Daddy-san (part 4): Immunising your child after arriving in Japan
Red on Feb 21 2010 at 4:50 am | Filed under: Japan: Life
Vaccinations in Japan are different than in the West - there are important points that you should know, because your Japanese doctor may not.
There are two very important things to know about new born vaccinations in Japan:
1. Japan doesn’t immunise for as many diseases as is standard in the West.
2. Japan has developed its own domestic vaccines for most diseases which means that they are not compatible with vaccinations taken for the same disease in other countries.
At the time of writing, the recommended injections for newborns in Japan (i.e. those that are provided free of charge to residents) are as follows:
The yobosesshu brand - Japanese babies will wear this mark with them until adulthood and beyond
- BCG (結核予防法) → at birth
- Diphtheria(ジフテリア) → 2, 4 and 6 months
- Pertussis(百日咳) → 2, 4 and 6 months
- Tetanus (破傷風) → 2, 4 and 6 months
- Polio (ポリオ) → 2, 4 and 6 months
In addition to these diseases, Hong Kong, for example, also recommends (and provides free of charge) vaccinations for the following diseases:
- Hepatitis B (Ｂ型肝炎) → 2, 4 and 6 months
- HiB (ヘモフィラス・インフルエンザ菌タイプB) → 2, 4 and 6 months
- Pneumococcal conjugate (PCV) (肺炎球菌結合ワクチン) → 2, 4 and 6 months
- Rota Virus (ロタウィルス) → 2, 4 and sometimes also 6 months
According to our paediatrician who was educated in London and Australia, both Australia and most of Europe vaccinate for the same diseases as Hong Kong. I’m assuming that they are all copy cats of the UK standard. Furthermore, each of these countries uses the same brand of vaccinations so your child isn’t going to have any problems if you travel between those countries. On the other hand, when we found ourselves in Japan 4 months after my son’s birth we realised that we’d created two problems for ourselves: (1) we were half way through vaccinations for diseases that Japanese paediatricians hadn’t even heard about (e.g. rota virus) and (2) we couldn’t even complete the four diseases that Japan also immunises for, as Japanese hospitals use domestically developed brands that aren’t compatible with the first two rounds that we’d taken overseas. Don’t let a Japanese doctor fool you on this point. They are not compatible.
This is an interesting chart (source) that makes a comparison of the standard Japanese vaccination schedule with that of the United States. Could be a good one to take with you when you visit your Japanese GP, to spur discussion about how he/she needs to help you:
It is actually possible to receive a hepatitis B vaccination in Japan if you pay for it yourself so I guess it is unfair to include it in the second list although it is not standard and most children don’t receive it. I’ve also heard that the HiB vaccine is very close to approval in Japan as well. Even if it is improved, it is unlikely that it will be included on the free list of vaccinations for several years so will probably be in the same basket as the hepatitis B vaccination.
It might seem like a lot of injections for your baby to receive but in actual fact almost all of these injections are administered at the same time. If you find a friendly paediatrician in Japan then you will probably get diphtheria, pertussis and tetanus together in one injection called a DPT (三種混合, sanshu kongo) which reduces some of the shock to the poor little kid. If you’re unlucky, your paediatrician might
Some clinics in Japan will give vaccinations the Western way - at 2 months the baby receives all of them at the same time with simultaneous jabs in both legs
It only took a few phone calls to leading hospitals in Osaka and Tokyo to realise that no public hospitals were able to administer any vaccinations other than those officially recommended by the Japanese government. They recommended me to try and find a small private hospital that might be importing the drugs on a proprietary basis. After smiling and dialling every international sounding private hospital I could think of in Osaka, Kobe and Tokyo, I was proudly offered various combinations of DPT and a bunch of branded vaccines that I’d never heard of. I thought I’d almost struck gold with a small practice in Hiro (広尾), until the senior doctor (院長先生, inchosensei) – who will remain unnamed – started trying to convince me that both brands of the rota virus vaccination were interchangeable. It scares me to think how many unsuspecting parents take their children to that guy and get the wrong vaccination!
Anyway to cut a long story short, I was only able to find one hospital that was able to administer each of the injections for us. Here are their details:
Tokyo Medical and Surgical Clinic
Address: 32 Shiba koen Building 2F,
3-4-30 Shiba-koen, Minato-ku, Tokyo 105-0011
Telephone: 03-3436-3028 (24 hours)
Fax: 03-3436-5024
Unfortunately for families coming from Australia, they only had Rotarix (and not Rotateq which is standard in Australia) for the rota virus at that time but that might change in the future. I highly recommend them for the other vaccinations and their professionalism. At the time of writing these vaccinations cost a hefty 80,000 yen for one round of all 8. For obvious reasons, it is nice to have an insurance policy that covers these payments – but it will have to be private as the clinic is not recognised by the Japanese health insurance system. While my focus has been on newborns, parents of children who are either 12 months or 4 years old will probably want to know what the story is with chicken pox, mumps, measles and rubella. All of these injections are available in Japan, but only measles and rubella are provided free to residents. Whereas the west generally administers measles, mumps and rubella together in a 3-in-one injection called MMR, for some reason Japan doesn’t include mumps and just gives an “MR”. It’s worth confirming the brand that you used for the first round at 12 months if you are giving the 4 year booster to your child for the same reason as mentioned above.
Lets us know about your yobosesshu experiences in Japan, or for that matter, anywhere else. It’s a fascinating topic, but sometimes a scary one, especially when it involves your own little one.
Other stippy.com articles possibly of interest:
14 Responses to “Daddy-san (part 4): Immunising your child after arriving in Japan”
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great article, very helpful, you always here about medical issues in Japan (and China) because they stick to local drugs which doesn’t help expat families
Did you try the British Clinic in Ebisu?
They did the UK immunisations for our daughter, although it costs an arm and a leg without international health insurance.
previous articles in the Daddy-san series:
1) Introduction/Overview
http://www.stippy.com/japan-life/first-time-gaijin-dad-1/
2) Breast-feeding
http://www.stippy.com/japan-life/first-time-gaijin-dad-2/
3) Travel
http://www.stippy.com/japan-life/first-time-gaijin-dad-3/
i’ve only recently found this blog (blog?) and finding it very interesting.
i’m in the same boat (well will be soon) as my wife is about to give birth in hong kong and we will then be moving back to japan when our little one is 7 months old.
such immunization issues never crossed my mind until today so i will be sure to jot down that tokyo medical clinic address!
Our doctor only provided the HepB vaccination at 3 months for our daughter. I’ve printed the U.S. Centers for Disease Control vaccination schedule (http://www.cdc.gov/vaccines/recs/schedules/default.htm), and according to our pediatrician here in Hiroo (a very popular place, right on Gaien Nishi Dori near the Lambo dealership), they didn’t have any information on 2 of them/did not offer them (PCV & Rota Virus).
Our daughter DID NOT receive any type of vaccinations at birth.
I just received the Shibuya Ward immunization coupon/schedule (trying to deciper it with my poor Japanese- will need the wife to look at this tomorrow) and from what I gather, National Health Care offers (free or cheap):
DPT (Diphteria, Pertussis, Tetanus)
DT (Diphteria & Tetanus?)
MR (Measles / Rubella… No Mumps).
Our doctor here suggested we do the remaining vaccinations once we get to the U.S. (we’re moving back in a few months) since it’s much cheaper there.
I would assume the risks of contracting any of these diseases is much less in Japan versus the rest of the world, hence, non-conforming vaccinations here. However, given that we are an international family, I will surely follow the U.S. CDC schedule, and maybe integrate some of the Japanese-specific vaccinations as well (i.e: Japanese Incephalitus)…
Very nice and helpful article.
As a Pediatrician in Orange County, California I have a number of Japanese families who start the US series of vaccines and want to continue getting the vaccines when they go back to Japan. The information on the Tokyo clinic will be most helpful.
Just one point on immunization compatability and intercheangability. Although it is ideal to start and end with one manufacturer’s vaccine, even in the US we have to switch back and forth at times so we do mix brands often. As long as you follow the guidelines from the CDC on timing of the vaccines this is OK.
I also have many internationally adopted patients and deal with foreign manufactured vaccines all the time. On this matter the CDC states, “Although some vaccines with inadequate potency have been produced in other countries, most vaccines used worldwide are produced with adequate quality control standards and are reliable.” So even if you had to get Japanese vaccines most Pediatricians in the US will accept them. The only thing to be careful of is that the timing of the vaccines is compatible with the schedule used in the US. The problem I have found with the Japanese schedule (besides not including many of the US vaccines) is that the ones used are given too close together. In those cases I just ignore the ones given too soon and count the others given at the correct intervals. This usually means the child needs a dose or two extra to become fully vaccinated by US standards. This is better than ignoring all the vaccines and starting over from scratch.
Does the Japanese health care system vaccinate for free for travel in other parts of Asia or is this all out of pocket? We are moving to Japan in December with our 3 and 4 year olds, I am wondering if I should ask their doctor here to vaccinate them as if they were traveling to China, Viet Nam, the Phillipeans, which are some of the places we might visit.
Kathleen,
You can get the vaccinations here but you have to pay for them. It is a bit old information but I found this data from 2002 with a Japanese language google search:
Hepatitis A 8830 yen
Tetanus 4330 yen
Yellow Fever 4900 yen
Rabies 7230 yen
Japanese Encephalitis 5130 yen
Cholera 1500 yen
(http://www48.tok2.com/home/sawakon/3oyakudachi/3-03vassiation.htm)
Pretty cheap I think? How much would it cost you back home?
I think you actually need a yellow card (proof of a yellow fever vaccination) to go to some strange countries but I think the three you mentioned should be fine.
Interesting article
Just wanted to say that in the Western world, many parents are sceptical of immunization, especially in connection to any possible side effects, like for autism and such, and actually some say that it’s better for the kid to recieve immunisations separately as to not overwhelm their system…
You may want to read up on it…
Not sure if any of the Japanese immunization is mercury-based or not? Or containing any other possibly iffy chemicals?
Good news (for all but Layla perhaps?)
The Japanese immunization scene has changed dramatically over the last 12 months. You can now get Hib, Prevnar, HPV, etc.
see here:
http://idsc.nih.go.jp/vaccine/dschedule.html
the interesting thing is that these changes are opening up the eyes of Japanese to realize that they are trailing the world in this field.
David Shinmei, M.D.
(or anyone else who might be able to help out)
My son began his vaccinations in Hong Kong and I just realised that we forgot to get his fourth and final HiB vaccination (I guess it is a booster – the one at 18 months). He is now 3 yo. His first three were included in Infranhexa. Is it worth while/safe/advised getting a booster from a Japanese MD with the Japanese vaccine (ActHIB)?
I love this article so much, it helps and give me an idea about the difference of the vaccination in japan and other country because me and my baby are going to migrate in japan.A little bit scared after reading this,all I want is the best for my baby. so maybe I”m gonna finish first his vaccination here in PH before we gonna transfer there.
nice article..thanks for the info..me too is worried about my 1 year old daughter to get the oral polio vaccine here in japan cause i heard that some child who got this OPV got the disease..it took me a year of thinking and im still undecided weather we should go for that vaccine this coming october because japanese government only gives the vaccine on spring and autumn.can someone tell me what to do..is it really safe to go for OPV here in japan?me too all I want is the best for my baby…can someone help me here..thanks a lot.
http://www.healing-arts.org/children/vaccines/vaccines-information.htm
Great informative article! My son is due for his 12 mth vaccincations and his 2,4,6 were all done in australia while we avoided the dangers of radiation etc… Now were back in tokyo and have a dilemma about what to do with his 12 mth vacc in january. Id love to go back to australia to get the vaccs and hang out with my family, but finances are a bit tight… I personally dont really trust the vaccs here in japan as there have been so many scary stories, polio… And the the prevenar one that was cancelled march 2010 cuz several cases of children died within weeks of it…. Apparently that batch of imported prevenar had problems (???).
Anyway, im glad to know that we can get import stuff and that there are hospitals that support the vaccs needs of foreigners with kids in japan.
Ps: rhea i wish i had an answer for you… Sorry i cant help, but just from my gut feeling and opinion, i would rather wait to go back to home country or wait until they can do the shot. Ive seen the news about oral polio on tv these days and its just so sad for the unlucky ones that got polio from the oral vaccine…