Development of vaccination policy in Japan: current issues and policy directions.

Until November 2001, eight vaccinations had been offered to Japanese children on a routine basis; namely, diphtheria-tetanus-pertussis, polio, measles, rubella, Japanese encephalitis, and BCG. The 2001 amendment of the Immunization Law introduced an influenza vaccine for the elderly population. This paper reviews the progress of the immunization program in the broader context of infectious disease control in Japan. There are two recent major policy changes in the field of infectious disease control in Japan. One is the strengthening and revitalization of the infectious disease control program, particularly surveillance, by the enactment of new 1999 legislation entitled "Law concerning the Prevention of Infectious Diseases and Patients with Infectious Diseases". The other major policy change is a review of existing immunization programs and the amendment of the Immunization Law in 2001. In this article, the present routine vaccination program, as well as the recent amendments to the law, are described. Current policy issues are then discussed, including polio vaccination after the WHO "Zero Polio" announcement in the Western Pacific Region in 2000; strategies for changes in measles, rubella, tuberculosis, and influenza control; as well as adverse reaction monitoring/surveillance and feedback for improving vaccine safety. Finally, the future prospects of intended/planned changes in the vaccination policy are considered.