people aren’t getting vaccinated would be a messaging fiasco that only serves to infuriate them,” he said.

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