Petition to Improve the National Policy on Adult Immunization in Japan

See official statement here.

With a low birth rate and long life expectancy, Japan is holding on to its position as the world’s oldest society, a quality to be admired, with 1 in 4 people aged 65 and older.  It is therefore essential that the government policies provide older people with the best healthcare so that older people can lead healthy, independent lives.

Prime Minister Shinzo Abe administration endorses the policy goal of “promoting the dynamic engagement of all citizens.”  This policy encourages the participation of all citizens in societal affairs and helps promote a society where men, women, youth, older people, and people with intractable diseases can proactively engage in activities; whether that be at home, in the workplace, or in the community (PR Cabinet Office).

Faced with a hyper ageing society, the Japanese government acknowledges the grave issue of infectious disease and the growing need for disease prevention.  Pneumococcal disease is an important cause of morbidity in older adults, with a significant impact on quality of life.  In fact, recent reports rank pneumonia as the 5^th leading cause of death in older adults with pneumococcus, remaining by far the most important organism causing pneumonia.  According to a report by the Small Committee for Vaccine Evaluation (SCVE),[1]  the most severe pathologic condition of the pneumococcal pneumonia infection is Invasive Pneumococcal Disease (IPD).  Thus, the prevention of IPD should be prioritized.

To achieve a dynamic society that engages all its citizens, it is crucial to consider the prevention of pneumonia, and fit pneumonia policy into initiatives that strive for a society that promotes healthy life expectancy, as decreed by the Ministry of Health, Labour and Welfare.

As of May 2018, pneumococcal conjugate vaccine (PCV13) has been recommended in 44 countries across the globe and has been recognised by SCVE and the Basic Policy Sub Committee as highly important to the prevention of pneumonia.  For at-risk groups (those with an underlying medical condition), PCV13 has been recommended in 31 countries including France, Italy, Spain and Russia.  However, in four countries including Japan, only pneumococcal polysaccharide vaccine (PPSV23) is recommended in the National Immunization Plan (NIP) for the prevention of pneumonia.

Based on the reasons presented above, we strongly encourage the government of Japan to review the current adult pneumococcal vaccination program, highlight the importance of choice in the Adult NIP to enable physicians and patients to choose the best options for pneumococcal prevention, and acknowledge the value of including PCV13 in the NIP.

[1]Draft version dated 31st October 2018 issued by the Small Committee for Vaccine Evaluation (SCVE) on vaccines to prevent pneumococcal pneumonia infection