Challenges surrounding COVID-19 vaccination in Japan: Fraught history and current vaccine hesitancy

(Credit: Unsplash)

This article was exclusively written for The European Sting by Mr. Tai Nguyen Van, a forth-year medical student at the International University of Health and Welfare, Japan. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Japan is facing a third, biggest and most severe wave of COVID-19 and there is yet no signs of abating. COVID-19 vaccine is anticipated as the key strategy to contain the pandemic. However, while millions of people have already been immunized in the United States and European, Japan has not yet approved a single jab.

For a vaccine to get approved in Japan, it requires additional domestic clinical trials to ensure vaccine safety, which means that the process usually takes longer time, and the first vaccine may not be rolled out before late February, the latest among developed countries.

Japan’s current caution in the vaccine approval process has its root in the country’s bitter history when dealing with adverse events following immunizations. In the early 1990s, measles, mumps, and rubella vaccine was suspected to cause aseptic meningitis among children, leading to the vaccine withdrawal in the following years. The government was held liable for adverse reactions related to vaccines, even though there was no definitive link1.

Another event was related to reports of chronic pain and walking abnormalities following human papillomavirus (HPV) vaccine immunization in 2013. Extensive media coverage on the adverse events and public outcry prompted the government to suspend the active recommendation for the shot afterward. However, the problem went on at the court when the anti-vaccine groups established by the parents of “HPV vaccine victims” raised a lawsuit against the government and pharmaceutical company for compensation for the adverse events2.

Those past issues cause the government to be very cautious and passive in introducing new vaccines or taking initiative in vaccination, owing to the fear of being involved in lawsuits.

Vaccine hesitancy may also pose a threat to the COVID-19 vaccination campaign. Japanese’s confidence in vaccines is one of the lowest in the world. Only about eight to nine percent of people strongly agreed that vaccines were safe, according to a Lancet study3. A recent survey by Ipsos found that 31 percent of Japanese said that they did not want the jabs4.

Some medical experts also express doubts about the emergency approval of the vaccine. Dr. Tetsuo Nakayama, the director of the Japanese Society of Clinical Virology, said that despite showing effectiveness in clinical trials, it is uncertain that antibodies created by the vaccine remain a year or two after immunization. There are also concerns related to the vaccines’ long-term safety. The abbreviated development timeline means that there is little opportunity to identify adverse events that might occur in the longer term or only appear after massive administration of the vaccine.

Complacency is another significant factor. Japan’s COVID-19 death toll is about 5000, much smaller in the U.S. and Europe where the death toll has exceeded 500 000. The fact that the risk of developing a severe condition or dying from the disease is low, and most infected people only manifest mild symptoms may, ironically, become a major hurdle to a successful vaccine campaign. 


  • Gomi, H., & Takahashi, H. (2004). Why is measles still endemic in Japan?. Lancet (London, England), 364(9431), 328–329.
  • Okuhara, T., Ishikawa, H., Okada, M., Kato, M., & Kiuchi, T. (2019). Newspaper coverage before and after the HPV vaccination crisis began in Japan: a text mining analysis. BMC public health, 19(1), 770.
  • de Figueiredo, A., Simas, C., Karafillakis, E., Paterson, P., & Larson, H. J. (2020). Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study. Lancet (London, England)396(10255), 898–908.
  • Ipsos (2020). Global attitude on a Covid-19 vaccine, Ipsos survey for the World Economic Forum. Available at: (accessed: January 24th, 2021)

About the author

Tai Nguyen Van is a forth-year medical student at the International University of Health and Welfare, Japan. He is the Director of Academics, AMSA Japan and a student peer reviewer at Journal-AMSA. He has an interest in immunization and vaccine hesitancy. He is the first author of the white paper “The HPV vaccine crisis in Japan”, which were selected as finalist of the academic competition, East Asian Medical Student Conference, Manila 2021.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Thousands of Syrians in ‘life and death’ struggle amid harsh conditions in remote desert camp, UN warns

Meet the Junior Enterprise network at JEWC 2014!

Brussels to point the finger to Washington for lack of commitment over TTIP

European Defence Fund: EU funds new joint research and industrial projects

Plan for troop pullback ‘now accepted’ by rival forces around key Yemen port, but fighting intensifying elsewhere, Security Council warned

New malaria vaccine trial in Malawi marks ‘an innovation milestone’, declares UN health agency

Progress in medical research: leading or lagging behind?

Yemen talks: Truce agreed over key port city of Hudaydah

Girls hold the key to Zambia’s future

New UN report shows record number of children killed and maimed in conflict

COVID-19 threatens the developing world’s small businesses. This is how to save them

ECB to people: Not responsible if you lose money on Bitcoin, your governments are

Bioethics: how to recover trust in the doctor-patient relationship

ECB with an iron hand disciplines the smaller Eurozone member states; latest victim: Greece

Barcelona’s ‘superblocks’ could save lives and cut pollution, says report

This is how we can save millions of people from extreme poverty after COVID-19

Governments should step up their efforts to give people skills to seize opportunities in a digital world

Unity, regional cooperation and international support needed for Horn of Africa to develop sustainably

The shrinking Arctic ice protects us all. It’s time to act

International World Summit Award calls for outstanding digital applications with impact on society from 178 UN member states

Chinese Premier Li Keqiang’s speech from World Economic Forum’s Annual Meeting of New Champions commits to align practices presenting offers and prices with EU law following EU action

Science leads the response to COVID-19. These 25 scientists are tackling the other global challenges

Europe’s forests are booming. Here’s why.

UN’s Bachelet rejects Sri Lankan official’s ‘spin’ on Human Rights Council encounter, urges reforms

Global South cooperation ‘vital’ to climate change fight, development, Guterres tells historic Buenos Aires summit

Ten UN peacekeepers killed in a terrorist attack in northern Mali

Yemen war: UN chief urges good faith as ‘milestone’ talks get underway in Sweden

Lockdown is the world’s biggest psychological experiment – and we will pay the price

State aid: Commission approves €511 million Italian scheme to compensate commercial rail passenger operators for damages suffered due to coronavirus outbreak

4 ways to deliver social justice during the COVID-19 recovery

This Brooklyn farm company is training a new generation of urban farmers

Why vaccines are not just for children

Online radio and news broadcasts: Parliament and Council reach deal

World’s Press Calls on the United Kingdom to Address Press Freedom Concerns

Turkey: Commission continues humanitarian support for refugees

New UN forestry project bids to help countries meet climate change commitments

Conflict prevention, mediation: among ‘most important tools’ to reduce human suffering, Guterres tells Security Council

5 ocean success stories to chase away the blues

Coronavirus: Pandemic alert should be trigger for countries to do more against COVID-19

Financial services are changing. Here’s how

Thursday’s Daily Brief: Climate crisis and food risks, fresh violence threat for millions of Syrians, calls for calm in Kashmir

The application that encourages us to be heroes

EU shapes its ambitious strategy on India

Chart of the day: When do young Europeans leave home?

Dear Davos: time to declare an emergency opportunity for people and planet

EU Parliament raises burning issues over the FTA with the US

How the world can gear up for the fight against cancer

The World Health Organization has called on countries to ‘test, test, test’ for coronavirus – this is why

Key quotes from China’s Premier Li on COVID-19, the economy and US relations

“ASEM: Global Partners for Global Challenges”, a Sting Exclusive by China’s Ambassador to the EU

There is no patient safety without healthcare workers’ safety

Safer roads: More life-saving technology to be mandatory in vehicles

Canada has the most comprehensive and elaborate migration system, but some challenges remain

Global hunger is on the rise. These simple steps could help eradicate it

The Europe we want: Just, Sustainable, Democratic and Inclusive

Ambassador Zhang Ming Attends the EP Debate on China-EU Relations and Answers Questions

Asia’s plastic problem is choking the world’s oceans. Here’s how to fix it

Guterres censures terrorist attacks in Nigeria, pledges UN ‘solidarity’

UN Mission in Haiti calls on protestors, authorities, to refrain from violence

More Stings?


Speak your Mind Here

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s