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:
6 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.