This is the only industrialized country that does not vaccinate twice, an expert says.

The situation surrounding measles in Japan is ``miserable'' because of mistaken beliefs, lack of awareness and a low vaccination rate, according to an Asahi Shimbun survey and medical experts.

Many Japanese believe that one measles vaccination is effective for life, but pharmacologists warn that the shots are effective for only five to 10 years.

Of the 60 prefectural governments and major cities around the country contacted by The Asahi Shimbun for its survey, health officials in 31 governments reported instances in the past five years of people developing measles even though they had been inoculated as infants.

The patients ranged from elementary school children to young adults, the survey showed.

A measles outbreak occurred at an elementary school in Iwatsuki, Saitama Prefecture, in April and May 2002. Of the 54 patients, 36 had been vaccinated, city authorities found.

The city of Chiba found that 46 of 134 measles patients between June and September had been vaccinated in the past.

Most likely, the problem is that the patients had received shots only once, not twice as is the norm in other countries.

``Among industrialized nations, Japan is the only one that does not vaccinate twice,'' said Tatsuo Kato, professor of pediatrics at St. Marianna University School of Medicine.

According to the Centers for Disease Control and Prevention in the United States, more than 150 nations have adopted the two-vaccination system.

In the United States, the first shot is administered to children 18 months old and the second when a child is 3 or 4 years old.

Another problem is the relatively low rate of children who get even one measles vaccination. An estimated 80 percent of Japanese children receive the shots, compared with close to 100 percent in the United States.

Japanese health statistics show that only about half of all 12-month-olds had been vaccinated in 2001.

``The circumstances surrounding measles in Japan is miserable and the vaccination rate is not sufficiently high,'' Kato said.

Every year, between 100,000 and 200,000 people in Japan contract the disease and 20 to 30 patients die.

In 2001, when a widespread measles epidemic broke out in Japan, about 80 people died, including those who developed pneumonia or encephalitis.

Japan's reaction to measles outbreaks is also woeful. The World Health Organization, in a survey of nations around the world, put Japan in the worst of three categories in terms of ability to contain a measles outbreak.

Experts say such epidemics could be prevented if children receives inoculations twice.

Previously, the antibody created from measles vaccination replicated itself whenever the carrier was exposed to the disease. But exposure to measles has decreased as the number of cases of the disease has fallen. Therefore, the antibody simply wears off.

Experts also note that vaccines produced in Japan are less effective than in other countries because Japanese drug makers try to minimize side effects. In addition, different types of measles viruses are increasing, and vaccines simply do not work for around 3 percent to 5 percent of people, they say.(IHT/Asahi: November 29,2003) (11/29)