Local government preparations for vaccination of the new corona are in full swing.

How are local governments preparing for an unprecedented large-scale outbreak?

What kind of issues are you seeing?

Adachi-ku, Tokyo

Adachi-ku, Tokyo with a population of about 700,000.

On the 4th of this month, we set up a specialized department in charge of vaccination with the new coronavirus, and are making preparations at a rapid pace.



(1) Simulation of the number of people


Adachi City first conducted a simulation of the number of people who wish to be vaccinated.


The Ministry of Health, Labor and Welfare says that if the vaccine is approved, medical staff will be vaccinated in advance from the end of next month as much as possible.

And 25 days, shows the expected schedule of such as to ensure a system that can be inoculated with the late March to more than 65-year-old elderly in prospect, system in which all of the elderly are vaccinated for the first time within nine weeks from inoculation start We are asking the local government to maintain.

In response, Adachi City has decided to proceed with preparations with a plan to inoculate 220,000 times in two and a half months to 110,000 people, 65% of the approximately 170,000 elderly people in the city.

It is said that if the plan is advanced on the premise that all elderly people will be vaccinated, the plan may not be able to be established on the way.



Hideo Enozawa, director of the new coronavirus vaccination department, said, "If you organize your business with the idea of ​​blindly inoculating all residents, there is a possibility that vaccines will be wasted or your plans will collapse. First of all, I would like to set goals with realistic numbers, and if there are more vaccination applicants than expected, I would like to restructure the plan and respond flexibly. "



(2) To secure the venue


Adachi City is also promoting the securing of a place to inoculate based on the estimated number of inoculations.

The expected number of vaccinations is 20,000 per week.

We plan to open 40 vaccination venues every week using the public hall on weekdays and the gymnasium of elementary and junior high schools on Saturdays and Sundays, and we are working to secure places.


We also assume that the vaccination time per person will be about 25 minutes, and we are also considering how many doctors and nurses will be assigned to each venue.

It is said that it aims to inoculate 220,000 people in half a year and 350,000 people, which is about half of the ward's population, by the end of next year by inoculating at 40 places every week for 22 consecutive weeks.



(3) Preparation of reservation system


Adachi City is preparing to print coupons by contracting with a contractor within this week in order to send coupons necessary for vaccination to elderly people in March. ..

We are also preparing to improve the reservation system and set up a call center where you can choose the place and date you want to receive the vaccination.



(4) Issues and anxieties


However, I am

also anxious as

I prepare at a rapid pace.

The first is a "preliminary examination slip" that you need to fill out before vaccination.

In Adachi Ward, we are preparing to have the person receiving the vaccination fill in directly at the venue, and it is assumed that the number of people will be adjusted every 15 to 30 minutes so that the venue will not be crowded. I am.

However, it is difficult to calculate how long it will take for the elderly to actually fill out the form of the pre-examination slip.

And the biggest concern is whether the vaccine supply will proceed as expected.



Director Enozawa said, "We have a fairly detailed plan to facilitate vaccination, so if the vaccine is not supplied according to the ward's wishes, the plan will collapse in the first place. I don't want to think too much about the vaccine, but I would like to ask the country to avoid only the situation where the vaccine does not arrive. "

Inagi City, Tokyo

"It's like you're still solving a jigsaw puzzle that doesn't have all the pieces."



Some local governments preparing for vaccination say:

Inagi City, Tokyo, with a population of over 92,000.

Approximately 20,000 elderly people aged 65 and over were planning to give the second vaccination after completing the first vaccination, and were preparing to secure venues and medical staff.



However, at a briefing session held by the Ministry of Health, Labor and Welfare for local governments on the 25th, the second vaccination should be started before the first vaccination is completed, and a system should be established to receive the required two vaccinations in about three months. Etc. were requested.

For this reason, depending on the time of year, it was necessary to double the system of venues and medical staff from the original plan, so we decided to reconsider the system.



(Anxiety 1) Securing doctors One


of the issues is securing doctors.

Inagi City is in discussions with the local medical association, but the medical institutions in the city are already under pressure due to the spread of the new virus, and to increase the number of doctors in charge of vaccination, we will open our own clinic. This means that you may need to take measures such as having your doctor take a leave of absence.



(Anxiety 2) Cost burden is


also an issue.

The government says that it will bear all the costs of vaccinations incurred by local governments, but the maximum amount of subsidies etc. has not yet been shown.

For this reason, there is concern that the government will be able to provide compensation when the clinic is closed and responds to vaccinations.

In addition, while the timing of vaccine supply and the schedule of inoculation are not clearly decided, there is a current situation where preparations cannot proceed as expected due to fear of extra expense.



Satoshi Watanabe, chief of the Inagi City Health Division, in charge of the new coronavirus vaccine, said, "While the city's finances are already tight due to the new corona response, we are worried about proceeding with preparations in a situation where the plan is not clearly shown. I'm also impatient to see if I can really make it in time, including the coordination with the meeting. It's like continuing to solve jigsaw puzzles that don't have all the pieces. "

Tokyo Islands

Vaccination of the new coronavirus, which is also being prepared in the islands of Tokyo.

When I interviewed each local government, I could see the issues peculiar to remote islands.



(Issue 1) Securing doctors


First, we need to secure doctors.

Hachijo Town in the Izu Islands, which is about 280 kilometers away from Tokyo, has a population of about 7,000, of which about 3,000 are 65 years old or older, accounting for 40% of the total population.

The town wants to secure two or more doctors in charge for smooth vaccination, and is considering dispatching doctors from outside the island.

However, due to the spread of the infection, the number of passenger planes departing from and arriving at the island has decreased, and it is not possible to respond on a day trip, so the person in charge of the town said, "It is difficult to get a dispatch."



(Issue 2) Vaccine delivery


Vaccine delivery is also an issue.

Pfizer's vaccine, which the country wants to start inoculating healthcare professionals from the end of next month, is characterized by a large number of vaccinations per delivery unit of about 1000 times.

Also, if you store it at an ultra-low temperature of around minus 75 degrees Celsius and take it out of the freezer, you must inoculate it within 5 days.

Vaccines are to be transported "refrigerated" from the facility where the freezer is installed to other inoculation sites, but the Ministry of Health, Labor and Welfare said, "Even if there are special circumstances such as remote islands, the transfer time may exceed 12 hours. I can't. "

If delivered from a warehouse in Tokyo, the ferry travel time to Hachijojima is approximately 10 hours and 20 minutes.

It may take longer when considering loading on the ferry or transferring to the venue.

It is scheduled that the ultra-low temperature freezer for storage will arrive in Hachijo Town from the national government in March, so the Tokyo Metropolitan Government will consider delivery methods etc. in order to start vaccination of medical workers on remote islands according to the expected schedule. It means that you are doing it.



(Issue 3) Do you really inoculate?


Some say that it is difficult to predict how many people will actually want to be vaccinated in the islands, where the number of infected people is smaller than in urban areas.

The population of Oshima Town, 120 kilometers away from Tokyo, is about 7,500.

Approximately 2,800 people, or 30% of the total, are elderly people aged 65 and over, and we are proceeding with a plan to install a freezer, which is scheduled to arrive from the national government, at a hospital on the island for mass inoculation.

So far, seven people have been infected with the new virus in Oshima Town.

Since some residents are worried about the side effects of vaccines, it is difficult to calculate how many vaccines should be prepared.



Tetsuya Yoshizawa, chief of the Welfare Health Division in Oshima Town, said, "I would like the government to fully explain the safety of vaccines and their effectiveness in preventing the spread of infection to the residents of the islands."

Ministry of Health, Labor and Welfare "Carefully respond so that local governments do not get in trouble"

Regarding the preparation status of local governments for vaccination, the Ministry of Health, Labor and Welfare said, "I fully understand that the preparation status differs depending on the size of the local government and the actual conditions of the region. I asked them to plan according to the schedule shown as a guide, and the vaccine was released. I would like you to establish a system that allows you to inoculate as soon as it is supplied. We will carefully respond to individual consultations so that the local government will not be in trouble. "

Tokyo "Vaccine delivery to the islands is flexible"

Regarding the delivery of vaccines to the islands, the Tokyo Metropolitan Government is considering various methods such as subdividing the vaccine from the city center to each island and delivering it from some islands to the surrounding islands. He said, "I would like to work closely with the local governments in the islands and respond flexibly."