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Sunday, March 6, 2011
Vaccination policy booster
Japan's vaccination policy has taken a small step forward. The fiscal 2010 supplementary budget approved by the Diet in late November includes some ¥108.5 billion to financially help local governments subsidize the costs of inoculation with three types of vaccines: one to prevent haemophilus influenza type b (Hib), another against the human papillomavirus (HPV), which causes cervix cancer, and a pneumococcal conjugate vaccine (PCV), which prevents pneumonia in children.
The measure covers a period through the end of March 2012. The central government will shoulder half of the subsidies for inoculation with the three types of vaccines. The remaining half will be shouldered by municipalities. A total of some ¥217 billion of public money will be used to promote the vaccinations.
This does not mean that they will be free. Each municipality will decide how much money it will provide as a subsidy. Then the same amount of money will come from the central government. In using grants from the central government, municipalities should give priority to using the money to promote the vaccinations.
According to a survey whose results the health ministry made public on Dec. 15, 1,489 or 85.1 percent of the nation's 1,750 municipalities plan to provide subsidies for the three types of vaccinations. Of them, 49 percent will start providing subsidies by the end of this month, and 37.5 percent on and after April 1; 13.5 percent are undecided.
If municipalities pay for only part of the vaccination costs, local residents will have to shoulder a financial burden. Depending on municipalities' financial situation, the financial burden of local residents will differ. Municipalities should make utmost efforts to enable citizens to receive vaccinations free of charge.
The new budgetary measure is good news because so far, in principle, people have had to shoulder the whole cost of the vaccinations. But having learned of the measure, some people have chosen to wait until their municipal governments decide to provide subsidies for the vaccinations. This is unwise because infants could suffer serious health damage. Infants have to receive the first shots of the PCV and the Hib vaccines when they are 2 to 6 months old. A delay in inoculations could invite the onset of bacterial meningitis. This provides a strong case for municipalities making a decision on subsidies for the vaccinations as soon as possible.
Girls in their early teens should be vaccinated against HPV. The vaccine can prevent some 70 percent of cervical cancer cases. The central and municipal governments should strive to have girls ranging from middle school first graders to senior high school first graders receive the vaccine with public financial assistance.
The central government should heed the call for making the HPV vaccine inoculation free. Since the vaccine cannot prevent all cervical cancer cases, it is important to have women in their 20s and older receive regular checkups to detect the cancer.
The central government's budgetary measure is not backed by a law. It should quickly revise the Preventive Vaccination Law to enforce regular inoculation across the nation not only with the PCV and the Hib and HPV vaccines but also with vaccines to prevent mumps, chicken pox and hepatitis B. It should establish a system to watch for serious side effects from vaccinations and give adequate relief to victims.
The central government has been inadequate in its vaccination policy over the past two decades. Of the types of vaccines that the World Health Organization has recognized as safe and has recommended for free inoculations, Japan has instituted regular inoculation with only about half of them. It also lags behind other countries in approving new vaccines.
One case in point is the vaccine against polio. Japan is still using a live vaccine. It has not yet approved an inactivate vaccine, although some 40 countries, mainly in North America and Europe, have approved it. In Japan, the live vaccine causes several cases of paralysis a year. On Dec. 15, an association of polio victims submitted a petition with signatures of some 35,000 people to health minister Ritsuo Hosokawa, calling for approval of the emergency import of an inactivate vaccine.
A panel of experts within the ministry on preventive vaccinations also calls for such emergency import. But the ministry's policy is to wait for the four domestic makers to develop an inactivated vaccine. It may take nearly two years before such a vaccine is actually used. The ministry's attitude will only deepen suspicion that it may be trying to protect vested interests related to vaccine development and production.
The ministry should delegate vaccine-related decisions to a transparent third-party advisory panel that will decide after holding public discussions involving experts and citizens.