Japan's vaccination rate is a red flag amid concerns about a superspreader Olympics

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Japan’s vaccination drive has gone from a marathon to a sprint as the country rushes to protect as many of its 126 million people as possible from Covid-19 ahead of the Tokyo Olympics.

Less than a month away from the lighting of the ceremonial torch, the Japanese government recently announced that it had hit the benchmark of vaccinating 1 million people in a single day.

But hobbled by a slow rollout, a severe shortage of doctors and nurses, and by the fact that it must import all its vaccines, Japan has fully vaccinated just a little more than 8 percent of its people, according to the World Health Organization.

That’s a big red flag for many public health experts concerned that the world’s biggest sporting event could turn into an Olympic-size superspreader event.

“The upcoming Olympics make the low rates of vaccination in Japan a substantial concern for widespread worsening of the pandemic within Japan and globally as people travel to and from the games,” said Dr. Sadiya Khan, an epidemiologist at the Northwestern University Feinberg School of Medicine.

But Tara Kirk Sell, a former U.S. Olympic swimmer who is now a public health expert, said it is likely "there will be cases" but the Tokyo games should go on.

“Higher vaccination rates in Japan would certainly be better, but there are other ways to reduce opportunities for transmission,” said Sell, a professor at the Johns Hopkins Bloomberg School of Public Health. “Most people who are coming into the country for the games will be vaccinated. And most won’t have much of a chance to get out and about as much as at a normal games.”

Japan has had nowhere near the number of Covid-19 infections (795,756) and deaths (14,669) as the United States, United Kingdom, Brazil, Russia or India. But that’s because the island nation imposes severe restrictions and mandatory quarantines on foreigners coming in and because the government has been successful at getting residents to wear masks and practice social distancing.

Mask-wearing, which was first adopted by the Japanese to combat the spread of the Spanish flu in 1919, was already a widespread practice in the country even before the Covid-19 pandemic.

As of Monday, Japan had administered 15.6 million vaccination doses, accounting for just over 8 percent of its population, the latest WHO figures show.

That is less than the global average of 10 percent per country and far less than the U.S. (45 percent) and the U.K. (46 percent), according to statistics compiled by Our World in Data.

Part of the reason is because, under Japanese law, only doctors and registered nurses are allowed to “legally give injections,” said Dr. C. Jason Wang, a professor of pediatrics and general medicine at Stanford University.

“That severely limits the distribution,” he said.

Also, Japan already was grappling with a severe shortage of doctors and nurses even before the pandemic and a large population of very vulnerable people.

“In an aging society, it’s very difficult to find doctors and nurses,” Keio University professor Sayuri Shirai told CNBC’s “Street Signs Asia,” adding that local governments have said vaccination rates are low because they don't have enough people to administer the shots.

Plus, there’s Japan’s sprawling bureaucracy.

“Japan has a slow regulatory process,” Wang said. “For a vaccine like Pfizer, for example, to get approved, they had to run clinical trials involving Japanese citizens. So it takes a long time to make a decision in Japan.”

That said, “they’re making progress,” he said of the Japanese government.

And while Japan has pockets of resistance to vaccinations, “it’s not like America,” Wang said. “It’s just that the Japanese are traditionally risk-averse.”

The Tokyo Olympics were postponed last year because of the pandemic and are taking place this year despite polls showing widespread opposition in Japan — and warnings from both local and international epidemiologists — that hosting the world’s largest sporting event in a country that is still reporting 400 new Covid-19 cases per day is asking for trouble.

One of the most prominent voices sounding the alarm about the Olympics has been Hitoshi Oshitani, the Japanese scientist credited with crafting the country’s successful “Three Cs” pandemic strategy, which stands for avoiding closed spaces, crowds and contact situations.

“It’s 100 percent impossible to have an Olympics with zero risk … of the spread of infection in Japan and also in other countries after the Olympics," he told The Times of London.