Japan's Vaccine Problem

Japan has a vaccine problem.

No, there isn't anything wrong the Prevnar or ActHIB vaccines that they are using. They have temporarily suspended these vaccines since last week after reports of four deaths in children, even though there was no direct casual relationship between the vaccines and the deaths. The children were of different ages (six months to two years), some had underlying medical problems, many received different combinations of vaccines, and many of the vaccines came from different lots.

Still, use of the vaccines was suspended until an expert panel could look into the issue, which has since said that they don't think the vaccines were connected to the deaths. Although they will likely resume use of the vaccines now, that still leaves a problem for those kids who missed their vaccines because of the suspension and the fear that was caused and which may linger and cause parents to not vaccinate their kids.

This is especially a problem in a country that is slow to add new vaccines and has an immunization schedule that resembles the 1983 immunization schedule from the CDC, with kids only getting DTaP, OPV, Measles and Rubella (2 doses), DT (11 Years). There are some differences between Japan's schedule and the 1983 schedule though. In 1983, the U.S. immunized kids against mumps (MMR vaccine) and we didn't give kids the BCG vaccine or the vaccine against Japanese Encephalitis, which are routinely used in Japan.

And we weren't giving a booster dose of the measles vaccine yet. Japan started that in 2006, while we added that to our immunization schedule in 1994.

It is kind of ironic that the first varicella vaccine was developed in Japan in the 1970's and was licensed in Japan in 1988, but still isn't on their routine immunization schedule.

Why is all of this important? Although anti-vaccine proponents will likely applaud Japan's immunization schedule, it is important to note that vaccine-preventable infections are still a big problem in Japan. In early 2000, there were 20 to 30,000 reported cases of measles a year in Japan, with actual numbers of cases 5 to 10 times higher due to under reporting. Although rates are trending down, as recently as 2008, Japan had 11,015 reported cases of measles, compared to 140 in the US.

Also of note is that there were 104,568 cases of mumps in Japan in 2009, along with 148 cases of rubella, 2 cases of congenital rubella syndrome, and 113 cases of tetanus.

Routine pertussis vaccinations were halted in Japan in 1975 following the deaths of two children. That eventually lead to epidemic cases of whooping cough in the country and at least 41 deaths in children before the vaccine was restarted. Did halting the pertussis vaccine lead to their seemingly fear of vaccines over a fear of vaccine-preventable diseases?

Will halting vaccines again cause further fear of vaccines and increased rates of vaccine-preventable diseases?

As we continue to see these kinds of vaccine-preventable infections, like measles, being imported by travelers from Japan, Europe, and other areas, these vaccine questions are important to think about.

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