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Why Japan is Lagging Behind in Vaccination

It's evident that despite Japan’s best efforts to quarantine and enforce protocol, COVID-19 is still spreading among athletes and staff involved in the 2021 Olympics. Recently, COVID has been discovered among 7 hotel staff hosting Brazillian Olympic members, plunging the 31-strong team into a bubble. Additionally, 2 soccer players for the South African soccer team tested positive despite testing negative for it prior to traveling to Japan.

Japan was among the most diligent in its first response to the COVID outbreak: enforcing masks, testing, contact tracing, and closing certain businesses. This amounted to only 839 thousand current cases and only 15 thousand deaths. The US, on the other hand, suffers from 34 million cases and 608 thousand deaths. Very impressive for a country with an average of 900 people per square mile and an aging demographic.

And yet, Japan is woefully unvaccinated. While 56% of the US has received a vaccine dose, only 32% of Japan’s population has received one. Cambodia’s population is 24% fully vaccinated, while only 20% of Japan’s population is. For a country responsible for hosting what might be the most prestigious international event, Japan’s vaccine rollout has been lackluster. But why?

Low Demand For Vaccination

Japan’s remarkable first response to the epidemic could ironically explain the low vaccination rates. The accelerating spread of the virus in the US and therefore high demand for the vaccine is part of why we were able to mass-manufacture and distribute it quickly. Japan didn’t experience as many cases, lessening the demand for the vaccine. Additionally, Japan’s strong healthcare system and insurance assuage the fear of many people and drives down any urgency to get vaccinated.

Vaccine Hesitancy

Yet, what may be the largest barrier towards vaccination is Japan’s vaccine hesitancy. According to a 2019 survey by the Lancet, only about 9% of Japanese participants strongly agreed that the vaccines are safe. Compare this to 61% of US participants, 52% of Cambodians, and 63% of Moroccans. If the US anti-vaccine movement seems prevalent, Japan’s anti-vaccine movement is probably stronger.

But this is all due to Japan’s history with vaccines. In 1948, the Japanese government established the Immunization Law that required innoculation against 12 diseases. In the 1970s, a few class-action lawsuits were brought against the Japanese Government over the side effects of the Smallpox vaccine and others. The diphtheria shot was also untrustworthy; it caused two deaths and abnormalities. The government withdrew the vaccine, but people’s faith in vaccines didn’t fully recover.

The Immunization Law wasn’t repealed until the introduction of the MMR vaccine in 1989. There were many cases of Aseptic Meningitis in children who received the vaccine, causing another vaccine withdrawal. Despite the fact that the link between the vaccine and Aseptic Meningitis was not clearly identified, this event was the final nail in the coffin. In 1992, the Regional Court of Tokyo ruled that the government be held liable for adverse reactions to future vaccines, even without scientific evidence of a link between the vaccine and symptoms. Japan revised the Immunization Law. It was no longer mandatory, and the government no longer made a conscientious effort to mass-vaccinate the population.


Prior to the 1992 case, Japan possessed sophisticated vaccination technology that is licensed to the US and other countries, but the case crippled the field and research. Vaccine approvals take 10 years in Tokyo. Additionally, there are many bureaucratic regulations hindering vaccine testing and development. The government is also not interested in accelerating vaccine research, allocating only $92 million for a COVID vaccine compared to the US’s $10 billion.

To sum it up, Japan has a population that is reluctant to get vaccinated and a government that is reluctant to invest funds into researching vaccines, purchasing them, and distributing them. This is more so due to Japan’s low number of cases and advanced healthcare. Finally, even if the government attempts to rush vaccine rollout, the appearance of a rushed job can turn already reluctant Japanese citizens away.


Japan should consider postponing the 2021 Olympics. Despite its best efforts to contain the spread of COVID-19, including a ban on spectators, cases will still continue to mount. Additionally, the go-ahead to host the 2021 Olympics is not popular with Japanese citizens or some sections of the International Community. A survey conducted back in January showed that 80% of Japanese respondents believe that the Tokyo Olympics should be delayed or shouldn’t happen at all.

As it stands right now, Japan shouldn’t risk harming the world’s athletes or causing an outbreak in Tokyo. By canceling the Olympics, it can focus on winning the trust of Japanese citizens and roll out vaccines. Once enough of Japan is adequately vaccinated, the Olympics can be held less stringently, and with spectators.

Japan is a remarkable country that handled the COVID response better than others, but its shortcomings must be observed and learned from. Japan’s history with vaccination teaches us how important trust is in fighting pandemics, and how important it is that the health of citizens is taken seriously in order to preserve that trust.

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