Health and Global Policy Institute (HGPI) presented a policy proposal entitled, “A Life Course Approach to Immunization and Vaccination Policy – Five Perspectives and Recommended Actions.”

HGPI aims to see a system established in which vaccinations are provided over the life course to everyone, from children to the elderly. This project gathered an advisory board of opinion leaders representing multi-stakeholders that identified issues and indicated the direction of solutions regarding immunization and vaccination. Topics examined by the advisory board included the value created by vaccines in normal times and during emergencies; the best ways of communicating the value of vaccines; the importance of a life course approach to vaccination, which would target people of all ages; and best methods for approaching unvaccinated generations.

HGPI compiled this proposal based on discussions held with multi-stakeholders including experts and representatives from civil society, the parties most affected, businesses, and the administration. Moving forward, we will have repeated opinion exchanges with a broader variety of multi-stakeholders based on this proposal to deepen discussions in this field and make progress on policy in this domain.

■ 5 perspectives and recommended actions

Perspective 1 – Immunization and vaccination policies based on a life course approach should be advanced.

1. 1. Eligibility requirements for routine vaccinations should be expanded to cover people with certain underlying medical conditions and risk factors so high-risk individuals can receive the benefits of vaccination.
   2. Special measures should be taken that expand catch-up vaccinations among unvaccinated people or people who have lived abroad and that reduce the cost burden on people who receive catch-up vaccinations.
   3. To improve access, more facilities should be allowed to provide vaccinations.
   4. Steps to offset the cost burden of vaccinations should be considered. These may include establishing progressive out-of-pocket payment rates by income bracket, granting public health insurance coverage, or revising the medical service fee schedule.
   5. Methods of managing individual vaccination records should be reviewed, individual vaccination records over the life course should be made viewable, and those records should be sharable among municipalities.

Perspective 2 – Dissemination, awareness-building, and communication strategies that target healthcare professionals and the public should be created.

1. 1. Departments responsible for science and risk communication should be established, and efforts should be made to promote the dissemination of and awareness-building for immunizations and vaccinations by providing appropriate information at appropriate times.
   2. Training systems should be introduced and best practices should be shared with the goal of improving awareness and literacy among healthcare professionals.

Perspective 3 – To achieve science-based policy decision making and evaluation, steps should be taken to promote the creation of a system that analyzes and shares the epidemiological effects of vaccinations by linking vaccination practices with information systems that track outbreaks of targeted diseases.

1. 1. The systems for gathering information and managing vaccination ledgers should be revised and a joint platform that is useful to healthcare professionals and municipalities, who are the parties responsible for entering registry information, should be built.
   2. An information registration system for accurately recording individual vaccination histories and that makes effective use of medical IDs and other such tools should be built.
   3. Steps should be taken to make information on adverse events viewable by revising the information utilization system for evaluating vaccinate effectiveness and safety.
   4. A unified evaluation system for the collection and analysis of adverse event information should be built.

Perspective 4 – Steps should be taken to create a system that enables multi-stakeholders to hold continuous discussions on vaccine policy.

1. 1. The public and specialist organizations should be invited to participate in efforts to foster social consensus.
   2. Protective measures should be developed to guard against biased, alarmist disinformation or medical misinformation.

Perspective 5 – Investments should be accelerated in immunization policies that address both non-emergency and emergency situations and anticipate future vaccine demand.

1. 1. Special approval processes that reflect the significance of vaccination during public health crises must be established. A system that remains operational during non-emergencies must be built for distributing vaccines, selecting targeted groups for vaccination, and assigning vaccination priorities.
   2. A domestic R&D and provision system for vaccines must be established.

For more information, please refer to the PDF.

■ Advisory Board (Titles omitted; in alphabetical order)

Kyoko Ama (Former Representative, Ippan Shadan Hojin Shiro Shoni Iryo Mamoro Kodomo-tachi no Kai; Board Member, Japan Patient Support Research Organization (JPSO))
Hidenori Arai (President, National Center for Geriatrics and Gerontology; Vice President, The Japan Geriatrics Society)
Satoshi Iwata (Department of Infectious Diseases, National Cancer Center Hospital Visiting Professor, Department of Infectious Diseases, Keio University School of Medicine Chairperson, The Expert Council on Promotion of Vaccination)
Isao Miyairi (Medical Director, Department of Infectious Diseases, National Center for Child Health and Development)
Kuniko Nakayama (Director, My Family Clinic Gamagori, Medical Association Mefa Jinaikai)
Leon Ochiai (Head, Public Relations Division, Responsible for Vaccine, Sanofi K.K.)
Nobuhiko Okabe (Director General, Kawasaki City Institute for Public Health)
Akihiko Saito (Professor of Pediatrics and Vice President, Niigata University School of Medicine)
Akinori Sugaya (Head Physician, Sugaya Children’s Clinic; Director, KNOW VPD Protect Our Children)
Mugen Ujiie (Director of Travel Clinic, Director of Immunization Support Center, Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine (NCGM))

■ Special Advisors (Titles omitted; in no particular order)

Ichiro Kamoshita (Member, House of Representatives; Chairperson, Association for the Promotion of Improved Public Health, Parliamentary Group for Vaccines and Prevention)
Keizo Takemi (Member, House of Councilors; WHO Goodwill Ambassador for UHC)
Noriko Furuya (House of Representatives Acting Chairperson, Association for the Promotion of Improved Public Health, Parliamentary Group for Vaccines and Prevention)
Kiyoshi Kurokawa (Chairman, Health and Global Policy Institute)

■ Related events

December 18, 2020 The Global Expert Meeting