Japan launched a national public health program to combat the COVID-19 pandemic through widespread vaccination. Initiated on February 17, 2021, this program aimed to achieve broad immunity across the population, mitigating the virus’s spread and its severe health impacts. Managed by the Ministry of Health, Labour and Welfare, the effort ensured all residents in Japan were eligible to receive these vaccines without charge, with the national treasury covering all associated costs.
Vaccines Approved for Use in Japan
Japan’s vaccination strategy relied on several approved vaccines. Among the first to receive approval was the Pfizer-BioNTech Comirnaty vaccine, an mRNA-based formulation. This vaccine delivers genetic instructions to human cells, prompting them to produce the SARS-CoV-2 spike protein, which then trains the immune system to recognize and fight the virus. The Moderna Spikevax vaccine, also an mRNA type, operates on a similar principle, providing genetic code for the spike protein.
A different technological platform was adopted for the Novavax Nuvaxovid vaccine, approved in April 2022. This particular vaccine is a protein subunit type, meaning it directly introduces purified spike proteins from the virus into the body, along with an adjuvant to enhance the immune response. Takeda Pharmaceutical Co. took on the responsibility for the local manufacturing of Novavax doses within Japan. More recently, Daiichi Sankyo developed its own mRNA vaccine, DS-5670, which received approval in August 2023 for the original strain and later for an Omicron XBB.1.5-adapted version in November 2023.
The National Vaccination Campaign
Japan’s initial mass vaccination effort commenced on February 17, 2021, and was characterized by a distinct municipal-led system. Local governments played a central role, distributing unique vaccination coupons, often referred to as vouchers, directly to residents via mail. Each voucher contained a specific ten-digit number, which was necessary for individuals to book their vaccination appointments.
The rollout proceeded in a phased manner to ensure equitable access and prioritize vulnerable populations. Healthcare workers were among the first to receive vaccinations, followed by individuals aged 65 and over. Subsequently, the program expanded to include the broader general population. Residents could schedule their appointments at various designated sites, including local medical institutions and large-scale mass vaccination centers established for efficiency.
Current Vaccination Status and Recommendations
As of April 1, 2024, Japan had administered over 436 million doses of COVID-19 vaccines nationwide. The vaccination rates reflect a broad uptake across the population, with approximately 80.4% having received their first dose and 79.5% completing their second dose. A significant portion of the population, 67.1%, had also received a third (booster) dose.
Current public health guidance emphasizes the ongoing importance of booster shots, as the protective effectiveness of vaccines against infection can diminish over time. The vaccination program has transitioned to offering updated vaccines, including bivalent formulations specifically designed to target newer variants such as Omicron XBB.1.5. From April 1, 2024, routine vaccinations are being administered during the fall and winter seasons, primarily targeting individuals aged 65 or older and eligible persons between 60 and 64 years of age. For those not covered by these routine programs, voluntary vaccinations are available at personal expense.
Domestic Vaccine Development Efforts
Japan also pursued ambitious goals to develop its own COVID-19 vaccines, aiming to achieve greater self-sufficiency in vaccine supply. Several Japanese pharmaceutical companies engaged in significant research and development. Shionogi & Co., Ltd., for instance, focused on recombinant protein vaccine candidates. Their S-268019 candidate was undergoing manufacturing and sales approval application, while S-268023, a monovalent vaccine targeting the Omicron XBB.1.5 strain, initiated Phase 3 clinical trials in December 2023.
Daiichi Sankyo emerged as another key player in domestic vaccine innovation, developing the mRNA vaccine DS-5670. This vaccine was approved for manufacturing and marketing in August 2023 as an original-strain monovalent mRNA vaccine, and an Omicron XBB.1.5-adapted version received approval in November 2023. This achievement marked DS-5670 as the first Japan-made COVID-19 mRNA vaccine, a milestone in the nation’s efforts to bolster its vaccine production capabilities. These domestic development initiatives have received support through collaborative projects involving the Japan Agency for Medical Research and Development (AMED) and the Ministry of Health, Labour and Welfare.