Teikyo University Graduate School of Public Health
Japan used to be one of the measles endemic countries that even exported measles to other countries including Canada and USA. Based on the Immunization law, measles vaccine was provided only once to the children aged 12-90 month until 2006 when two dose policy was introduced. Japan experienced several outbreaks, one of which occurred during 1999-2001. At that time, the number of estimated measles patients was approximately 100,000-200,000. Until 2015 when Japan was certified as measles-eliminated country, Japan conducted several national campaigns to decrease vulnerable cohorts. For example, giving vaccine to children soon after the first birthday was ended with a level of success, decreasing the younger cohort around 0-1 years old. Catch-up campaign with five-year time limit was also conducted targeting junior-high and high school students in 2008. A program was also conducted to promote vaccine history checking in primary school entry. These kinds of efforts worked well enough to decrease the local measles epidemics and result in measles elimination certification in 2015. However, Japan faces local epidemic every year; Osaka (2016), Yamagata (2016) and Okinawa (2018). We found that there exists three common points. First, the index case imports measles from foreign countries. Second, they spread measles with long distance travel on public transportations including air plain or Shinkansen bullet train. Finally, seeing from the age cohort, age 20-30s were the main epicenter cohorts that were left over for above-mentioned campaigns. This is Japan’s great challenge to address the left over cohorts.
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