Booster preferences pose a deployment challenge


Japanese authorities are hoping to combat the growing wave of omicron coronavirus by accelerating the rollout of COVID-19 vaccination boosters. Their plan will depend on how many people are willing to accept an injection from a different manufacturer for their first and second doses.

The wave of Omicron keeps on rising

During the previous wave of coronavirus, which peaked last August, the number of daily cases in Japan peaked at 25,992. On Wednesday, the number topped 90,000. Experts advising the Tokyo Metropolitan Government say that the surge in infections is straining the capital’s medical system. They raised the alert to the highest level on a four-point scale.

Chart: Daily COVID-19 cases in Tokyo

The Japanese authorities are betting on the booster shot to turn the tide. Clinical data suggests that the third dose is essential to ensure that the Omicron variant does not cause serious disease.

The rollout began in December, with healthcare workers on the front line. At the end of January, only 3.5% of the population had received a third dose.

vaccination site in Osaka
A site in Osaka Prefecture where people can get boosters is conveniently located in a shopping complex.

To pick up the pace, the Health Ministry has asked local governments to give reminders earlier than scheduled, shortening the window between doses. This month, more than 20 million people will become eligible.

But eligibility is only one hurdle. Authorities also need to persuade people that their booster doesn’t need to come from the same company as their original injections.

Switch decision makers

The Pfizer vaccine accounted for 84% of the first and second doses administered in Japan. But according to government plans, by the end of next month it will have offered more doses of the Moderna vaccine than the Pfizer version. The government says it will release information to residents about the effectiveness and safety of using a different vaccine for the booster.

Pfizer and Moderna vaccines
Some people in Japan are worried about switching between Pfizer and Moderna vaccines. About 80% of those vaccinated had Pfizer for their first and second shots.

Dr Shimizu Yasuki, from a clinic in Tokyo’s Meguro district, says a growing number of elderly patients are asking for his advice on changing vaccines for their third shot. Some worry about side effects from a vaccine they have never had before. Others ask him which vaccine is the best. Shimizu says some of his patients have turned down the chance to get Moderna shots right away, saying they’d rather wait until a slot for a Pfizer vaccine becomes available. Shimizu says his advice is to get a callback early, not worrying about whether it’s Pfizer or Moderna.

Doctor Shimizu Yasuki
Shimizu Yasuki says patients who visit his clinic are hesitant to get a third shot, and many want to have Pfizer because that’s what they got for their first two doses.

Project Professor Nakayama Tetsuo, an expert in clinical virology and vaccination at Kitasato University, agrees. He says the Omicron variant is spreading rapidly in Japan, so people are at high risk of contracting the virus. “Getting a third dose will reduce the risk of serious illness, so I would advise older people or anyone with underlying conditions not to miss any chance of getting vaccinated,” he says.

Professor Nakayama Tetsuo
Nakayama Tetsuo says that when it comes to the side effects of Pfizer and Moderna boosters, there is very little difference. He says a third injection will reduce the risk of becoming seriously ill.

More elderly people hospitalized

Ninety-eight percent of those who become eligible for booster shots this month will be over 65, the age group currently seeing a rapid rise in infections in the capital.

Dr Hayashi Kentaro
Dr. Hayashi Kentaro says the situation in hospitals has quickly become serious and recently the number of elderly people who have been double-vaccinated has increased.

Nihon University’s Itabashi Hospital in Tokyo’s Itabashi district has reserved 60 beds for patients with moderate or severe symptoms of COVID-19. As of Tuesday, 35 of those beds were occupied by elderly patients. Dr Hayashi Kentaro says that at the start of the Omicron wave, hospital staff cared more for unvaccinated youngsters with minor symptoms, but now they are getting much older who have been vaccinated. He says that in some cases the infection has made their underlying condition worse, and there are concerns that more people could become seriously ill.

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