Immunizing your child in Japan

By on September 28, 2012

Whether you have just had a baby or are sending your child off to college, decisions regarding immunizations are a crucial component of their preventative care. While the pros and cons of immunization are beyond the scope of this article, for those who do choose to immunize, the ever-increasing number of vaccines and recommended doses can be a source of confusion.

Childhood immunization schedules vary considerably between countries, adding to the frustration when trying to determine what is best for your child.

In Japan, the recommended childhood immunization schedule has traditionally consisted of relatively few vaccines, and none are required for daycare or school attendance. Immunizations in Japan are categorized by the government into “periodic” and “voluntary” vaccines, a distinction that is somewhat arbitrary and not necessarily based on disease prevalence or risk. The “periodic” vaccines include DPT (diphtheria, pertussis or whooping cough, tetanus), DT (diphtheria, tetanus), inactivated polio (IPV), measles/rubella (MR), BCG, and Japanese encephalitis. The “voluntary” vaccines include, haemophilus influenza type b (Hib), pneumococcal (PCV7), mumps, varicella (chickenpox), hepatitis B, hepatitis A, rotavirus, human papillomavirus, and seasonal influenza. A combined DPT-IPV is to be introduced into the schedule in November 2012.

Japanese National Health Insurance does not cover routine vaccinations, but “periodic” vaccines are generally subsidized by local municipalities and can be obtained free of charge within the municipality of residence. “Voluntary” vaccines are subsidized to varying degrees depending on your area of residence, with some completely paid for and others not at all. Such coverage is typically only applicable when the vaccination is done at a facility within the municipality.

Vouchers are usually sent automatically when your child is nearing the age for a “periodic” vaccine. Completing the questionnaire on the voucher and taking it to one of the designated clinics or hospitals will allow your child to be vaccinated. The specified age ranges for each vaccine are strictly enforced and vaccinations given too early or too late will not be eligible for the subsidy.

BCG, a vaccine against tuberculosis, is often a source of concern, especially after one sees the characteristic “track-marks” on an infant’s arm. The incidence of tuberculosis in Japan, while high for a developed country, is still relatively low. Tuberculosis in infancy, however, can be a very serious disease, and the vaccine does seem to offer protection. Discussion with your child’s doctor regarding the risks and benefits of the BCG vaccine is recommended prior to immunization.

If your stay in Japan will be relatively short-term, following your native country’s schedule may be preferable, as this will usually cover more diseases than the Japanese schedule. In this case, you may need to seek out clinics that provide imported vaccines to cover those that are not generally available in Japan.

The 13-valent pneumococcal vaccine (PCV13), meningococcal vaccines, MMR (measles, mumps, rubella), and various combination vaccines (5 or 6-in-one vaccines) are not currently approved in Japan but can be imported by physicians for use in individual patients. Government subsidies do not apply to these vaccines and in the event of a serious adverse effect, you will not be eligible for government assistance programs. Cost is generally high, but use of these vaccines can greatly simplify and reduce the number of visits and injections when trying to duplicate another country’s schedule.

Joe Kurosu, M.D.is director of Primary Care Tokyo, a solo practice in Shimokitazawa, Tokyo. He is a U.S. citizen, graduate of Yale Medical School, and is licensed in Japan and the United States. His clinic provides a range of primary care services for the pediatric and adult patient, including immunizations, check-ups, acute & chronic disease management, and minor surgical procedures. Dr. Kurosu has experience in caring for both the expatriate and local communities in Japanese or English. Japanese National Health Insurance is accepted. www.pctclinic.com
Tel 03-5432-7177.

About Dr. Joe Kurosu

Joe Kurosu, M.D., is director of Primary Care Tokyo, a solo practice in Shimokitazawa, Tokyo. He is an American graduate of Yale Medical School and licensed in Japan and the United States. His clinic provides a range of primary care services for the pediatric and adult patient, including immunizations, check-ups, acute & chronic disease management, and minor surgical procedures. Dr. Kurosu has experience in caring for both the expatriate and local communities in Japanese or English. Japanese National Health Insurance is accepted. www.pctclinic.com 
Tel 03-5432-7177.