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Japan seeing TB vaccine shortage after reports on possible effects against COVID-19

An infant with marks for the Bacillus Calmette Guerin vaccine is seen in Nagoya, on May 15, 2020. (Mainichi/Kazuki Sakuma)

NAGOYA -- Some medical institutions in Japan are seeing a shortage of tuberculosis (TB) vaccine as demand has surged most likely after it was reported that the vaccine could be effective in preventing new coronavirus infections.

Pediatricians are expressing concern over the possible heightened risk of children getting TB infections as some infants may not be able to get vaccinated during a period recommended by the government.

A 38-year-old woman in the Chiba Prefecture city of Sakura east of Tokyo got a phone call in late April from a clinic where she had an appointment a month later for her 4-month-old daughter's Bacillus Calmette Guerin (BCG) vaccination. The clinic told her that her daughter's vaccination had to be postponed due to a BCG vaccine shortage. Concerned, the woman contacted other medical institutions and finally was able to get an appointment at the fourth clinic.

"This is my third child but I've never had this kind of experience. I was desperate (to get the baby vaccinated) because I thought that the BCG vaccine needs to be injected as soon as possible," the woman told the Mainichi Shimbun.

Nitadori Clinic in Tokyo's Bunkyo Ward had at one point stopped accepting new appointments for BCG vaccinations as vaccine shipments slowed down. Clinic director Junichi Nitadori commented, "There are a lot of concerned mothers out there because we're not getting the vaccine. I would like the national and local governments to get the situation under control as (not getting vaccinated) will increase the risk of children getting TB infections."

Japan's Ministry of Health, Labor and Welfare sets the standard period for children to get BCG vaccinations at sometime between five to eight months after birth, and covers the cost with public funds if a baby gets vaccinated before they turn 1 year old.

Amid the coronavirus pandemic, however, the BCG vaccine has come under renewed spotlight. Several research institutions based in Australia and other countries have launched clinical trials on the vaccine as the COVID-19 death toll is relatively lower in Asian nations compared to the United States and those in Europe that do not carry out BCG vaccinations. The development had been reported for a while with hopes that the vaccine might be effective.

According to Japan BCG Laboratory, the only manufacturer of the BCG vaccine in the country, the volume of vaccine shipment to pharmaceutical distributors at around the end of March soared to about three times that of a regular year. The company produces the vaccine in a calculated manner according to the number of births in Japan. Since it takes at least eight months to manufacture the vaccine, it says it cannot increase production so quickly.

A Tokyo-based pharmaceutical distributor told the Mainichi, "Demand for the vaccine increased as a result of reports on its potential effects against the new coronavirus. We have rejected an order from a medical institution that has allowed BCG injections to those other than infants."

According to the health ministry and other sources, BCG vaccinations started in Japan in 1951. Those aged 30 and younger at the time who had not developed an immunity for TB were subject to the vaccination, and today, an overwhelming majority of people who live in Japan have been vaccinated. However, there are those who lived in countries where regular BCG vaccination was not available when they were infants, and many foreign residents in Japan have not been vaccinated. The aforementioned distributor speculates that the number of adults who wish to get the BCG vaccination hoping that it would prevent the new coronavirus infection is increasing.

The World Health Organization has announced that "there is no evidence" to support the effects of the BCG vaccine to prevent coronavirus infections. Similarly, the Japanese Society for Vaccinology has presented its view that "scientific results (of the BCG vaccine against the coronavirus) have not been confirmed" and that the society "does not recommend" people get the vaccine to prevent COVID-19.

The Japan Pediatric Society points out that those who have had TB or those with immunity for BCG bacteria might get severe swelling on the skin after injection of the vaccine, among other aftereffects. Doctor Koji Naito, director of otorhinolaryngology at Hiiragi Clinic in the Aichi Prefecture city of Obu in central Japan, emphasized that the BCG vaccination is "necessary" to protect infants from TB and worsening of the disease, and if it gets hit with shortages, infant fatality rates could rise.

(Japanese original by Kristina Gan, Nagoya News Center)

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