Now that the state of emergency has been extended, all eyes are on the new vaccines in the hope that they will be able to deliver a decisive blow against the coronavirus. Yet with vaccinations slated to begin in Japan in mid-February at the earliest, skepticism of the vaccines' efficacy and safety have become a hot topic in the weekly magazines and on social media. As one international study found, the Japanese public has low confidence in vaccines. Let's take a closer look at the issue, based on data and facts.
-- Developed in a single year
The first vaccines to be rolled out in Japan will be the products of three companies: AstraZeneca PLC (Britain), Pfizer Inc. (U.S.) and Moderna, Inc. (U.S.). Although the development of new vaccines typically takes more than 10 years, these three vaccines were developed in a mere year.
The unusually fast-tracked development may naturally leave you wondering whether the vaccines were thoroughly vetted for efficacy and safety.
Prof. Gen Suzuki, an expert in immunology and epidemiology with the International University of Health and Welfare, said, "The scale and methods of these pharmaceutical companies' clinical trials have met the quality requirements, and the efficacy and safety of the vaccines have been proven. This was achieved thanks to the latest scientific advancements, coupled with plentiful, focused investment."
Somewhere between 20,000 to 50,000 individuals of varying races participated in the final phase of testing. Randomized controlled trials were conducted to identify the efficacy and safety of the vaccines in comparison with placebos.
The vaccines developed by the two U.S. companies both proved highly effective at preventing the virus, reducing the number of people with symptoms by about 95%, without any observable serious side effects.
Be that as it may, some people have argued that these trials contained only a small number of Asian participants, and therefore, that there is still no guarantee that the vaccines will be safe or effective in Japan.
While true that the Asian demographic accounted for less than 5% of participants across the three companies' trials, these were sizable trials. Roughly 1,400 Asians participated in Moderna's testing, and about 1,600 in Pfizer's. This is about 10 times more than participated in Pfizer testing held in Japan, which had a subject pool of just 160 people.
"Verification has been conducted properly, even for different races, age groups and genders," Suzuki said.
-- Sudden allergic reactions
One concern is the number of severe allergic reactions that have been observed since vaccination started in the United States. Called anaphylaxis, symptoms include difficulty breathing and sudden drops in blood pressure.
According to the Centers for Disease Control and Prevention (CDC), the incidence of anaphylaxis in people who received one or two doses of the coronavirus vaccine in the United States was one in 200,000 doses for Pfizer and one in 360,000 doses for Moderna. These incidences are higher than that of ordinary vaccines, which is one in a million doses.
However, we also know that about 90% of anaphylaxis sufferers started to experience symptoms within 30 minutes of receiving the vaccine, and all of them recovered. Moreover, 80% of those who developed anaphylaxis also had a prior history of other allergies.
According to Sotaro Mine, a viral immunology specialist and research fellow at the U.S. National Institutes of Health, "If appropriate measures are taken, such as asking each vaccine recipient about their allergy history during a preliminary interview, monitoring them for 30 minutes post-vaccination, and having doctors and medicine ready onsite, then you don't have much to worry about."
Of course, vaccines aren't the only trigger for anaphylaxis. It also occurs at a certain probability as a result of taking antibiotics, painkillers, and other common medicines.
Other side effects from the vaccines have included pain at the injection site, fatigue, headaches, and muscle pain. These side effects are not much different from those caused by other vaccines, except injection site pain, which can evidently sting quite a bit in the case of the new shots. Mine, who received a Moderna vaccine, said that he experienced intense pain for two days.
At this point, vaccines do not seem to pose major problems from the perspective of short-term safety. However, since they are the world's first vaccines developed using cutting-edge genetic technologies, their long-term safety has yet to be fully assured. We may begin to see more unexpected adverse events as more people are vaccinated.
-- Low confidence in vaccines
In September last year, the British medical journal The Lancet published a paper on the results of a series of international surveys on confidence in coronavirus vaccines. Regarding Japanese attitudes, the paper reads, "Japan ranked among the countries with the lowest vaccine confidence in the world."
The surveys covered a little over 280,000 people across 149 countries and territories. As a general trend, public confidence in vaccines was lower in developed countries than in developing countries. Japan ranked toward the bottom in terms of the percentage of people who strongly agreed that vaccines are "effective" and "safe.".
It's possible that the Japanese respondents, given the cultural predilection for ambivalence, were simply predisposed to not choose "strongly agree" as an answer. However, we can also assume that the traumatic memory of past pharmaceutical-related safety incidents -- thalidomide, SMON disease, HIV-tainted blood products -- remain fresh in many minds.
"In the first place, unlike therapeutic drugs that can relieve symptoms, the effects of vaccines are largely imperceptible. As a result, it's the side effects and costs that stand out," said Mine.
Expanding on this premise, Mine pointed to the Japanese veneration of "zero-risk" situations. "Japanese people have a higher level of confidence in the government than you would find in the United States. On the other hand, they expect their government to be infallible, and are not so tolerant of blunders."
Mine added that does not mean the low levels of public confidence in vaccines will necessarily correlate with low levels of vaccine coverage.
In a Yomiuri Shimbun survey conducted in December, 15% of respondents said they want to receive coronavirus vaccines immediately; 69% said they eventually want to be vaccinated but are not in a hurry; while 15% said they do not want to be vaccinated. It would appear that a majority of Japanese people harbor concerns about the vaccine and want to wait and see what happens overseas before getting the shot themselves.
If anywhere, it's the West that has the most radical "anti-vaxxers." Anti-government and anti-elite movements are said to be connected to with a general feeling of malaise, and the World Health Organization ranks "vaccine hesitancy" as one of the "10 threats to global health" right up there along with climate change.
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