Jpn. J. Infect. Dis., 55, 101-111, 2002

Review

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Development of Vaccination Policy in Japan: Current Issues and Policy Directions

Hiroki Nakatani, Tadashi Sano* and Tsutomu Iuchi

Tuberculosis and Infectious Diseases Control Division, Health Bureau, Ministry of Health, Labour and Welfare, Kasumigaseki 1-2-2, Chiyoda-ku, Tokyo 100-8916, Japan

(Received April 23, 2002. Accepted July 29, 2002)

CONTENTS:
1. Introduction
  1-1. Law concerning the Prevention of Infectious Diseases and 
       Patients with Infectious Diseases
  1-2. Amendment of the Immunization Law
2. Routine vaccination
  2-1. Vaccination coverage
  2-2. Reported cases of EPI disease
  2-3. Improvements and problems regarding quality of services
3. Specific issues
  3-1. Poliomyelitis
    3-1-1. Poliomyelitis eradication: surveillance monitoring
    3-1-2. Poliomyelitis eradication: routine vaccination
    3-1-3. Poliomyelitis eradication: laboratory containment
  3-2. Measles control
    3-2-1. History
    3-2-2. Incidence by age and prefecture
    3-2-3. Immunization services
    3-2-4. National plan
  3-3. Rubella control
  3-4. Tuberculosis
  3-5. Influenza
  3-6. Adverse reaction monitoring/surveillance and 
       feedback for vaccine safety
4. Future directions

SUMMARY: Until November 2001, eight vaccinations had been offered to Japanese children on a routine basis; namely, diphtheria-tetanus-pertussis, polio, measles, rubella, Japanese encephalitis, and BCG. The 2001 amendment of the Immunization Law introduced an influenza vaccine for the elderly population. This paper reviews the progress of the immunization program in the broader context of infectious disease control in Japan. There are two recent major policy changes in the field of infectious disease control in Japan. One is the strengthening and revitalization of the infectious disease control program, particularly surveillance, by the enactment of new 1999 legislation entitled "Law concerning the Prevention of Infectious Diseases and Patients with Infectious Diseases". The other major policy change is a review of existing immunization programs and the amendment of the Immunization Law in 2001. In this article, the present routine vaccination program, as well as the recent amendments to the law, are described. Current policy issues are then discussed, including polio vaccination after the WHO "Zero Polio" announcement in the Western Pacific Region in 2000; strategies for changes in measles, rubella, tuberculosis, and influenza control; as well as adverse reaction monitoring/surveillance and feedback for improving vaccine safety. Finally, the future prospects of intended/planned changes in the vaccination policy are considered.

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