Local govts pressed to pad vaccine numbers

The Yomiuri Shimbun

This is the third installment of the series, “The Politics Behind Vaccination Program,” examining behind-the-scenes political moves concerning COVID-19 vaccines.

When Prime Minister Yoshihide Suga set an end of July target for completing vaccination of the nation’s elderly, the wheels of the lumbering Kasumigaseki bureaucratic machine began to churn.

In particular, the brunt of the arduous task of shoring up the vaccination effort in the nation’s cities, wards, towns and villages fell onto the shoulders of the Internal Affairs and Communications Ministry, which has jurisdiction over local municipalities.

On April 21, internal affairs czar Ryota Takeda was summoned into the Prime Minister’s Office, where Suga commanded his minister to “Push [local governments] to vaccinate fast.”

Suga, who himself once held the post of internal affairs and communications minister, has an insider’s knowledge of what goes on within the ministry’s walls. He strongly urged Takeda to provide full support to local governments for early vaccinations.

The ministry frequently assigns its new bureaucrats to work in local governments where they can build connections with governors and assembly members. Harnessing this network, the ministry selected bureaucrats with a feel for the turf to serve as liaisons with local governments, assigning about 60 staff members to act as individual minders for the deputy governors of each prefecture and the deputy mayors of each ordinance-designated city.

Having a direct line back to the central government did help facilitate some local vaccination drives.

For example, in early May, the ministry checked in with a municipality in the Kanto region and found that vaccines were not expected to arrive on schedule. The ministry brought the snag to the attention of the prefectural government and was able to ensure that vaccine delivery could be arranged without incident.

Around that time, Takeda joined the other ministry officials who spent their Golden Week holidays manning the phones, engaged in a blitz of calls to local governments.

Outwardly, the strategy presented the ministry team as what Takeda described as Suga’s “roundsmen,” making the rounds and listening with open ears for any concerns regarding the vaccine drive. But sources close to the prime minister said the calls had an ulterior motive of inducing municipalities to complete vaccination of their elderly by Suga’s avowed end of July goal.

A survey released by the central government on May 12, after the Golden Week holidays, suggested that the roundsmen’s campaign was not in vain. Out of the nation’s 1,741 municipalities, 1,490 municipalities, or 85.6%, answered that they expected to be able to hit the end of July target, a significant jump from the 1,000 or so seen in the late April survey.

Yet it turns out many municipalities were also unsure how exactly to define “end of July,” and remained confused by the prime minister’s vague verbiage.

Only 56% of municipalities in Akita Prefecture said they expected to be able to complete vaccination of their elderly residents by the end of July, placing the prefecture at the very bottom of the May 12 survey.

“I was honestly shocked [by the figure],” said Suga, who hails from the prefecture, when asked about the results by media outlets.

But Akita Gov. Norihisa Satake contended that many of the other prefectures inflated their figures and simply told the ministry what they wanted to hear during the courtesy calls. “This all boils down to making sure the prime minister is able to save face,” Satake grumbled to reporters.

One ministry official was quoted as telling municipalities that even if they were still “making arrangements” to get on track to meet the target, they were to “just go ahead and say that you will complete your vaccinations by the end of July.”

A high-ranking source within a prefectural government in eastern Japan said he could hardly believe his ears.

With the offhand comment, the official fueled suspicions that the ministry was attempting to drive up municipalities’ stats, under the guise of questionnaires that were ostensibly meant to gauge progress. Ultimately, the prefecture said it did as it was told. Although it was still not certain whether it would be able to wrap up vaccination by the end of July, it responded to the ministry’s survey that vaccinations “will complete,” including cases it was “making arrangements.”

Adding to the confusion was the lack of definitive criteria from the ministry. It was left up to the local governments to draw their own lines and decide at what point vaccination of their elderly populations could be considered “complete.”

Osaka City decided to set its benchmark for elderly vaccination at 70%, based on a survey conducted by the Osaka prefectural government in February that showed about 70% of respondents wanted to be vaccinated.

Hiroshima City, for its part, decided that its campaign could only be called complete when every single one of its elderly had been inoculated. Although the city initially forecast that vaccination would not be completed until early October, it later corrected course, upping the number of vaccinations with an eye for finishing by the end of July.

The ministry has allowed municipalities to claim that they will hit the July-end deadline, even if they do not have a plan in place to recruit enough vaccinators to actually put the shots in arms.

The policy has not gone without its critics.

“How much meaning are we supposed to place on giving the ‘old college try?’” asked Chiba Gov. Toshihito Kumagai.

In follow-up survey results released by the central government on May 21, the number of municipalities that said they will complete vaccination by the end of July increased even further to 1,616, or 92.8% of the total.

Some in Suga’s circle see this as evidence that the prime minister’s edict has been effective.

But a senior official at the Health, Labor and Welfare Ministry was less optimistic: “Come the end of July, I suspect that some municipalities will throw up their hands. ‘Oops, we didn’t finish in time, after all.’”

“Look, we [in the government] also want to wrap up [this stage of] vaccinations by the end of July,” said Osaka Gov. Hirofumi Yoshimura. “We just have to keep plowing ahead and do what we can.”

Yoshimura — who spearheaded the opening of an independent mass vaccination venue of Osaka’s own — petitioned the central government to allow vaccines to be administered at the prefectural level, not just the city, ward, town and village level. The Osaka governor is also reportedly evaluating whether to have pre-inoculation consultations be conducted online.

A senior ministry official highlighted the exigencies of the situation: “We will have ample supply of vaccine stocked up by the middle of June. Now is the time when we must hurry up to secure enough vaccination venues and medical personnel.”

Although thrown into confusion by Suga’s abrupt target, municipalities continue to feel out their own approaches to vaccination through trial and error, compelled to vaccinate their communities as soon as possible.

With less than two months until the end of July, every shot will count. The nation’s vaccine rollout was not without its wrinkles. Just how smoothly vaccinations proceed from here will be a telling test of not only the local governments, but of Suga’s administration, itself.