We would like to announce that the following three administrative notifications regarding countermeasures against COVID-19 in schools issued by MEXT.
Contact:
The Office for a Professional Platform of Health and Hygiene Environment in Schools for Foreign Students provided by MEXT
TEL: 050-3187-8114 (a multilingual consultation service)
Email: hsfs@mediphone.jp
Points regarding the Implementation of Vaccinations
for Infants and Children against COVID-19 Infections in Schools
We would like to inform you that the Health Education and Shokuiku Division, Elementary and Secondary Education Bureau has released the attached notification on September 6, 2022.
We are sharing this announcement with you with the hope that it will be utilized as a reference for your consideration of your responses to COVID-19.
To Prefectural miscellaneous category school departments: Please send this notification to the miscellaneous schools for foreign students under your jurisdiction.
To JCIS and AEBJ: Please send this notification to members of your council or association.
（Attachment）
Points regarding the Implementation of Vaccinations
for Infants and Children against COVID-19 Infections in Schools
MEXT
Elementary and Secondary Education Bureau,
Health Education and Food Education (Shokuiku) Division
Pursuant to the partial revision of the Cabinet order on Implementation of Immunization Law (No. 197, 1948), the obligation to make efforts for children under 12 to be inoculated with the COVID-19 vaccine becomes applicable, and pursuant to the partial revision of
Ministry of health order on Practical Implementation of the Immunization Law (No.27, 1958), approval has been granted for children aged 5 to 11 to receive a third COVID-19 vaccination.
We have announced the basic thinking and points for consideration regarding COVID-19 vaccinations for children in “Points regarding the implementation of vaccinations for infants and children against COVID-19 infections in schools” (Joint notification, February 21, 2022, Health Education and Shokuiku Division, Elementary and Secondary Education Bureau, MEXT; counselor, Children and Child-Rearing Headquarters (in charge of accredited early childhood education and care centers), Cabinet Office; Children and Family Affairs Bureau, Childcare Division, MHLW; Immunization Office, Health Division, Health Service Bureau, MHLW). Based on this revision, we would like to inform you of the points regarding the implementation of vaccinations for infants and children against COVID-19 infections in schools as below.
This administrative notification has been prepared based on the current scientific findings.
If new information and findings should be obtained, the notification may be revised.
《…》
1. Points regarding mass vaccinations at schools
Vaccinations against COVID-19 is supposed to be administered individually at medical institutions, etc. or at mass vaccinations at special locations set up by municipalities, towns, and villages.
Concerning the vaccinations for students, at present, the conducting of mass vaccinations at schools for students enrolled at those schools (hereinafter, “school mass vaccinations”) is not recommended due to the scarcity of opportunities for explanations to parents, the tendency for the creation of peer pressure without necessarily respecting individual dispositions towards vaccinations, and the difficulty of providing fine care to students showing physical problems after receiving the vaccination.
However, if the local municipality, town, or village, the administrators of the vaccinations, needs school mass vaccinations due to the particular situation in the locality, such as the difficulty for conducting individual vaccinations, school mass vaccinations can be conducted as long as sufficient attention is paid to the following points and appropriate measures are taken.
Based on the fact that the effectiveness of vaccinations against COVID-19 for children aged 5 to 11 has been confirmed for preventing hospitalization even during the spread of the Omicron variant, the obligation to make efforts to receive a vaccination now applies for children of that age range; however, since there has been no change in the policy that receiving a vaccination is strictly subject to the decision by the person involved and the person’s parents, please continue to take note of that fact so that vaccinations do not become de facto coercion.
(1) Provision of information to students and parents, obtaining parents’ approval, and ensuring parents’ accompanying of children
-Since it is important that explanations should be provided to students and parents about the effects of the vaccines and possible side effects and that information regarding contacts for consultation should also be made available so that they will be able to decide by
themselves about vaccinations, municipalities, towns, and villages should devise ways of providing information carefully to students and parents. In that case, municipalities, towns, and villages should also respond to questions about the vaccination by establishing a consultation service etc.
-In particular, when conducting vaccinations for students under 16, municipalities, towns, and villages should carefully provide information to parents and obtain their consent for the vaccination.
-Concerning vaccinations for students of elementary-school-age and younger, even if parents sign the parental consent column in the pre-vaccination questionnaire form, parents, relatives or other appropriate person need to accompany their children to the vaccination site.
Reference: Handling parents’ consent and accompanying children to vaccination In the case of vaccinations of students under 16, in principle, parental consent for the vaccinations and parents’ accompanying their children to the vaccination site are necessary.
Regarding parental consent, parents should always confirm their consent by signing the pre-vaccination questionnaire form. However, for junior high school students and older, as long as the parents’ consent can be confirmed by their signature in the parental consent
column in the pre-vaccination questionnaire form on the day of the vaccination, vaccination administrators can eliminate the requirement for parents to accompany their children.
In such cases, in addition to obtaining a means of contacting the parents, at the time of the vaccination, in order to confirm whether the person to be vaccinated is suitable or not for vaccination, or needs some special attention for a vaccination, the administrator should interview the student concerned regarding the contents of the responses to the questions
on the pre-vaccination questionnaire form. If necessary, it should contact the parents so as to conduct a further examination to confirm the facts related to any conditions unsuitable
for the student to receive a vaccination.
In case a parent cannot accompany the student to the vaccination site due to an exceptional reason, a relative or other appropriate person who is familiar with the health condition of the student may be entrusted by the parent to accompany the student. In such a case, if it is required at the medical institution or special location administering the vaccination, a request may be made for the submission of a letter authorizing the said relative’s accompanying of the student. (Guidelines regarding the administration of COVID-19 vaccinations [9th edition]).
(2) Preventing the de facto coercion for vaccinations
-Municipalities, towns, and villages should not conduct mass vaccinations at schools during time periods when classes and other educational activities are being carried out.
-From the viewpoint of taking due consideration of students and parents who do no not desire a vaccination, when conducting school mass vaccinations, municipalities, towns, and villages should devise measures for reducing the psychological burden on students and parents when deciding whether to seek vaccinations by setting vaccination dates and times after regular school hours, on holidays, or during long vacation periods.
(3) Preparation of systems that can handle mass vaccinations
-In collaboration with local doctors’ associations, medical institutions, etc., municipalities, towns, and villages should prepare appropriate systems that can handle the numbers of students targeted for the vaccinations. In particular, they should take all possible measures for providing follow-up observations after the vaccinations, systems for providing first-aid, contact measures, and emergency care in case of the appearance of side effects or adverse effects. In addition, administrators need to secure appropriate staff for confirming the pre-vaccination questionnaire forms and diluting and filling the vaccine vials.
- For ensuring an adequate vaccination system to handle a large number of students, administrators need to prepare appropriate systems, including not only calling on school doctors but also securing medical practitioners, and securing emergency medical supplies, and so on.
- It is conceivable for teachers and staff at schools where mass vaccinations will be administered to distribute pre-vaccination questionnaire forms, etc., but it should be clarified beforehand what kinds of duties teachers and staff should be involved in for the
mass vaccinations. However, the execution of duties that could obstruct the conducting of educational activities and create an excessive burden on them for the operation of the school should not be required of teachers and staff.
(4) Dealing with Immunization Stress-Related Responses (ISRR)
- Due to stress from anxiety and fear arising before and after vaccinations, reactions called the Immunization Stress-Related Responses (ISRR) may occur, as typified by acute stress reaction (particularly vasovagal reaction), at the time of the vaccination.
- Since ISRR can readily occur particularly during adolescence and may be caused by a chain reaction among students who are affected by the reaction of other students nearby, it is necessary to prepare an environment where students can be vaccinated in a calming atmosphere and to prepare measures in case of an emergency.
2. Handling school attendance during vaccination periods
(1) Handling attendance when students receive vaccinations at medical institutions
In cases when, for example. it is difficult for a student to select a designated day or location for a vaccination at a medical institution or a long time is required to go to the vaccination location, the school principal (including the kindergarten principal, considered the same below) may handle the case flexibly by deciding that absence for a vaccination is equivalent to the case of a student being absent from school due to a reason such as a natural disaster, etc. that cannot be attributed to the responsibility of the student or parent, and that non-attendance may therefore be permitted; the student shall not be marked absent by recording that the non-attendance is included in the “days for suspension of attendance, bereavement, etc.” in the student’s attendance record.
(2) Handling absences of students showing vaccination side effects
If students show cold symptoms like fever, etc. after a vaccination regardless of whether it is a side effect, steps may be taken to consider an absence as a “suspension of attendance,” in accordance with provisions in Article 19 (including cases of application of relevant mutatis mutandis) of the School Health and Safety Act. In case the symptoms are other than those of a cold like a fever, the student and parents should be asked about the student’s condition, and the school principal or head of the facility should decide an appropriate response.
3. Handling vaccination history
So as not to lead to coercive vaccination, municipalities, towns, and village and schools should not make a COVID-19 vaccination conditional for students’ participation in school events.
At the same time, however, in cases where the necessity arises for ascertaining students’ vaccination history for some reason in the students’ practical training, it will be important to give sufficient consideration to the handling of such information as personal information by making clear the aim for obtaining the information, gaining the consent of the students and parents, and taking measures to obtain the information without disclosing it to other students. In other cases as well, it is possible that the COVID-19 vaccination history will need to be obtained for health questionnaires, etc. required for health examinations; in such cases, sufficient attention should be paid in the same way to the handling of this information as personal information.
4. Prevention of discrimination and bullying
In order to prevent the occurrence of discrimination or bullying resulting from receiving or not receiving a COVID-19 vaccination, schools should:
• Not coerce students into getting vaccinated
• Not allow students to coerce other students around them to receive vaccinations
• Inform students that some people are unable to get vaccinated due to physical or other
reasons or do not want to receive vaccinations and that their decisions should be respected; moreover, the understanding of parents should also be sought.
In addition, municipalities, towns, and villages should establish consultation services regarding discrimination or bullying tied to COVID-19 vaccinations.
5. Providing information about COVID-19 vaccinations
For conducting the COVID-19 vaccinations, it will be important to provide adequate information to the public regarding the effects and side effects of the vaccines, consultation service contact about the vaccinations so that they can make informed decisions by themselves about the vaccinations.
Health Service Bureau, Ministry of Health, Labour and Welfare has sent the attached materials (in Japanese1 ) for parents, etc. regarding the administration of 3rd dose of the vaccinations against COVID-19 to students aged 5 to 11 to the hygiene departments of prefectural governments, municipalities, towns, and villages, and special districts. Depending on the local situation, we ask that school establishers and others provide the necessary cooperation to respond to the requests of the local hygiene departments so that parents wishing for it can obtain necessary information through the provision at locations like schools, community centers, and other locations easily accessible to parents, the websites of the board of education or the school or through school networks, etc. We ask that the provided materials receive the necessary editing to specify the local contact points, and so on at the hygiene departments so that parents can contact and consult them.
Reference 1: Points regarding COVID-19 vaccinations for children
The websites below provide professional points, findings, etc. regarding COVID-19 vaccinations for children.
o Japan Pediatric Society
Points of underlying diseases of children as related to vaccinations against COVID19, and underlying diseases of children that should be considered
when vaccinating (Committee on Immunization and Infectious Diseases,Japan Pediatric Society, February 14, 2022 [revised August 17, 2022])
1 Please refer to https://www.mhlw.go.jp/content/000986862.pdf
URL: http://www.jpeds.or.jp/modules/activity/index.php?content_id=409
• Points regarding vaccinations against COVID-19 for children aged 5 to 17(Committee on Immunization and Infectious Diseases, Japan Pediatric Society,August 10, 2022)
URL：http://www.jpeds.or.jp/modules/activity/index.php?content_id=451
o Japan Pediatric Association
• Vaccinations for children aged 5 to 11 (Japan Pediatric Association, January 19,2022)
URL：https://www.jpa-web.org/blog/sharp8000/a275
Reference 2: Immunization Stress-Related Responses (ISRR)
Immunization Stress-Related Responses (ISRR) were identified by a World Health Organization (WHO) experts team; in December 2019, the WHO published a manual regarding ISSR.
URL：https://apps.who.int/iris/handle/10665/330277