Watching out for mom & baby - a Japanese approach

Today I had the privilege of attending the National Vaccine Information Center's Fourth International Public Conference on Vaccination. Peter Doshi presented an informative look into the way the Japanese deal with mother and child health. From the time a pregnancy is confirmed, a woman is issued a Mother-Child Health Handbook in which to record information about her and the baby's health and development.

Into this boshi techo also go recordings of vaccinations. In fact, doctors will not give shots without the booklet in which to record them and to check on recent illnesses that might be contraindicated with getting a vaccine. The handbooks (and other information issued from the government) detail cautions about vaccines. They tell parents to reschedule vaccinations if the child has been ill (even in the last month) or has a fever, to plan for no strenuous activity that day, to pay attention the child all day the day of a vaccine and to make sure that someone who knows the child well is the one to take him or her to the doctor. The suggestion to take a child's fever before coming to the doctor in Japan contrasts sharply with information from the Centers for Disease Control's Parents Guide to Children's Immunizations that says that fever is "not usually a reason" to delay a vaccination.

Doshi, a doctoral candidate at MIT and visiting researcher (faculty of medicine) at the University of Tokyo, explained that since 1994, the Japanese have had a completely volunteer vaccination program in which recommendations have children getting about half the doses of vaccinations by age one that children in the U.S. typically receive. And, he explained, vaccines are always given only one at a time.

There is no school waiver or enforcement, and yet there is a high rate of vaccination. With a high expectation for product safety, the Japanese value vaccines and trust authority figures, but they seem to just have the whole different approach, Doshi's research showed. It seems that the Japanese embrace the idea of "first do no harm" and also of parents being expected to take an active role in paying attention not just to getting doses on time but to the whole context of health.

Yay for looking at the whole picture! Can we get some of that?