Japan Arrives Late to Vaccination Game

The Yomiuri Shimbun

In January, a room in the Health, Labor and Welfare Ministry headquarters in the Kasumigaseki district of Tokyo was the nerve center for Japan’s attempts to secure COVID-19 vaccines. Senior officials of the ministry’s Health Service Bureau, interpreters, people with U.S. legal qualifications and other attendees frequently assembled in the room to hold conference calls with U.S. pharmaceutical giant Pfizer Inc., which manufactures a vaccine to combat the disease caused by the novel coronavirus.

These meetings were always held at a time suited to Pfizer’s headquarters in the United States — which was late at night Japan time. During the day, attendees from the ministry had been doing their utmost to lay the groundwork for a bill to revise the Infectious Diseases Control Law, among other tasks. At night, they took part in negotiations to secure a supply of vaccines.

“Everyone was exhausted,” a senior ministry official said.

Japan has fallen well behind in the global scramble to acquire COVID-19 vaccines. It was not until Feb. 17 that an initial group of medical workers became the first to get the initial dose of the inoculation. Japan’s rollout was the slowest among the Group of Seven leading industrial nations.

Inoculations of people 65 and over were initially scheduled to begin from April 1, but have been pushed back. As things stand, the ministry expects vaccinations for people 65 and over will have a limited start on April 12 and get into full swing from April 26 or later.

‘Were there flaws?’

Prime Minister Yoshihide Suga has been pushing for a faster rollout of vaccines. “I have frequently held discussions with health ministry and other officials to ask if the process can’t be sped up,” Suga said at a House of Representatives Budget Committee meeting on Feb. 17.

Two main reasons have been cited for the delay in acquiring the vaccine. First, because Japan has had fewer coronavirus cases compared with the United States and European nations, it has been difficult to find enough infected people to conduct the clinical trials required before official approval for a vaccine is given. Second, clinical trials with Japanese people were needed because vaccine side effects may vary among different ethnicities.

Akira Nagatsuma, an opposition lawmaker from the Constitutional Democratic Party of Japan who is a former health minister, was not convinced by Suga’s assertion.

“Were there flaws in the contract?” Nagatsuma asked.

In the summer of 2020, the Japanese government and Pfizer reached a basic agreement under which 120 million vaccine doses — enough to inoculate 60 million people — would be supplied by the end of June 2021. But when the formal contract was officially announced on Jan. 20, the numbers had changed; Japan would receive 144 million doses, enough for 72 million people, by the end of 2021.

This raised concerns that the timing of Japan actually getting these vaccines could be pushed back by up to six months.

The basic agreement “had been thrown in the trash,” Nagatsuma said as he kept up his attack.

Suga: It’ll be fine

A team mainly composed of health ministry officials and headed by Hiroto Izumi, a special adviser to the prime minister, has been in charge of procuring COVID-19 vaccines.

When a Liberal Democratic Party lawmaker reminded Suga that success or failure in securing vaccine supplies “would directly affect the approval rating” for his Cabinet, the prime minister was unfazed.

“It’ll be fine. I’m leaving it in Izumi’s hands,” Suga replied, according to sources.

However, according to government sources, Taro Kono, the minister in charge of administrative reform who was appointed head of Japan’s COVID-19 vaccination program on Jan. 18, was shocked when he asked health ministry officials to show him a copy of the contract.

Kono was presented with a summary only and the ministry dawdled when responding to his request.

The content of the contract the reluctant ministry eventually produced was staggering. Details about the volume of vaccine to be supplied and when were still undecided.

The contract did not “commit” Pfizer to a specific timetable for delivering the Pfizer-BioNTech vaccine, but only said the drugmaker would make its “best effort.”

The government has been at mercy of Pfizer in what is most definitely a sellers’ market.

This was why Kono has collected information himself even after the contract was concluded and continued to stay in contact with Pfizer.


‘Barely any progress’

Information about these vaccinations also has added to the confusion. It was initially estimated that each vial would contain enough vaccine for six doses, but it was later revealed that syringes Japan planned to use could draw only five doses.

Local governments were also forced to change plans to transport vaccines by motorcycle after Pfizer warned the quality of its product could not be guaranteed if they were shaken.

Japan Medical Association President Toshio Nakagawa could not hide his frustration at this situation.

“Regrettably, the disclosure of information pertaining to the Pfizer vaccine is barely making any progress,” Nakagawa said to reporters after meeting with Suga at the Prime Minister’s Office on Feb. 10.

A senior health ministry official said regarding the lack of information: “In most cases, Pfizer has not conveyed information to us, or not agreed to release the information. The government is not stopping the flow of information.”

Health ministry criticized

Japan’s first shipment of Pfizer-BioNTech vaccines arrived from Europe on Feb. 12, a few days earlier than initially scheduled.

“It was due to Pfizer’s circumstances,” the senior ministry official admitted. “The Japanese government isn’t sure why it arrived so soon.”

Reaching a final contract took longer than expected because, according to sources, both sides sparred over who would be liable for compensation should any adverse side effects occur. Privacy protection considerations prevent the Japanese government from providing pharmaceutical companies with personal data they desire, such as information about the impact of the shots.

“The government’s only bargaining chip was the price, which put it at a huge disadvantage,” the senior official said. “Pfizer had the upper hand, so there was little room for negotiation.”

That being said, the health ministry’s approach continues to receive flak.

“Ever since Prime Minister Shinzo Abe was in power, we were constantly told that getting vaccines was vital for holding the upcoming Tokyo Olympics and Paralympics,” a senior official at the Economy, Trade and Industry Ministry said. “The public has every right to grumble and ask what the government has been doing for the past year.”

A close aide to Suga also admitted the issue could have been handled better.

“We should have started domestic trials of a vaccine earlier,” the aide said. “The Prime Minister’s Office made a mistake in leaving it completely up to the health ministry.”