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Inoculation has divided public opinion since the first vaccine for smallpox was introduced in 1797. In Japan, vaccines were once compulsory, but public pushback because of side effects has since see this change.

On July 27, Dr. Takeshi Enami, director of the Immunization Office, Health Service Division, Health Service Bureau, for the Ministry of Health, Labour and Welfare (MHLW) and Dr. Nobuhiko Okabe, director general, Kawasaki City Institute for Public Health, spoke to members of the American Chamber of Commerce in Japan about the significance of immunization.

Enami opened with the history of vaccination policy.

The purpose of a vaccine is to control infectious disease, he explained, and if a disease can be prevented through vaccination then the vaccination should be given. In terms of immunization policy in Japan, he suggested that the number of vaccines for infectious diseases covered by local governments needs to be expanded.

Another issue is supply. In 2015, Japan faced a shortage of the mumps vaccine due to high demand, and there have been shortages of other vaccines since. Enami said the gap between supply and demand is beginning to close, however, with suppliers and administrations collaborating and communicating better.

Changing public perception in Japan is a core focus for the ministry, and a large part of this is finding ways to reduce the adverse effects of vaccines. Centers to promote vaccinations have been set up in 20 prefectures, which are also monitoring how vaccinations are being adopted.

He added that being able to smoothly introduce new vaccines—and to incorporate the public’s response into policy—is a continuous struggle.

Okabe, whose career involves many years in vaccination administration, detailed some of the positive and negative side effects, and recapped the history of vaccines starting from 1797, discussing the control and eradication of smallpox and the control of polio.

One fundamental idea shared by both speakers is that vaccines address the future prevalence of different diseases. As Okabe pointed out, the challenge is staying ahead of new diseases.

In addition, there are accompanying costs, correct application, and possible side effects to consider. These effects, he said, must be closely monitored; but it is impossible to know who is susceptible to what, so it is important for vaccines to work for everyone. Okabe believes they must also be single-dose, painless, and long-lasting, with low side effects and no waste.

To tackle side effects, he explained that a countrywide survey is being conducted to assess what errors are being made in application, such as with needles and leaks.

Despite these negative cases and side effects, Okabe highlighted their impact, mentioning the eradication of diseases such as diphtheria and rubella.

Another challenge is awareness. Restoring the public’s faith in vaccines requires a careful balancing act. Okabe believes the efficacy and safety of vaccines should be evaluated purely through scientific review, and experts and media should take care to promote accurate information.

Enami emphasized that the MHLW and Japan’s National Institute of Infectious Diseases are working hard to keep the website updated, while ensuring further collaboration between suppliers and the administration to strengthen vaccine policy.

Maxine Cheyney is a staff writer at Custom Media for The ACCJ Journal.
Being able to smoothly introduce new vaccines—and to incorporate the public’s response into policy—is a continuous struggle.