A system that respects the judgment of doctors is needed for the timing of vaccination
The third dose of the new coronavirus vaccine began to be administered to medical personnel on April 1.
The Ministry of Health, Labor and Welfare (MHLW) has decided to make an exception for the third vaccination only for hospitalized patients, facility users, and staff of medical institutions and elderly facilities where clusters have occurred, based on the principle that “at least eight months have passed since the completion of the second vaccination. However, Prime Minister Fumio Kishida made an exception to this rule, saying that the interval between the third vaccination and the first vaccination could be shortened to six months.
However, Prime Minister Fumio Kishida stated in his policy speech at the extraordinary Diet session on March 6 that he would bring forward the third round of vaccinations as much as possible without waiting eight months. On March 17, he announced that he would bring forward the third vaccination to six months after the second one for medical personnel and elderly people, including 31 million medical personnel and residents of elderly facilities who are at high risk of serious diseases. For other elderly people, the period will be shortened to seven months from February next year.
After Prime Minister Kishida’s speech on March 6, Minister of Health, Labor and Welfare Shigeyuki Goto said at a press conference, “Vaccines are imported sequentially, and it is difficult to move up the vaccination interval for the entire population at present. The fact that Prime Minister Kishida has narrowed down the target to medical personnel and 31 million elderly people suggests that he does not foresee the possibility of securing enough vaccines to cover the entire population ahead of schedule.
So what is the appropriate way to move up the vaccination schedule with vaccines that are available?
Professor Yukio Osawa of the University of Tokyo’s Graduate School of Engineering, a member of the Cabinet Secretariat’s “COVID-19 AI/Simulation Project” research and development team, who was interviewed by this site in September about the need for a third round of vaccinations, had this to say about the vaccination system Professor Yukio Osawa of the University of Tokyo’s Graduate School of Engineering, a member of the COVID-19 AI and Simulation Project research and development team, made the following recommendation regarding the vaccination system
It would be better to leave the decision of who to give the third vaccine to and when to give it to the medical staff.
I should warn you that Dr. Osawa is not a medical professional. He specializes in “simulation using data and computational models,” and as he puts it, “I am not an expert on viruses or vaccines themselves. He is working on a project for the Cabinet Secretariat to simulate the spread and control of infection in society as a whole. They have presented the results of a simulation comparing the third vaccination six or eight months after the second vaccination and the method in which doctors determine the timing of additional vaccinations for each individual.
I asked Dr. Osawa again about the most effective way to administer the third dose.
One of my collaborators, Dr. Morihito Takita of Navitus Clinic, who is involved in vaccination in the medical field, said that it is possible for medical personnel to decide the timing of vaccination at their own discretion, based on the subject’s medical history and interview. Dr. Morihito Takita of the Navitus Clinic, who is in charge of vaccination, says that it is possible for medical professionals to decide the timing of vaccination at their own discretion, based on the subject’s medical history and interview.
If the third round of vaccination is to be moved up, I think the method of letting the doctor make the decision is even more effective. This is because it is possible to narrow down the target group for priority vaccination and achieve the best infection control effect with a limited supply of vaccine.
Vaccination in the workplace for those who act as “bridges between communities”.
Dr. Takita divides the “priority targets” for vaccination into the following three categories.
- (1) Immunosuppressed drug users
- (2) Elderly people, cancer patients, chronic kidney disease, obstructive pulmonary disease, emphysema, diabetes, people with frequent asthma attacks, and smokers.
- (3) People who come into contact with an unspecified number of people.
Dr. Takita said that for people in (1) and (2), depending on the degree of immunosuppression and medical conditions, he would recommend a third dose starting two months after the second vaccination. As for (3), Dr. Takita said that he would consider additional vaccinations depending on the person’s situation based on the interview.
What kind of job or position does “people who come into contact with a large number of unspecified people” in ③ refer to, for example?
For example, what kind of job or position does “a person who comes into contact with a large number of people” mean? For example, a doctor, an administrative staff member of a hospital, or a person who works in a hospital. For example, doctors and administrative staff at hospitals, people in contact with people outside the company and sales representatives at companies, faculty members and administrative staff at universities, and counter staff at city and ward offices.
If the third vaccine is given to these people on a priority basis, the infection will not spread from community to community. Since the network is divided, the spread of infection can be effectively controlled.
However, it is probably unlikely that people in this position will be eligible for priority vaccination. But it’s unlikely that people in such positions will be eligible for priority vaccination, so we’ll have to wait for local governments to start administering the third dose.
I believe that occupational vaccination will become more important.
According to the Ministry of Health, Labor and Welfare’s website, the number of venues for the first and second inoculations at work is 4,045. However, as of December 20, the number of sites applying for additional vaccinations was 1,675, and since the supply of vaccines for the first and second vaccinations could not keep up with the demand, the government suspended accepting applications for occupational vaccinations, which delayed the vaccination process and caused confusion in the field. Apparently, some companies and universities are considering applying for additional vaccinations.
If your workplace doesn’t offer occupational vaccinations, the only option is to apply for municipal vaccinations as soon as possible if you think you are a bridge between communities.
In any case, it is too late for people other than the elderly to get their third dose eight months after the second.
Resuming “GoTo Travel” at a time when the third round of vaccinations is not yet underway is a bad idea!
By the way, the secretary general of the Liberal Democratic Party, Toshimitsu Mogi, said on January 13 that the party is considering restarting the suspended GoTo Travel program at the end of January next year, before the third round of vaccinations begins in earnest. I don’t know.
I think it’s a bad idea. I think it’s a bad idea, because it increases the chance of coming into contact with strangers outside of the community you normally interact with.
Based on the “stay with community” concept that I have been advocating for a long time, if you have more contact with people outside of your community than with people inside your community, it will lead to an infection explosion. If you only have contact with people you know in your community, at some point there will be a saturation point where a certain number of people in that group will be infected, but no more, and the virus will not spread outside the community. On the other hand, if the contact with people outside the community exceeds a certain level, the virus will move to the other community and spread. This is the most important factor that causes an infection explosion.
Dr. Osawa advocates a “stay-with-community” lifestyle, in which people take care of their own communities, such as family, friends, and co-workers, and avoid as much as possible contact with people outside of those communities. His guideline for his community is “people I see at least once a week,” and he considers the rest to be people outside his community.
Based on this guideline, I would say that most of the people I come into contact with in my travels are outside my community.
In particular, if a large number of people travel by GoTo Travel when vaccination is not yet advanced and the speed of vaccination is very slow, it may trigger the spread of infection. However, if the vaccine is being administered at a certain speed, the number of newly infected people may even be suppressed as the distribution of vaccine among prefectures is equalized by the movement of people between prefectures. In other words, when people are getting more and more vaccines, it is not necessarily a risk to move from one prefecture to another, but there is an advantage to having vaccinated people distributed evenly across the country.
Some people may wonder why the number of infected people is so low at the moment, but the factors I just mentioned are probably the main reasons. I believe that they may be kept in check not only by vaccination, but also by the uniformity of the speed of vaccination and by reducing the ratio of contact with people we don’t normally meet, even if the human flow increases.”
Could it be that the government should have implemented GoTo Travel in October-December?
Maybe. But the reality is that in January, when the government is planning to resume GoTo Travel, very few people will have received their third dose. It is indeed a bad idea to reopen it at that time, in my opinion.”
I am sure there will be people who are looking forward to the reopening of the GoTo in January. However, if you are going to travel, it may be better for the world to do so after the third round of vaccinations.
Yukio Osawa is a professor at the Department of Systems Innovation, Graduate School of Engineering, the University of Tokyo. born in Kyoto in 1968, he received his Ph. He has been in his current position since 2009. He specializes in system design, knowledge engineering, and business science. His research interests include opportunity discovery, innovation markets based on data jackets, and data visualization and valorization.
He is the author of several books, including “Future Salesmanship Discovery” (edited and published by Diamond Inc.), “Business Chance Discovery Technology” (Iwanami Active Shinsho), “Innovation Idea Technology” (Nihon Keizai Shimbun Publishing Inc.), and “Data Market” (Modern Science Inc.).
Interviewed and written by： Sayuri Saito Photo： Afro