Informal Network of Communication Tools Played an Important Role in Sharing Safety Information on H1N1 Influenza Vaccine
when the MHLW’s prohibition against vaccinating people other than members of priority groups was unrealistic in clinics and hospitals. Under such pressures, clinicians and patients might have chosen to receive a shot instead of missing their chance and taking the risk of influenza A (H1N1) in addition to their underlying diseases. The MHLW made the vaccine that was dispatched on 29 January and thereafter available to all [10]. The circulation of vaccine available to all at the discretion of clinicians and vaccinees may partly explain the lack of deaths after March, together with the decreased number of vaccinees. The vaccine manufactured by Novartis and GlaxoSmithKline obtained regulatory approval on the basis of clinical trial data, but the vaccine made by Japanese manufacturers went through the routine process of strain change for the annual seasonal influenza vaccine, which did not require clinical data. The details of the approval process have not been revealed by the MHLW. The withdrawal of the MHLW’s interference in clinicians’ decisions regarding the administration of vaccines may save lives. We also recommend that a legal basis for a national vaccine program, including some type of regulatory approval process that can be implemented quickly in an emergency, be discussed in Japan. Acknowledgments