A Personal Journal From January to April 2021

Kalani M. Fujiwara
Special to The Hawai‘i Herald

Japan’s vaccination efforts started in earnest on Feb. 14, 2021, after the Pfizer-BioNTech mRNA vaccine was approved by the Japanese ministry of health and the Japanese medical system. The deployment of this vaccine started few days later with the priority given to medical personnel throughout Japan. Japan’s vaccination efforts had a real late start compared to the U.S. and Europe, which started in the fall of 2020 and with quick approval of all three main line vaccines. (Pfizer-BioNTech, Moderna and AstraZeneca) Japan’s initial vaccination efforts were mired with bureaucratic delays and import issues. The other major problem was the overpromising of COVID-19 vaccination as way for social and economic normalcy by Prime Minister Suga and his cabinet to the Japanese public. He oversold the Japanese public on how serious he believed the COVID-19 vaccination was for Japan’s economic recovery from this pandemic in order to stage a “normal” Tokyo Olympics by July. He appointed a capable political leader Taro Kono as the vaccination minister in his cabinet. Minister Kono had previously served as the foreign and defense minister under Prime Minister Abe. He was very popular with the Japanese public due to his early adoption of social network communication with use of Facebook, Twitter and LINE. Unlike the usual Japanese politician, Minister Kono was articulate and frank with his discussions on many political and social issues in Japan. He was considered a “maverick” politician, who the Japanese public found refreshing. However, to the Japanese political establishment and his political party, Liberal Democratic Party (LDP), Minister Kono was regarded as a loose cannon, showboat and non-team player. Minister Kono’s public popularity was probably considered useful by Prime Minister Suga and his cohorts to illustrate to the Japanese public on how serious his administration viewed the vaccine efforts to mitigate the COVID-19 pandemic.

Vaccination mistrials in Japan. (Photo by Jernej Furman, flickr.com)

You could have Michael Jordan, LeBron or Shohei Otani as a centerpiece of your team; however, if the rest of the team and team ownership are clueless and way below average in their mindset/effort, you are probably going to get a bad regular season and no playoff run. The same thing occurred with the Japan’s initial efforts in vaccinating the Japanese public against the COVID-19 virus. Despite Minister Kono’s and the vaccine ministry’s best efforts, Japan’s vaccination program ran into stiff headwinds until fall of 2021. 

The first problem was the archaic method in which foreign-made vaccine was approved by the Japanese medical system and the Ministry of Health. The U.S. and Europe quickly approved all the emerging vaccines and mass deployed it in the fall of 2020. In January 2021, the Japanese medical system and the Ministry of Health were still mulling on the approval of Pfizer-BioNTech vaccine (just one out of the three vaccines already used in the U.S. and Europe). This bureaucratic red tape delay cost weeks and maybe lives were lost to COVID-19 if you look at the fourth and the fifth waves of infections that started in April 2021 and in July 2021. Moderna and AstraZeneca vaccines were not approved and deployed until late May 2021 due to this same Japanese bureaucratic red-tape delay. 

The second problem was due to the dependency of foreign-made vaccines and importing it into Japan. In February 2021, there was already a global shortage of vaccines since the U.S. and the Europe were making huge efforts to get their public vaccinated. Thus, the delivery of the Pfizer-BioNTech vaccine into Japan was limited due to the global demand and needing an E.U. approval since the vaccine was being imported from Belgium. The Japanese government tried very hard to have more Pfizer-BioNTech vaccines delivered into Japan to no avail. Of course, rushing the approval and deployment of Moderna and AstraZeneca vaccines were out of the question. What bothered the Japanese public and the media was the fact that Japan has a real advance biotech research and development infrastructure to create its own domestic COVID-19 vaccine, but unable to create it due to the bureaucratic inertia and very little investment in preventive vaccine development. The first Japan-made COVID-19 vaccine is due out later this year (2022), too late to make an impact on the current pandemic. 

The third problem was the availability of medical personnel and proper equipment to administer the vaccine. Due to the strict medical regulations in Japan, any vaccine must be administered by a physician or at least witnessed by a physician. Thus, a bottleneck in distributing the vaccine was already evident with this tough medical regulation. There were not enough physicians to mass administer the COVID-19 vaccine throughout Japan as envisioned by Prime Minister Suga. The Japanese medical professionals were already stressed out with treatment of COVID-19 patients and now are asked to mass administer the COVID-19 vaccine. On top of the physician shortage, Japan also lacked the special syringes to maximize the administering of the vaccine. Thus, about three to four dosages were wasted due to the lack of the necessary special syringes. Also, the lack of sub-zero storage equipment to store the mRNA vaccines contributed to the bottleneck in administering the vaccine to the Japanese public. 

The fourth problem was coordination between the central government in Japan and the local governments in Japan regarding the distribution and administration of the COVID-19 vaccine to the Japanese public. There were local municipality that were well organized and ran a well-orchestrated administration of the COVID-19 vaccine to its residents, while some local governments were clueless on how to effectively administer the vaccine to prospective residents that led to wasted dosage since the vaccine has a short self-life. Also, what was evident was that a wealthy municipality like Kanagawa, Tokyo, Osaka and Aichi prefectures, due to it’s larger tax base and geographic compactness, had the resources in funds and facilities to deliver the vaccine dosages more effectively to its residents. While the less wealthy municipality, due to the rural geography, have a harder time in reaching out to its residents. Although the Japanese central government provided all the necessary resources to the country; however, one could see the subtle differences in the deployment of the vaccine between the cities and the prefectures in Japan. 

All these problems were compounded by the overpromise and overselling of the COVID-19 vaccine and its impact to the pandemic by Prime Minister Suga and his administration to the Japanese public. The great majority of the Japanese public like the other Asian nations were onboard with the COVID-19 vaccination. There was very little vaccine hesitation or opposition to the COVID-19 vaccine by the Japanese public unlike what has occurred in the U.S. COVID-19 vaccination in Japan never became a political issue as it has become in the U.S. Much of the Japanese public viewed COVID-19 vaccination as a way to return to normalcy of life and were very willing to get vaccinated. What frustrated the Japanese public were the four problems of the vaccination process just outlined above. That led to the fourth and fifth COVID-19 wave infections of 2021; more infections, hospitalizations and deaths that could have been prevented had the vaccinations of Japan been better executed. 

Kalani M. Fujiwara was born in Japan and raised in Hawai‘i. He formerly taught political science at Kapi‘olani Community College and Honolulu Community College for 20 years. He lived in Japan off and on altogether for 12 years. He is currently living in Japan for the third time.


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