Preparations for rolling out coronavirus vaccinations nationwide are underway. During a press conference on Jan. 7 when Prime Minister Yoshihide Suga declared another state of emergency for Tokyo and three other prefectures, he said that vaccination is a "trump card in the measures against infections." Administering vaccinations is a big project for the country, with 50 million people prioritized to receive inoculation, but local governments – who will play a leading role – are growing concerned.
-- Speeding up coordination
The Japanese government has reached agreements with three foreign pharmaceutical companies to supply a combined total of 145 million doses of coronavirus vaccines. The vaccine developed by U.S. pharmaceutical giant Pfizer Inc. could be approved as early as February.
Municipal governments – cities, wards, towns and villages – in charge of implementing vaccination programs for high-risk groups of people aged 65 and older and those aged 20 to 64 with underlying medical conditions, are busy preparing.
The city government of Sagamihara, Kanagawa Prefecture, has established a team in charge of coronavirus vaccinations within its Section on Disease Measures and had assigned 10 officials as of Jan. 12. The team will accelerate its efforts to develop relevant systems, issue coupons to those eligible to receive the inoculation and coordinate with local medical institutions.
Vaccinations are expected to be carried out at local medical institutions, community centers and so forth, and the city government is considering such methods as having those who want to be inoculated bring their coupons to the designated location. Doctors and nurses will be needed not only for vaccinations but also for medical examinations through interviews and dealing with side effects and other contingencies. As it remains unclear how many doses will be delivered and when, the Sagamihara city government has been unable to decide on how many locations to prepare. With its over-65 population totaling 190,000, it will need to review its plan if the supply falls short.
The health ministry has received inquiries from across the country. But the ministry itself is waiting for pharmaceutical companies to make contact. Eiji Yakuwa, head of the Section on Disease Measures at the Sagamihara government, complained, "We can understand the circumstances the central government is facing, but without relevant information, we at the local government are working helter-skelter." An official in charge at the central government said, "We can only ask them [the local governments] to prepare for vaccinations with whatever information is available now, while extending our support."
Regarding the vaccinations, in an emergency proposal made on Jan. 9, the National Governors' Association asked the central government to swiftly clarify any information concerning side effects and those groups who have priority, and to promptly share information with local governments and other entities administering the vaccines.
In foreign countries, there have been reports of serious allergic symptoms following vaccination. During an online meeting of governors on Jan. 9, Aomori Gov. Shingo Mimura said that, in terms of responding to inquiries about side effects, "it is difficult to develop a relevant system with so little information available," strongly urging the central government to take necessary measures.
-- Local health-care holds key
The central government has included a combined total of \600 billion in reserve funds and the third supplementary budget for fiscal 2020 to bear the cost of vaccinations and the expense of developing relevant systems. Vaccinations will start from late February. The first group to be inoculated will be 10,000 frontline health-care workers including doctors and nurses, followed by 4 million health-care workers other than doctors and nurses.
The peak for local governments will come in late March and later when the vaccines are given to over 65s, which is 36 million in all. The ministry released a roughly 40-page manual on vaccinations for local governments in December. It has also held online briefing sessions, with officials in charge at pharmaceutical companies explaining in detail how to manage and store the vaccines.
The vaccine developed by Pfizer is to be stored at minus 70 C or lower. It is expected to be delivered in batches of 1,000 doses and they need to be administered within five days after they are unfrozen. The health ministry will secure 10,000 freezers for the Pfizer vaccines alone, and distribute more than one freezer to each municipality across the country, in proportion to population.
If there is a large number of people to be inoculated at one location, few vaccines will be wasted. When a lot of people gather at one location, however, it may become crowded. As citizens are not obliged to be inoculated, it would be difficult to forecast the number of people who would go. There are also fears of a situation whereby doses are delivered in smaller lots or their production is delayed.
Local bodies related to health care hold the key to success. Preparations have to be made even when the spread of infections shows no signs of slowing, which makes the burden of dealing with the virus heavier. Minoru Hosoda, 66, chairman of the Sagamihara Medical Association, confided, "On the part of doctors, there are fears that their getting involved in coronavirus-related medical services would see their number of routine patients decline." But the association is poised to extend its full support to the task, saying, "It is not an option to not tackle an endeavor to protect people's lives."
Koji Wada, a professor at the International University of Health and Welfare who is knowledgeable about public hygiene, said: "Planning elaborate scenarios of various situations, such as the supply to local governments falling behind schedule, are necessary. The central government needs to make detailed explanations, whereas local governments need to aim at making less fallible preparations."
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