TOKYO -- Japan began vaccinating health workers against the coronavirus on Wednesday, with a doctor in Tokyo receiving the country's first Pfizer dose.
Kazuhiro Araki, director of the Tokyo Medical Center, received the landmark shot in the morning. The launch sets up a new challenge for a country that expects to achieve a high inoculation rate despite public concern about the safety of the new technology behind the vaccine.
The rollout also comes as local governments continue to work out the details.
"There is nothing surprising about local governments still [being] unprepared," Taro Kono, minister in charge of COVID vaccinations, said on the eve of the vaccination drive. Kono emphasized the importance of being flexible rather than having a neatly laid-out plan, saying there are always unexpected contingencies, like the large earthquake that hit the nation on Saturday.
"Japanese are people who have overcome a lot of difficulties," Kono said.
Wednesday's kickoff follows in the footsteps of the U.K., which began a mass rollout on Dec. 8, and the U.S., which started injections on Dec. 14. In the Asia-Pacific region, China, India and Indonesia have been leading the way.
Japan hopes the program reassures a fearful public about receiving athletes, their coaches and possibly some spectators for the Tokyo Olympics, scheduled to begin on July 23.
The inoculations will rely on a vaccine developed by Pfizer and BioNTech that uses DNA information from the coronavirus, a hitherto untested technology. It was approved by the government of Prime Minister Yoshihide Suga on Sunday. There are two other vaccines that Japan is expected to use, one developed by AstraZeneca and the other by Moderna, but these have yet to receive official authorization.
Kono struck a positive tone about whether Japanese will embrace the new technology but declined to disclose the target vaccination rate. He stressed that opinion polls are pointing to strong public support for vaccinations, adding that he will wait to receive an injection himself so the vaccine can go to as many older adults as possible.
Here are five things to know about the Japanese vaccination campaign.
What is the time frame?
Inoculating Japan's 126 million people is expected to be a yearlong endeavor. The first group will be 40,000 or so front-line medical workers at public hospitals. The government will periodically announce the results of health checks on 20,000 of them, including whether they have any side effects.
The program will then move on to the rest of the country's roughly 4 million medical workers.
The second group will consist of 36 million people 65 or older; this group will start receiving jabs in April. They will be followed by 8 million people with chronic health conditions, 2 million people who work in nursing care homes and 7.5 million people aged 60-64.
In total, 57.7 million people will be vaccinated in the initial rounds of the program. The government hasn't disclosed further details regarding the vaccination schedule.
"I was focusing first on how to smoothly start off the vaccination of older adults, and there is no strategy for what comes after, to be honest," Kono said.
The vaccine minister also said each person will receive two shots spaced three weeks apart. Some countries are rationing the shots one to a person as they attempt to stretch their vaccine supplies.
Is it mandatory?
No, but people 16 and older are required to make efforts to be vaccinated. This is similar to other inoculation programs, such as those for tuberculosis and diphtheria.
Mass vaccination was implemented in Japan in the postwar period to stamp out rampant infectious diseases such as smallpox and typhoid that were brought back by soldiers returning from overseas. Vaccinations were mandatory under the original immunization act.
In response to accidents and lawsuits caused by vaccinations, the law was revised in 1994, obliging people to "make efforts." Today, vaccinations in Japan are mainly for infants and small children, or those 65 and older.
How will the vaccines be distributed?
A mass vaccination program has not been implemented for quite a while and is expected to be a major logistical challenge.
At hospitals, doctors and nurses will have to ensure that they take turns to receive vaccinations while avoiding disruptions to hospital operations. Pfizer's vaccine is known to cause moderate side effects, including fever and fatigue.
Pfizer is expected to bring vials of the vaccine to its own warehouses in Japan. From there, transport companies such as DHL, Yamato and Seino will deliver them to major hospitals.
Local authorities will take responsibility for organizing vaccinations for their own residents. Some local governments plan to hold vaccinations at large public facilities, such as school gymnasiums, while others are calling on neighborhood clinics to help carry out the program. Some local governments will use large shopping malls for vaccinations or allow residents to be vaccinated at their workplace.
How will local governments and other parties coordinate their efforts?
Implementation will be complex, and smart management will be critical.
Nationwide deliveries and progress will be managed via the V-Sys system, which was developed by Japan's health ministry. For medical workers, V-Sys will help medical facilities share information with the authorities, vaccine makers and other parties such as dry-ice suppliers. Japan is planning to release another national system for managing records on who has been vaccinated.
How about the rest of Asia?
China, India and Indonesia are Asia's vaccination front-runners. China launched a vaccination program for selected groups in mid-December, while India's got underway in mid-January. Singapore started vaccinating its medical workers by the end of December.
On Monday, Indonesia said it has inoculated 73% of its 1.48 million health workers.
Many countries have yet to start inoculating their populations.
This week, Australia said the first shipment of COVID-19 vaccines developed by Pfizer and BioNTech has arrived. Malaysia expects to receive doses of the same vaccine on Sunday and to start injections on Feb. 26. South Korea will also start its vaccination drive on Feb. 26, according to media reports.