No, Japanese children are not healthier because vaccines are not mandatory in their country

An article shared thousands of times on Facebook claims that Japan “has the healthiest children on the planet” because vaccination is not mandatory in their country. This is false. Children in Japan are particularly healthy by international standards, but they are also one of the most vaccinated populations in the world.

“Japan has NO vaccine mandates, yet achieves the HEALTHIEST children in the world.” The headline was published on Natural News, a website that regularly publishes anti-vaccine articles. Within a few months, it was shared 16,000 times on Facebook in English, according to social media monitoring tool CrowdTangle. A similar claim also circulated in French.

Screenshot taken on January 13, 2020 of an article on Natural News

The Japanese law on vaccine

Vaccination has not been strictly mandatory in Japan since the mid-1990s. 

However, Japanese law on vaccines stipulates that all citizens “must endeavour to undergo a routine vaccination” against “category A diseases,” such as measles, mumps, rubeola, tetanus, etc. 

The law was amended in 1994 in order to make vaccination more of a civic duty than a strict legal obligation.

Screenshot taken on January 10, 2020

The Japanese health ministry also publishes specific recommendations regarding vaccines, and the requirements for organizing vaccination campaigns are also published by the ministry.

In practice, schools ask for children’s vaccination history as they apply.

Although there are no fines for not vaccinating children, vaccination rates are very high and frequently reach 100 percent of the population for certain diseases, according to the Japanese Health Ministry.

Certain figures top 100 percent because numbers are calculated by dividing the number of vaccinated individuals by those who were expected to get a vaccine on a given year. As a result, those who get vaccinated late or the following year can make the numbers exceed 100 percent.

Japan has some of the highest immunization rates in the world, according to the World Health Organization (WHO). The Natural News article, on the other hand, claims that Japan “has the lowest vaccination rate in the entire world.”

Japanese children, “healthiest on the planet”?

The Natural News article asserts that Japanese citizens enjoy the “highest healthy life expectancy” in the world. Healthy life expectancy at birth, as defined by WHO, is the expected life expectancy for a newborn if current death rates do not change.

According to the WHO, Japan has one of the highest healthy life expectancies, with an average of 74.8 years in 2016. Only the city-state of Singapore surpasses this, with an average of 76.2 years.

Japanese children are also some of the healthiest in the world. According to this October 2019 article from AFP, Japan manages to have “high scores for nutrition but very low obesity rates.”

More generally, according to the latest report on health from the Organization for Economic Co-operation and Development (OCDE), “Japan, Spain, Switzerland and the Netherlands generally have the best overall health outcomes.”

Lunch at a Yokohama school in Japan in 2016 (KAZUHIRO NOGI / AFP)

According to experts interviewed by AFP, school lunches explain Japanese children’s good health, with 600 to 700 calories balanced across carbohydrates, meat, and vegetables.

Child mortality in the USA linked to vaccination rate?

As the Natural News publication points out, child mortality for toddlers under one is particularly high in the United States, compared to other rich countries. 4.8 deaths for 1,000 live births in 2017, according to the OECD report on health. This is below the OECD average (3.5), while Japan has the lowest (1.7).

Immunization is mandatory in the US. The Center for Disease Control and Prevention (CDC) warns that “all states require children to be vaccinated against certain communicable diseases as a condition for school attendance.”

However, the CDC website adds, “all states provide medical exemptions, and some state laws also offer exemptions for religious and/or philosophical reasons.”

Vaccination rates in the United States are also high, though slightly lower than Japan’s in the case of children under one, except for measles.

As this CDC chart shows, the main causes of mortality for children under one in the United States are congenital anomalies, short gestation and maternal pregnancy complications. Not only are vaccines absent from the list, but, as UNICEF points out, immunization is precisely what allows child mortality to drop everywhere in the world.

Screenshot of a CDC chart

Other false claims on vaccines

The article further states that in Japan, “chronic illness is a rarity.” This is false. The WHO estimates that in 2016, more than a million Japanese individuals died prematurely due to a non-transmittable disease (cardiovascular and respiratory diseases, diabetes, or cancers for the most part). This represents 82 percent of all deaths. 

Moreover, chronic illnesses are unrelated to vaccines, which target infectious diseases that are contagious.

A child getting vaccinated for measles in the Samoa in December 2019 (RUDY BARTLY / AFP)

The article also mentions that the measles vaccination causes autism, a claim debunked by AFP Fact Check.

The MMR (Measles-Mumps-Rubeola) vaccine is a regular target for anti-vaccine movements. The United Nations has blamed anti-vaccine campaigns for the drop in vaccine coverage in the island nation of Samoa, which is currently the site of a deadly outbreak.

This article was translated from French by AFP Canada.