Changes in vaccination administration in Japan.

• The mass campaign carried out by the emergency import of OPV in 1961 achieved great results for polio control in Japan. • School influenza vaccination in the 1960–80 s was discontinued without adequate and proper evaluation. • The judgment by the Tokyo High Court in 1992 and the discontinuation of the use of the MMR vaccine in 1993 were attributed for the creation of the so-called 'vaccine gap.' • In the revision of the Immunization Act in 1994, a big change was added to individual vaccination by 'obligation to make efforts.' • From around 2010, efforts have been made to bridge 'vaccine gap' and establish the global standard in vaccination. This paper reviews the administration related to vaccination in Japan after the enactment of the Immunization Act in 1948, under which vaccination was implemented mandatory for the public. To enhance the effectiveness of vaccination activities, the government implemented group vaccination, which is convenient for vaccinating recipients all at once. In 1976, Japan established the relief system for health damage after vaccination. While some projects, such as the mass administration of live oral polio vaccine in 1961, achieved excellent results, incidents leading to health damage occurred, such as the diphtheria toxoid immunization incident (1948) and frequent occurrence of aseptic meningitis owing to the measles, mumps, and rubella vaccine (1989). In December 1992, the Tokyo High Court sentenced that the onset of health damage after vaccination could be attributed to the negligence of the national government. In the revision of the Immunization Act in 1994, the "mandatory vaccination" enforced until then was changed to "recommended vaccination." The Act was also changed to recommend "individual vaccination" in principle, which is performed after primary care physicians investigate the physical condition of individual recipients and carefully conduct preliminary examination. For approximately 20 years from the 1990s, a vaccine gap existed between Japan and other countries. From around 2010, efforts have been made to bridge this gap and establish the global standard in vaccination. [ABSTRACT FROM AUTHOR]