A COVID-19 vaccine for children ages 5 to 11 was formally classified Thursday by the health ministry as a provisional shot that can be received free. However, the ministry has also decided that children in this age bracket would be exempt from a legal provision that requires people to make efforts to get vaccinated, so it remains hard to predict just how many guardians will allow their young children to get the vaccine.
Some local governments are struggling over how to handle the rollout of these vaccines, which could start as soon as the end of this month.
Whether guardians should be required to make efforts to get children ages 5-11 vaccinated was the main agenda item during a meeting of a Health, Labor and Welfare Ministry expert subcommittee held Thursday.
"There isn't sufficient scientific evidence showing the vaccine's effect against the omicron variant of the novel coronavirus," was one opinion in the subcommittee.
"I think getting public support for such a move will be difficult," was another opinion.
U.S. pharmaceutical company Pfizer Inc. manufactured this vaccine for children. A clinical trial Pfizer conducted on 2,000 people last summer confirmed the vaccine was 90.7% effective in preventing COVID-19 symptoms. However, the delta variant was dominant at that time, so the ministry is taking a careful approach.
"The vaccine can be expected to have an effect against omicron, but at the moment, we can't definitively say that it does," a ministry official said.
Few children have become seriously unwell after catching the novel coronavirus. The omicron variant also apparently has a low risk of causing severe illness. These factors bolstered the views of subcommittee members cautious about legally requiring efforts to vaccinate children with this vaccine.
-- Respecting wishes
Some subcommittee members felt the legal "duty to endeavor to receive vaccination" should be applied to the 5-11 age bracket.
"It's possible even more young children will catch the virus, and there are reports from overseas of children who become very sick," was one opinion.
Another opinion said not applying the legal provision "could give the impression that the vaccination is not necessary."
Infections have been surging among children under 10 in Japan. According to the ministry, 76,856 such children caught the virus between Feb. 2 and 8.
However, the subcommittee was unanimous in its view that a system should be "quickly put in place" to vaccinate children with a high risk of becoming seriously ill, such as those with heart conditions.
"The wishes of people who don't want to receive the vaccine must be respected," said Keio University Prof. Tetsu Isobe, a subcommittee member and medical law expert. "On the flip side, we should create an environment in which people who want the vaccine can get it and make a decision based on information provided."
The ministry will produce and distribute a pamphlet explaining the effects and safety of the vaccine to help guardians better understand the issue.
-- Legal exemption
The decision to exempt young children from the legal provision to make efforts to get vaccinated has perplexed some local government officials.
"We're concerned that fewer people might come forward for the vaccine," said an official from the local government of Bunkyo Ward, Tokyo.
The vaccine for children 5-11 is given in a smaller dose and diluted in a different way to the vaccine for people 12 and over. Each vial of the children's vaccine contains 10 doses, four more than the regular vaccine.
Bunkyo Ward plans to establish vaccination venues exclusively for children 5-11 due to concerns some medical institutions might struggle to bring together 10 children at the same time. Even so, the ward is also worried this approach might have shortcomings.
"If fewer children than anticipated come along, some vaccine might end up getting discarded," a ward official said.
"It's hard to know what tone we should use when notifying the target age group about the vaccine," said an official from the local government of Edogawa Ward, Tokyo.
Edogawa Ward is making arrangements to administer vaccines to individual children at about 80 medical facilities, including pediatric and internal medicine clinics.
"I'm not for making this vaccine subject to the law requiring efforts to get vaccinated," said the head of one of the target clinics in the ward. "I want guardians to decide for themselves what they want to do for their children, without being swayed by what people around them say."
Taking steps to deal with bullying or discrimination arising from vaccinations also will be essential.
The Kobe government will push ahead with vaccinating children individually instead of holding mass vaccination sessions at schools. The city was worried these events could lead to bullying because each student's vaccination status would be known by others at school. Last summer, the city considered holding mass vaccination events for children 12-15, but was forced to drop the plan following a barrage of criticism from guardians.
"We want to do this in a way that doesn't make people uncomfortable," a Kobe official said.
Kawasaki University of Medical Welfare Prof. Kazunobu Ouchi said a flexible approach will be required.
"Giving priority to third shots for the elderly and other people is vital, but there also are concerns that infections could spread further among children," said Ouchi, an expert on children's infectious diseases. "Depending on how the infection situation unfolds, the ministry might need to swiftly and appropriately decide to also apply the legal provision stipulating the 'duty to endeavor to receive vaccination' to this children's vaccine."
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