TAIPEI (Taiwan News) — While Japan's donation of 1.24 million doses of AstraZeneca coronavirus vaccines to Taiwan demonstrates the close ties between the two nations, it also highlights the slow rollout of COVID-19 vaccines amid the rigid approval system and prevalent vaccine hesitancy in the third-largest economy in the world.

Since early February, Japan has received a portion of the 194 million Pfizer vaccines it has ordered, and 50 million more Moderna vaccines will arrive before the end of September. The country has also ordered 120 million vaccines from AstraZeneca, lifting its total vaccine count to 364 million doses, according to CNA.

However, because of a very low chance of blood clots, the Japanese government currently does not plan to inoculate its population with the AstraZeneca vaccine, which means the 30 million AstraZeneca doses the country has so far received are up for donation.

Even with all the doses it has, the vaccination rate in Japan remains low. As of June 3, only 9.21 percent of Japanese had received at least one jab of a COVID-19 vaccine after the country began vaccinating its health workers in February, followed by people over the age of 65 in April.

The country's widespread mistrust of vaccines and lengthy approval process have been the major hindrances to its vaccine rollout.

Although Japan launched its mandatory vaccination scheme in 1948, the severe side effects connected to several vaccines in the 1980s, especially the measles, mumps, and rubella (MMR) vaccine introduced in 1989, sparked panic in society and led to class-action lawsuits against the government.

Among the 1.8 million newborns inoculated, the triple jab was suspected of introducing a record number of aseptic meningitis cases and other adverse reactions. Then, a 1992 court ruling made the government responsible for any adverse reactions related to vaccines, including suspected side effects, which damaged the government’s motivation to roll out more effective modern vaccines in the following decade.

After Japan's National Immunization Program withdrew its recommendation for the MMR vaccine in 1993, the country became one of the few developed nations that still deal with recurrent rebulla outbreaks.

The rooted hesitancy also caused the HPV vaccination in 2013 to fail when the government tried to inoculate female students between 12 to 16 years old with free jabs. After media coverage of the vaccine’s possible side effects, including severe headaches and seizures, the health ministry withdrew its recommendation, and the vaccination rate tanked from 70 percent to less than 1 percent.

"When I was in high school, every girl could get free HPV shots, but it was reported some people had terrible reactions after the vaccination, so I gave up," said Kana Komukai, a 26-year-old Japanese working in Taipei. "I am so afraid of getting vaccines. In Japan, people don't usually fully understand the side effects of vaccination."

The change of policy has put tens of thousands of Japanese women at risk of contracting cervical cancer and other HPV-related diseases down the road.

The introduction of new vaccines in Japan has been slow and cumbersome: In order to approve the vaccine for use in the country, Pfizer began its trial of 160 volunteers in Japan last October, which is considered to have been "meaningless" because of the small size, Takahiro Kinoshita, a Japanese researcher based in Boston, told Reuters.

At the end of May, the daily number of vaccinations had reached 500,000 in Japan, according to Kyoto News. At the current rate, the news agency suggested that even if about 1 million people daily might be able to receive doses from mid-June, it is unlikely the government will hit the goal set by Japanese Prime Minister Suga Yoshihide to vaccinate 3.6 million seniors by the end of July.