February 22, 2021

Asia

JAPAN: Political stakes high as vaccination program begins

BY Tobias Harris

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( 4 mins)
  • Japan has begun its vaccination program, starting with a limited campaign targeting frontline medical workers.
  • Supply constraints could limit the government’s ability to expand the campaign beyond medical workers in the near term.
  • The vaccination campaign presents Prime Minister Yoshihide Suga with an opportunity to reverse his political fortunes, but he will have to contend with logistical and communications challenges.

In a television appearance on Sunday, 21 February, Taro Kono, the minister responsible for overseeing Japan’s vaccination program, acknowledged the potential for delays in distributing vaccinations due to likely supply shortages this spring. Kono’s admission highlights the risks to Prime Minister Yoshihide Suga as the vaccination program begins. Although a successful vaccination campaign will likely be Suga’s best chance of rebuilding public support and winning a new leadership term in September, there remain significant questions about the Suga administration’s ability to distribute vaccines effectively. Whether the government can address these issues and assure the public that the process will be conducted swiftly and transparently may ultimately be the key to Suga’s political survival.

The Covid-19 vaccination program began on 17 February with a trial campaign aimed at vaccinating roughly 40,000 frontline medical workers, 20,000 of whom will be monitored for adverse reactions before the program moves on to more medical workers and then the general public. However, the administration faces two major, interlocking challenges as it looks to scale up from the initial phase.

First, only the Pfizer-BioNTech vaccine has been approved for use thus far, meaning that the vaccination campaign can only draw on limited supplies. For at least the next several months, these supplies will be vulnerable to EU export controls. Although two deliveries have arrived thus far, EU member governments have the ability to block each future shipment at least until the end of March. Even if Japan receives all of the Pfizer doses it preordered – enough for 72mn people – the uncertainty about delivery could complicate planning, particularly as the government begins vaccinating the general population. The AstraZeneca vaccine, of which Japan has ordered doses for 60mn people, will ease supply concerns since the company plans to produce at least half of Japan’s order in-country. However, the Ministry of Health, Labor, and Welfare (MHLW) has not yet approved domestic production of the AstraZeneca vaccine or the use of the vaccine itself. The Moderna vaccine, meanwhile, is undergoing domestic trials.

Second, the uncertainty about vaccine supplies could exacerbate concerns about communication and coordination between the national government and the prefectural and local governments that will implement the vaccination campaign. The Suga administration has suggested that starting in mid-March, local governments should send residents over-65 “coupons” to notify them to schedule their appointments beginning in early April; supply issues could mean that this timeline is too ambitious, and if residents are forced to reschedule due to shortages, the prime minister could pay a political price.

The administration is also still finalizing plans for expanding the campaign beyond the elderly to the under-65 population, with some debate underway over how to prioritize individuals with underlying conditions that make them more vulnerable to Covid-19. But, given that by March, the administration anticipates only having enough doses for 1.17mn of the roughly 4.7mn medical workers it plans to vaccinate in the first wave, it appears increasingly likely that the vaccine rollout will experience delays. As previously noted, these delays could be compounded by shortages of specialized syringes that can draw a sixth dose out of vials and shortages of medical professionals legally capable of dispensing vaccines. Meanwhile, it is unknown how the government’s new data management system – known as V-SYS – will perform once the campaign begins in earnest.

These challenges may not be insurmountable. There may also be favorable shifts that enable the administration to stretch limited vaccine supplies, such as the new Lancet study that showed that the first dose of the Pfizer vaccine might be more effective than initially anticipated. Chief Cabinet Secretary Katsunobu Kato said on Monday, 22 February, that the government was looking closely at the new finding on the effectiveness of a single dose and the possibility that the Pfizer vaccine can be safely stored at higher temperatures than initially recommended.

However, the test for the Suga administration may be less whether vaccines will be distributed exactly on schedule than whether the administration communicates effectively with the public about bottlenecks and other disruptions. Suga and former prime minister Shinzo Abe both shed public support when the public believed that they were struggling to make decisions and communicate clearly with the public about the pandemic; Suga will face a similar communication challenge given the fluidity of the outlook for vaccinations.

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