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Annual Vaccinations

Japan With Kids - Forums: Health Topics: Immunizations: Annual Vaccinations
By Tsuchiya on Wednesday, October 11, 2000 - 8:21 am:

Flu vaccination is recommended to be done from Oct. 10 to Dec. 31 (actually it's better to be ended by Dec. 28 since from Dec. 29, public offices are closed for holidays). The above recommendation was circulated from Hokensho (Public Health Care Office) recently.

You may get vaccination after Dec. 31, but in that case a shortage of the vaccines may happen.

The strains of vaccines expected in Japan are the same as the CDC (Center for Disease Control, USA) expected in the comming flu season 2000-2001. The following is the URL of CDC site for the strains of the flu.

>Influenza viruses continually change over time, and each year
>the vaccine is updated to include the viruses that are most
>likely to circulate in the upcoming influenza season.
>The influenza vaccine (flu shot) that has been produced for
>the 2000-01 flu season contains three influenza virus strains
>designated A/Panama, A/New Caledonia, and B/Yamanashi.

CDC also wrote the persons who are thought to need flu vaccinations:

>Persons aged 65 years and older;
>Residents of nursing homes and other chronic-care facilities ...
>Adults and children who have chronic disorders of the ...
>Adults and children who have required regular medical follow-up ...
>Children and teenagers who are receiving long-term aspirin ...
>Women who will be in the second or third trimester of pregnancy ...

Until last year the number of shots of flu vaccination is twice in Japan (in one season). I didn't find any definitive data on this point; the data circulated from the Hokensho lacked the information about the duration of serum antibody which was obtained after single or double flu shots, which is the critical information.

Thus, I cannot support the opinion that single shot may be OK in the case of flu shot. In the US single shots are performed, but we cannot deduce the results obtained from the different vaccine preparations.

The cost of flu vaccination is 4200 yen per one shot in Kumamoto City.

Hiroyuki Tsuchiya, M.D., Ph.D.
Department of Pediatrics
NTT West Kyushu Hospital
1-17-27 Shin-yashiki, Kumamoto City, 862-8655 JAPAN

By Cornelia on Friday, November 29, 2002 - 10:25 am:

Annual flu vaccination is now given in one dose for people age 13 years and older. Children under 13 continue to receive the flu vaccination in two doses.
Adult dose: 0.5ml x1
Child dose age 6-13: 0.3 ml x2
Child dose age 3-6: 0.2 ml x2
Child dose age under 3: 0.1 ml x2

The price tends to be around Y4500 per shot.
However there is a new public policy (Japan-wide) due to a high rate of influenza victims in the 65 and older age group in the 1999-2000 flu season, particularly in nursing homes. All people in this age group can get a "coupon" from their public health office for a flu shot from a local provider costing Y2200.

In addition, if you go to a local hospital that is run as a co-op (seikyo) and you become a member (kumiai) you are may be able to get a cheaper shot. My local hospital (Tokyo Kensai Byoin in Bunkyo-ku) gives flu shots for Y4500 to non-members and for Y2500 yen to members. Membership is a refundable donation of Y1000 or higher if you wish.

Sorry, this is a bit on the late side, but I only just got this information myself. As a single mother it is important that I stay healthy, even though I am not in the highest risk groups. Flu shots are still available, roughly until the end of December.

The good news is that there are also some drugs available now for treatment of influenza. Here are the details:

"Tamiful (oseltamivir phosphate), pill form, was developed by Swiss Hoffmamm-La Roche company and America Gilead Sciences company, 1999. It was obtained foreign country's approval for the drug of influenza. In Japan it was approved at Feb 2001 and can be used for children from this year (2002).
Relenza (zanamivir hydrate) is inhalation type and went on the market in 1999 in Australia. In Japan it was approved Feb 2001 .
Both medicines are used to treat A type and B type influenza."

The important thing is to remember that flu is sometimes misdiagnosed (so if you are given one of these drugs and they appear not to work, it may be that you are not actually suffering from the flu but from something else).

In the past I've squeezed in trips to the local public health offices on autumn business trips to the USA or Canada (where indeed flu shots are less costly than in Japan going from $12-$15 USD), but it is time consuming given tight scheduling. So now I've decided to nail this info here in Tokyo! I hope this is of use to someone out there. I would particularly recommend flu shots for self-employed and all employees of small companies, teachers at small schools, etc. as well as single parents, in short for anyone whose labor can not easily be replaced should they become non-functional!
Details for Tokyo Kensai Byoin:
4-3-8 Otsuka, Bunkyo-ku, Tokyo
tel: 03-3944-6111
closest stations: Myogadani or Shin-Otsuka on the Marunouchi subway line, OR Otsuka on the Yamanote line.

By Cornelia on Wednesday, December 4, 2002 - 9:16 am:

More on the flu shots.

In the web literature there is a warning against giving children under a certain age a flu vaccine (North America). But as far as I know there is not a differentiation in dosage (between adults and children) in that area, such as in Japan.

On a case by case basis there might be an imbalance of risk that would indicate a flu shot as a good idea even for a very young child.

Also the best time distance between the dual shot program is ~4 weeks (for maximum immunity build up), but the second shot can be taken sooner if necessary.

By Natasha on Tuesday, January 28, 2003 - 10:33 am:

Well, my kid's been diagnosed with flu type B (they have test they did with a nose swab sample right there in front of me. Took 10 minutes to see the result) She is getting Tamiflu (oseltamivir phosphate) made by Roche. It comes only in 75 mg capsules so they empty the capsules and re-divide the contents into those little paper packets for doses appropriate for a 20kg person. (This is because they've run out of the "dry syrup" version that is the children's product.)

Very bitter. I'm mixing with half a spoonful of strawberry jam to make it go down. I'm hoping the medicine shortens the duration.

By Michael on Wednesday, January 29, 2003 - 12:36 pm:

From the Mayo Clinic:

The Centers for Disease Control and Prevention (CDC) recommends that children between the ages of 6 months and 2 years get a yearly flu shot (influenza vaccine). In addition, the CDC recommends the flu shot for everybody living in a household with a child younger than age 2 or an adult older than age 65.

Older children may get a flu shot. But not all older children need an annual flu shot. Most doctors recommend an annual flu shot for older children who are at high risk of serious complications from influenza, such as bacterial pneumonia. Children at high risk include those with:

Asthma or other chronic lung conditions
Cardiovascular disease
Sickle cell anemia
Human immunodeficiency virus (HIV) infection
Chronic kidney disease
Chronic metabolic disease

Children who are on long-term aspirin treatment or medications that suppress their immune system, such as corticosteroids or chemotherapy, also are at high risk.

The time to get an annual flu shot is in the fall before the start of the flu season. In the United States, the flu season typically extends from October to March. The first year children get the influenza vaccine they need two doses given 1 month apart. In subsequent years, children only need one dose. A new influenza vaccine is prepared each year.

By Cornelia on Wednesday, February 5, 2003 - 12:26 pm:

Michael, Thank you for your illuminating bit from the Mayo clinic. I think that I will start getting the annual shot for my daughter as well as myself after reading it. She has allergy induced asthma (6 years old).
Her school has been closed today and tomorrow because so many people are out sick.

By Cornelia on Friday, November 21, 2003 - 7:30 am:

Yesterday I was able to talk my now 7-year old into getting an influenza vaccine with me. The hospital we use has a co-op where you pay a small refundable amount (Y1000 is OK) to be a member and then you can get your flu shots for Y2625 each (includes 5% tax). That is a very good price. It usually costs around Y5000 each! I already gave the details in an earlier post above for those of you who wish to pursue it.

By Natasha on Thursday, December 4, 2003 - 10:33 am:

This year's influenza season has already started. 4 toddlers died in England and Scotland. Texas and Colorado already hard hit. Unless they are allergic to eggs, please consider getting a flu shot for the kids this year, even if you have never done so before. About 36,000 people die from the flu in the USA every year and they are mostly children and elderly. This year the figure is projected higher. I don't know what the numbers are for Japan, but with all the riding around on crowded trains, I'm sure that lots of people get it.

By Cornelia on Friday, December 5, 2003 - 9:22 pm:

influenza mortality stats in Japan as researched by a Japanese doctor friend of mine:
"2002-2003 season: death by influenza in Japan was 11,215.
1997-1998 season: 217 Children suffered Influenza encephalitis or encephalopathy and 58 died. 86 recovered.
I could not find the number of total death by influenza last season."

By Natasha on Monday, December 8, 2003 - 8:48 pm:

Here's another article on this year's flu. Vaccine supply is running out, etc.

By Cornelia on Thursday, January 1, 2004 - 10:23 pm:

Here is more on influenza's influence on mortality (this is Japan only):

Births fall for 3rd straight year in 2003

Thursday, January 1, 2004
TOKYO EThe number of births in Japan in 2003 is projected to fall for the third straight year by 33,000 to 1,121,000, while the number of deaths is likely to hit the highest figure since 1947, according to data released Wednesday by the health ministry based on a January-October survey on vital statistics.

Due to the severe flu epidemic in January and February [2003] along with the nation's increasingly aging population, the number of deaths will total 1,025,000, up 43,000 from the year before, the Health, Welfare and Labor Ministry's annual estimates said. (Kyodo News)

By Susanne Erbeck Habiro on Thursday, January 1, 2004 - 11:34 pm:

I just read so much about flu vaccine here but never about any serious adverse reactions...well, I got this shot 2 weeks ago and I've been feeling really bad since then, with drowsiness, tiredness and muscle pains; and I've heard from quite a few people who had bad reactions as well - if it's like that for an adult, then what can it do to a small child? My daughter cannot get this shot because she's had bad side effects after DPT (colitis, bloody diarrhea) and had to be treated for three months.
I'd just like to recommend everyone to get really well informed about side effects before giving that shot. Maybe it can "save lives", but it can also be very harmful (deadly in worst cases as I heard).

By Cornelia on Friday, January 23, 2004 - 4:28 pm:

I just wrote a long post under childhood immunizations in response to the comments about Thimerosal which is about 46% mercury:

Since then, I went down the street and paid a visit to my daughter's pediatrician and we talked about the inclusion of Thimerosal in the annual flu vaccine. (I slipped in right before the end of her lunch break.)

First of all I want to point out that this is not a response to Susanne's post above. This is actually written in response to Esther's comment in the discussion on childhood immunizations (about us who like flu shots so much ;-) Eon't worry I did not take it the wrong way).

First the answers that my daughter's doctor easily provided: Yes, the annual flu vaccine that we received contains Thimerosal. The amount is 0.008 mg/ml. An adult dose of the vaccine is 0.5 ml so an adult gets 0.04mg Thimerosal along with the flu vaccine injection.

The dose for a child 6-13 years old is 0.3 ml given two times four weeks apart. That means the total amount of Thimerosal is 0.048mg/ml! More than an adult. The dose for a child 1-6 is 0.2 ml given twice four weeks apart, so the total Thimerosal is 0.032mg/ml.

Finally, why is this an issue? Well, mercury is excreted by the body in bile. The toxic level threshold is very low. Babies less than 6 months old do not produce bile and can not excrete mercury. Mercury is retained permanently once it is changed into its inorganic form which is what it happens when it reaches the nerve cells and becomes "bound" to them. Injected mercury is more dangerous than ingested mercury. It has a better chance to get to nerve cells before being cleared out. You can read a lot about this here:

What are the risks? It turns out that mercury poisoning can happen at any age (Minamata disease is a form of mercury poisoning). There is a predisposition more or less based on your body's ability to eliminate the mercury. If you produce a lot of bile easily you may be getting rid of mercury efficiently, if you don't, then you may be storing it in dangerous places. The source also matters: airborne mercury is absorbed permanently at about 90% or more.

I have been a great believer in flu shots. It really wreaks havoc in our lives when I get sick for 5 days (as a single mother with no support kin this is really a disaster). Second, I got a flu shot for my daughter this year for the first time, because I didn't want her to miss any school like she did last year.

So I asked my daughter's doctor if there were any flu vaccines available that are mercury free. She said, no, there is only the one company. I suggested that a letter explaining that there is growing awareness among patients, and some are declining flu vaccines because of the Thimerosal contentE She knew where I was going with this, and responded that they are aware of the need to find a replacement for the Thimerosal, but the fact is that Thimerosal is still the best understood of the preserving agents while the other possibilities are relative unknowns.

The Environment Canada web site has a really good page on the more prevalent sources of mercury: vaccines and immunizations is not one of them, but teeth fillings are! There is dark insinuation on another web site that this information blackout is the result of big money.

I believe that one has to read everything with a grain of salt. After spending about 2 hours on this I've decided to stop getting the flu shot for my daughter until the murky information becomes more clear. I might continue getting one for myself. I read about a way to find out your own mercury levels by having your hair analyzed (3 inches = 6 months), but it only shows a time line and not the precise amount of mercury stored in your body at this instant (cost about $180 USD on via internet). A more precise test is to check the liver and kidneys, which is what they do with fish (after death). I'm relieved that I followed the Japanese childhood immunization schedule. The American one introduces more vaccines in stronger doses and at a much younger age.

Finally, the symptoms of autism and mercury poisoning are remarkably similar, which is one reason why autism is now being linked to mercury in immunizations (if I'm interpreting correctly). Ways to flush the body of permanent inorganic mercury are being researched. One doctor (Dr. Amy Holmes) has achieved a measure of success getting the mercury back into the blood using alphalipoic acid (where it then can be removed with a chelating agent) in 300 autistic patients (and their I.Q.s went up). But then confusingly, there is other evidence that the increase in autism is not caused by thimerosal alone, but perhaps independently by the multiple vaccine MMR (measles/mumps/rubella) which does not contain thimerosal.

This is what I mean when I say that the information is not entirely clear!

By Marie Kawachi on Wednesday, November 23, 2005 - 12:40 pm:

I just like to share this information to all the members who are living here in Arakawa-ku area. There is a childrens' clinic that gives a flu vaccine for 3,000yen. And what is good about it they have an English speaking staff who could help you. The clinic's name is Matsuoka Kodomo Clinic, near Arakawa-ku City Hall. Tel: 03-5604-1569 and you can make reservation by phone.

By Cornelia on Thursday, November 24, 2005 - 8:40 pm:

Dear Marie, I'm wondering is it 3000 yen each time, or 3000 yen for both shots (for kids under 13)? Where I'm going it is Y2500 plus tax for each shot. Since kids get two shots (4 weeks apart) I ended up paying Y5250 for my daughter's flu vaccination (last year when I got it for her).

By Marie Kawachi on Friday, November 25, 2005 - 2:21 pm:

Dear Cornelia, sorry for not being specific, yes 3,000 yen each time and not for both shots.

By Cornelia on Monday, January 30, 2006 - 4:31 pm:

Just heard of someone giving flu shots for Y2200, and also operating his clinic as a General Practitioner (though he is specialized in Internal Medicine). I'm not sure if it includes the 5% tax or not. But it is still the best price that I've found anywhere. He is not strictly a pediatrician but he has recently completed a residency program of Pediatrics at Otsuka Metropolitan Hospital (Toshima-ku). For more on this hospital see the discussion under Hospitals in this health section.

Nobuhiko Kubo, M.D.
Azuma Street Clinic
3-18-34-101, Minami-ikebukuro, Toshima-ku, Tokyo 171-0022, Japan
tel: 03-3982-7203, fax: 03-3982-7209
Access: Ikebukuro, Higashi Ikebukuro and Zoshigaya stations.

Because he is close to my daughter's school, we will visit him in our process of selecting a new doctor for her, since her pediatrician since birth has retired.

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