Immunization administration—paper questionnaires, paper vaccination certificates, and claim formats that differ by municipality—has long been a heavy burden for medical institutions. On June 1, 2026, the revised Immunization Act and related rules took effect, launching a mechanism to process this chain of work digitally: "Vaccine DX." This article organizes what changes, when it will affect your clinic, and how to design operations while paper remains in use.
Disclaimer: This article is general information. Post-enforcement operations, participating municipalities, and format details may change. In practice, always confirm the latest primary sources (MHLW, the Digital Agency, and your municipality's published materials).
For the overall map of Medical DX, see What Is Medical DX? The Government Roadmap and Its Three Pillars.
What Vaccine DX Changes
The basic idea is to enable the whole chain of immunization administration to be processed digitally rather than on paper. Three flows are covered.
| Task | Conventional | After digitization |
|---|---|---|
| Confirming eligibility | Check paper questionnaires and vouchers sent by the municipality | Electronic eligibility check via My Number Card |
| Completing and checking the questionnaire | Written on paper at the counter or at home | Entered in advance via Mynaportal (digital questionnaire) |
| Recording and certifying vaccination | Paper certificate, entry in the maternal and child health handbook | Vaccination record registered electronically; certificate issued electronically via Mynaportal |
| Cost claims and payment | Claims in each municipality's format | Claims and payment processed electronically |
The foundation for this is PMH (Public Medical Hub), which connects municipalities and medical institutions. Viewing Vaccine DX as the vaccination portion of PMH's covered areas makes it easier to place within the overall picture.
Key Points on Digital Questionnaire Operations
Questionnaires have the greatest frontline impact. In practice, understand the following.
Shorter Waits Through Advance Entry
Recipients (or guardians) can enter questionnaire content in advance via Mynaportal. Waiting to fill out forms at the counter disappears, and checking for omissions completes on screen. The more vaccinations a clinic handles, the greater the easing of reception congestion.
How Consent Is Handled
With digital questionnaires, the workflow adopted has the physician entering the recipient's verbal consent on their behalf. Because the treatment of what corresponds to a signature on a paper questionnaire changes, the procedure during consultation should be standardized across the clinic.
Paper Remains Usable
Importantly, vaccination and claims using paper questionnaires remain possible. Digital questionnaires can also be printed out and used on paper. Since this is not an all-or-nothing switch, design your reception flow on the premise that electronic and paper coexist for the time being.
The National Rollout Schedule
Vaccine DX does not start in all municipalities at once. It expands in stages from participating municipalities.
| Period | Expected situation |
|---|---|
| June 1, 2026 | Revised Immunization Act and related rules take effect |
| August 2026 | National operation begins, rolling out from participating municipalities |
| During FY2026 | Around 21 municipalities supported |
| During FY2027 | Around 49 municipalities supported |
| By April 2028 | Nearly all municipalities supported |
In short, a state persists for some time in which the system has started, but when it actually goes live in your area depends on your municipality. Not every institution nationwide must respond immediately.
Practical Steps for Clinics
1. Confirm Your Municipality's Timing
The top priority is understanding when your own municipality—and those where your main patients live—will go live. Check their published information and attend any briefings.
2. Design a Reception Flow for Both Electronic and Paper
Even after go-live, three patterns will coexist for a while:
- Patients who entered a digital questionnaire in advance
- Patients who printed the digital questionnaire and brought it on paper
- Patients using a conventional paper questionnaire
Deciding in advance how reception identifies which applies and routes each to the right procedure avoids confusion.
3. Confirm System Support
Electronically registering vaccination records and processing cost claims may require support from your EMR/rececon or immunization management system. Confirm your vendor's approach and timing.
4. Brief Staff Early
Vaccination is work coordinated across reception, nurses, and physicians. When procedures change, it is essential that all staff share the same understanding. Once your municipality's start date is set, hold an in-clinic briefing.
Expected Benefits
- Fewer omissions and transcription errors: advance entry and system checks reduce errors inherent to paper
- Visibility of vaccination history: recipients can check their own history via Mynaportal, helping prevent missed or duplicate doses
- More efficient claim processing: claims in municipality-specific formats are replaced by electronic processing
- Records carry over when families move: linkage across municipalities becomes possible
The last point addresses a problem that was previously hard to solve. Fewer cases of vaccination history being lost after a move also helps clinical decision-making.
With AI Karte
The AI-native EMR "AI Karte" supports vaccination schedule and record management, assisting clinics—pediatrics above all—that handle many vaccinations. We are examining our approach in light of how digitization progresses on the regulatory side, and we welcome consultations on adoption tailored to your immunization workflow.
Conclusion
Vaccine DX began with the June 2026 enforcement and the start of national operation in August. Because when your own operations change depends on your municipality's status, the starting point is confirming its schedule. Since paper operations will coexist for some time, designing a reception flow that handles both electronic and paper is the most practical preparation for avoiding frontline confusion.
Through providing AI Karte, Pottech aims to be the ideal business partner for clinics—improving the working environment for physicians, nurses, and medical clerical staff, and supporting clinics in fully realizing what they want to achieve.
For more details, please feel free to contact us.