The pace of Japan’s vaccination rollout is inexcusable. There are explanations aplenty for the delays, but the answer is simple: The Japanese government has not approached this problem with urgency.
That is inexplicable. Japan is lucky that more people have not died because of the glacial pace of the inoculation campaign, but we should not rely on luck. Luck can, and usually does, run out.
As of May 25, Japan had given out 10 million doses of the coronavirus vaccine and fully vaccinated 2.93 million people, just 2.9% of the population. At least 6.61 million people received at least one shot as of Monday, putting the daily average at less than 400,000 people. Those numbers put Japan 30th, or last, among members of the Organization for Economic Cooperation and Development, the group of industrialized nations.
The Japanese government said it intends to fully vaccinate all people 65 and older who want the jab by the end of July, a one-month delay from the original target. That would require a more than doubling of daily inoculations, to 1 million. Not surprisingly, some 15% of local governments say that they will not be able to make the new target.
There are many reasons for those abysmal numbers. Japan was slow to procure vaccines. Japan’s pharmaceutical companies have foregone vaccine manufacturing, judging them a poor use of resources. As a result, Japan had to import its shots, and that meant it had to compete with other governments for supplies.
The nation has secured 344 million doses, enough to cover the entire population, however. They will be delivered throughout the year, but there are already doses in freezers, waiting to be used.
Delays were compounded by a slow approval process. Almost every country expedited the COVID-19 vaccine review and authorization process. Japan held out, demanding domestic clinical trials, although it was quick to approve the drugs once testing was complete.
Now the problem is getting shots into arms. Medical rules are strict about who can administer shots. Normally, only doctors and nurses can do so. The government has amended procedures to allow dentists as well as doctor and nurses from the Self-Defense Forces to administer jabs as well, but that is not going to suffice. The government is reportedly studying plans to authorize paramedics (640,000 in Japan), clinical technologists (200,000) and pharmacists (another 300,000) to give shots.
Vaccination programs are run by municipalities, however, so Tokyo’s directives are not going to be enough. The central government must do more to build capacity in localities to deliver vaccines. It should facilitate coordination between local governments and medical institutions that give shots. It should identify new ways to motivate health care providers to participate and to encourage citizens to get their shots. It should help develop systems for appointments and ensure that citizens with mobility problems are not left out.
The Tokyo government has developed task forces for this coordination effort but again, there needs to be more understanding of local needs and limits, more creativity and more urgency.
That last factor seems to be missing. While Japan was one of the first countries to face the COVID-19 pandemic last year — when it had to deal with the outbreak on the Diamond Princess cruise ship, in which 712 people of 3,711 on the ship became infected and 14 passengers died — its subsequent experience suggested that the country had a grip on the situation.
As of May 25, Japan has had 727,000 cases and nearly 12,500 deaths, more than half of them occurring since February. Japan had low infection rates compared to many Western countries, with correspondingly low mortality numbers. No one knows why.
Whatever the explanation, the immunity has run out. Japan is facing record numbers of new cases daily and hospitals are reaching capacity. Inoculations are needed to stem the tide; evidence from other countries shows that infections notably slow when 20% of the population receives at least one dose.
The next challenge, then, is to convince the Japanese public to take the vaccine when it is available. That will be harder than it should be.
Japan has the lowest rates of confidence in vaccines in the world, with just 30% of Japanese saying they “strongly agreed” that vaccines are safe and effective; according to an NHK survey from last year. And more than one-third of Japanese said they did not want to get the COVID-19 jab. Worse, a growing number of people in Japan don’t believe that vaccines are effective.
Still, surveys show that more than 60% of the public will get shots when they are available. Those are encouraging numbers, but they are not large enough. The government must launch a campaign that fights disinformation about the side effects of the COVID-19 vaccine and make clear the benefits from getting the jab. The media and news personalities will be core components of any success since getting younger Japanese (20- and 30-somethings) to get shots will be essential.
The 2021 Summer Olympic Games, once thought to have been a great opportunity for Japan, have muddied the situation. The commitment to holding the games has antagonized many Japanese who feel the government is putting the prestige of the Olympics over national health. Majorities now favor canceling the event, but the government continues to insist that the games can and should be held. It will be soon be too long to decide otherwise.
Given the confusion and the fatigue triggered by the continuing state of emergency, there is a simple message that the government can deliver to increase public acceptance. “Get your shots and life can return to normal” may prove to be the motivation that the country needs.
The Japan Times Editorial Board
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