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Vaccine Policy Reform in Japan: Progress & Challenges
Vaccination Policy Reform in Japan: Progress and Challenges
It is said that there is a “vaccine gap” between Japan and other developed countries. Indeed, the number of available vaccines in Japan was smaller than in other advanced industrial nations and five vaccines recommended by the World Health Organization (WHO) were not covered by the national immunization program (NIP) before revision of the Vaccination Law.
But in April 2013, the Japanese Government revised the Vaccination Law to reform the vaccination policy. Since then, there has been significant progress on vaccination policy. In 2014, the Ministry of Health, Labour and Welfare (MHLW) issued the Basic Immunization Plan. This plan states clearly that vaccine-preventable diseases should be addressed by vaccination and sets out the medium-to-long term vision for immunization in Japan.
One of the priorities of the plan is solving the vaccine gap. MHLW organized a new advisory committee on immunizations to promote the discussion on NIP; six vaccines – HPV, Hib, pediatric pneumococcal, chicken pox, adult pneumococcal and hepatitis B – were included in the NIP between 2013 and 2016. As a result, the number of NIP vaccines doubled in only three years.
While we are seeing remarkable progress, we are also seeing some challenges in vaccine policy reform. Confidence in vaccines is one of the major challenges in Japan. A recent global survey of public trust in immunization demonstrated that vaccine safety-related sentiment is not positive in Japan. The survey was conducted in 67 countries and Japan was the second lowest country on confidence in vaccine safety. 31% of respondents in Japan disagreed that vaccines are safe, while the global average was 13%.
The survey report mentions that losses in confidence in vaccines and immunization programs can lead to reluctance and refusal to accept vaccinations, risking disease outbreaks and challenging immunization goals. WHO pointed out that, if not rapidly and effectively dealt with, adverse events following immunization (AEFI) can undermine confidence in a vaccine and ultimately have dramatic consequences for immunization coverage and disease incidence.
AEFI monitoring, assessment and communication are critical components to deal with AEFI rapidly and effectively. A system where AEFI is monitored and managed within a science-based process supported by fair communications and disease surveillance must be established. In addition, considering that it is difficult to visualize the effect of vaccinations since they are primarily administered to healthy people, the balance between efficacy and safety should be fully explained to citizens and the media in an easy-to-understand manner.
References available upon request.