The immunization program in Japan: Issues and perspectives as a public health intervention

Abstract

In the past few decades, new vaccines were developed and introduced into a national immunization program of many countries in the world, including Asian, African and Latin American countries, through international initiatives to promote immunization programs. In Japan, the disease burden from vaccine-preventable diseases (VPD) is substantial, when compared with other high-income countries, while its immunization program has made only limited progress in the past decades. Unlike in the US or UK, the program in Japan has been planned and implemented based, not on scientific evidences, but on court orders or mass media reports, which sensationalized the vaccine adverse events (VAE) and downplayed its benefits. Even though the management of VAE is essential for the success of the national immunization program, multidisciplinary discussion is currently not undertaken in Japan, and most of health professionals are not interested or well-informed on VAE. These challenges contributed to the stagnation of the program in the past decades. What we need for the advancement of the immunization program in Japan should include 1) formulation of a long-term national strategy to reduce disease burden from VPD, 2) promotion of cooperation between vaccine-professionals and local/central governments, 3) promotion of well-balanced understanding on the program among general public, mass media, jurist and clinicians, and 4) amendment of the immunization laws and other related laws and ordinances to materialize the aforementioned tasks.