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Under pressure, PM Suga bets the house on full vaccinations for Japan's elderly by July 31

Prime Minister Yoshihide Suga is seen answering press questions regarding a fresh state of emergency declaration, on April 21, 2021, at the prime minister's office in Tokyo. (Mainichi/Kan Takeuchi)

TOKYO -- With an aim to quell coronavirus infections through vaccinations, Japanese Prime Minister Yoshihide Suga is throwing his energy into trying to speed up inoculations, setting the government a target to "vaccinate all elderly people by the end of July."

    Large-scale vaccination centers managed by the Self-Defense Forces (SDF) under direct government jurisdiction are starting to be set up in Tokyo and Osaka, and thorough efforts will be made to provide support to municipal governments plagued by shortages of personnel to manage inoculations. But at municipal governments yet to put a system in place, and among members of the SDF, some are expressing confusion and doubts over the plans.

    On the afternoon of April 29, a public holiday, Suga went to his office in the Second Members' Office Building of the House of Representatives, in Tokyo's Chiyoda Ward. He made strong calls to senior members of the Ministry of Health, Labor and Welfare to expedite vaccinations, telling them to "ensure vaccinations are done comprehensively."

    During an April 26 prime minister's office meeting with Taro Kono, the government's vaccinations chief and minister in charge of administrative reform, Suga instructed him to "do whatever we can as the government to ensure municipal governments vaccinate all elderly people (aged 65 and over) by July." An executive member of the Cabinet Secretariat revealed, "The prime minister has a habit recently of saying 'in any case, vaccinate them quickly.'"

    The rush is down to the view that a sped-up vaccination program is seen as the ace in the hole among government coronavirus prevention measures. The current state of emergency declared for four prefectures including Tokyo and Osaka appears less effective than the previous two because of the public's self-restraint fatigue. Even if future infections are suppressed, it will have been down to mere stopgap measures; any end to the spread needs the widespread uptake of vaccinations.

    Among the issues foremost in the prime minister's view is upcoming House of Representatives elections set to come by autumn. Public support for the previous Abe administration was described as tied to the stock market, while conversely the Suga administration's support appears directly correlated to new coronavirus cases; its approval ratings wax and wane in an opposite trajectory to infection numbers.

    An individual connected with the government emphasized to the Mainichi Shimbun, "For the sake of the House of Representatives elections and the holding of the Tokyo Olympic and Paralympic Games, too, we want to widely disseminate vaccinations as early as we can."

    The prime minister's specific goal is to complete inoculations for all elderly people by the end of July. He announced the target suddenly at an April 23 press conference held after the formal decision to declare a further state of emergency. A senior official at the prime minister's office offered their view, saying, "To try to avoid darkening the people's spirits with the emergency declaration, comments were made suggesting the end of the battle with the virus is near."

    The target has no clear basis, and some within the ruling Liberal Democratic Party (LDP) maintained it "shouldn't have been said," but another leading official revealed, "It was also done with a view to giving a bit of a push to municipal governments that have been slow to move."

    In response to the prime minister's intentions, government ministries and agencies have been speeding up the construction of systems to support vaccination programs. The establishment of large-scale inoculation centers is one sign of this. The Ministry of Defense has decided to work toward setting up one such center, run by SDF medical officials and others, in Tokyo by May 24. Adjustments for a similar facility in Osaka are also in progress.

    On April 27, the Ministry of Internal Affairs and Communications created a "regional support headquarters" to provide aid to municipal governments tasked with running vaccinations. It aims to use its logistical framework with regional areas to support partnerships between the municipal governments and the health ministry.

    But municipal governments are already feeling the pressure. So far, some 30% of them have indicated they expect full vaccinations of their elderly residents to be completed by August or later.

    On April 26, opposition parties including the Constitutional Democratic Party of Japan listened at a National Diet hearing to a government employee in the city of Kofu, who said, "We haven't had any contact from the national government, and were shocked to hear the news reports (of the target). Our city government expects the vaccinations to take until mid-September." Irritation is also being stoked over lack of confirmation from the central government on how many vaccines will be delivered and when.

    For the government, the biggest issue facing municipal government vaccination programs is a lack of staff to administer them. In response, the health ministry decided on April 23 to recognize dentists as eligible to administer vaccines. On April 30, Suga will meet with the presidents of the Japan Medical Association and the Japanese Nursing Association at the prime minister's office, and intends to call for vaccination cooperation from medical professionals and nurses across the country.

    If targets to vaccinate all older people by July meet with failure, the damage to Suga's administration will be enormous. An end to the coronavirus will be further away, and it may bring up questions about the prime minister's ability as the government's chief executive. A senior LDP figure said, "It's by no means an exaggeration to say that the fate of this administration lies in widespread vaccinations."

    (Japanese original by Kazuhiko Hori and Shiho Fujibuchi, Political News Department)

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