COVID-19 in 2025: Vaccine Boosters and Healthcare Updates for Expats
COVID-19 is no longer an emergency in Japan, but it has not disappeared. This guide explains 2025 booster recommendations, which vaccines Japan is using now, how costs work, and what expats should know about testing, isolation, and getting care in English.
Disclosure: This post may contain affiliate links. We may earn a commission at no extra cost to you if you make a purchase through these links. Read full disclosure.
COVID-19 in 2025 – what has changed, what has not
Globally, COVID-19 has shifted from crisis to “ongoing health issue”. In May 2023, the World Health Organization (WHO) declared that COVID-19 was no longer a Public Health Emergency of International Concern, but stressed that the virus still poses a health threat and needs long-term management.
Japan made a similar shift. On 8 May 2023, the government reclassified COVID-19 as a Class 5 infectious disease, the same category as seasonal flu. This ended most special restrictions and emergency measures and moved COVID-19 into the “normal” health system, with local clinics and hospitals taking the lead.
For expats in 2025, this means:
- No routine testing or vaccination is required to enter Japan.
- COVID-19 care is handled like other respiratory infections through regular clinics and hospitals.
- Vaccination has moved from “everyone, for free” to a more targeted booster system, especially for older adults and high-risk groups.
If you are new to the system, it helps to first read Japan’s National Health Insurance: What You Need to Know and Vaccinations and Health Check-ups for Expats in Japan.
COVID-19 in Japan today: the 2025 picture
Japan has kept overall COVID-19 deaths relatively low compared with many Western countries, helped by high mask use, strong healthcare capacity, and good vaccine uptake. One analysis found only 7.3 deaths per 100,000 people in 2020–2021, versus 130.6 per 100,000 in the US.
Vaccination coverage is high:
- By April 2024, about 80% of the population had at least one dose, nearly 80% had two doses, and roughly two-thirds had received at least three shots.
- Among people aged 65 and older, over 95% completed the initial series, and many have received multiple boosters.
Even so, COVID-19 continues to cause seasonal waves, particularly in autumn–winter, and hospitalizations still cluster in older adults and people with chronic illness. Modeling and surveillance from 2023–2024 show that booster campaigns for adults, especially seniors, can significantly reduce hospitalizations and deaths.
COVID-19 vaccine boosters in Japan in 2024–2025
Which vaccines is Japan using now?
Japan has approved several COVID-19 vaccines, including Pfizer-BioNTech, Moderna, AstraZeneca, Janssen, Novavax, and a domestic mRNA vaccine by Daiichi Sankyo.
In 2023 and 2024, the government shifted to variant-adapted boosters:
- A monovalent XBB.1.5-adapted mRNA vaccine (Daiichi Sankyo DS-5670) was contracted for the autumn 2023 program.
- Japan became the first country to approve a self-amplifying mRNA vaccine (Kostaive) and planned to use it in the October booster campaign.
- In May 2024, a health ministry panel recommended updating vaccines to target the JN.1 Omicron family for the 2024/2025 season, and supply of about 32 million updated doses is expected for fall–winter 2024/2025.
These updated shots are designed to match the variants currently circulating and to give better protection against severe disease.
The Ministry of Health, Labour and Welfare (MHLW) continues to state that approved vaccines are effective at reducing infection and especially severe illness, and their safety is monitored through national systems.
Who is recommended to get a booster in 2025?
Japan and WHO now treat COVID-19 vaccination like other routine adult vaccines: the focus is on those at highest risk. Recent reviews and policy documents emphasize:
- Adults 65 and older
- Adults 60–64 (and sometimes younger) with serious underlying conditions such as heart, kidney, or lung disease, diabetes, obesity, immune problems (including HIV), or cancer
- Healthcare workers and staff in elderly care facilities
- People of any age who live with or care for someone at high risk
From fall 2024 onward, these groups are being moved into Japan’s “routine” vaccination schedule for COVID-19, similar to flu or pneumococcal vaccines.
You may also be offered a booster if:
- You are an adult with frequent close contact with many people (e.g., in customer-facing jobs)
- You are planning travel, or live with a newborn or elderly person
- You received your last COVID-19 vaccine or infection more than 6–12 months ago (exact timing depends on local policy)
Because details differ by municipality, always check your local city or ward website, or call the helpdesk listed on your vaccination voucher.
Are boosters still free for expats?
This is where things can be confusing. Different sources say different things, because the system changed in 2024.
- For several years, all residents, including foreign nationals with valid residence status, could get COVID-19 vaccines free of charge under a special program funded by the central government.
- From April 2024, this universal free scheme ended and responsibility moved more into the regular national immunization program and local budgets. Studies note that cost has become a barrier to vaccination for some groups.
- High-risk groups (especially older adults and certain medical conditions) remain eligible for publicly funded boosters, often with little or no out-of-pocket payment. However, younger, healthy adults may need to pay part or all of the cost depending on their municipality or clinic.
For expat residents, the safest assumption in late 2025 is:
- If you are in a priority group and receive a vaccination voucher, your booster will probably be free or heavily subsidized at designated venues.
- If you are not in a priority group but still want a booster, you may be able to get one at a private clinic, but fees can apply.
Always check:
- Your municipal information letter or postcard
- The city or ward website
- The staff at your local city office
Articles like Vaccinations and Health Check-ups for Expats in Japan and Private Clinics and Out-of-Pocket Healthcare Costs in Japan explain how these programs usually work for foreigners.
Where and how expats can get a COVID-19 booster
For residents with a visa
If you are a medium- or long-term resident with a residence card:
- Watch for a vaccination voucher from your city or ward office.
- Follow the instructions to book online, by phone, or at a local clinic.
- Bring your voucher, residence card, and health insurance card to the appointment.
Large cities often list multilingual information pages, and the national MHLW site has a multilingual COVID-19 information hub in English, Chinese, and “easy Japanese”.
If you prefer care in English, you may choose an international clinic instead of the mass vaccination centers. Finding English-Speaking Doctors in Japan and Telemedicine in Japan: Remote Healthcare Options are good companions to this guide.
For short-term visitors and tourists
Short-term visitors are not usually included in local vaccination programs. If you need a booster while traveling, your options are:
- Ask a large private clinic or international hospital if they can vaccinate you as a self-pay patient.
- Consider getting vaccinated before travel, in your home country.
Tourists should focus on good travel insurance and know how to access care if they get sick; see Navigating Emergency Medical Services in Japan (Dial 119, ER Tips) and Travel Insurance and Healthcare Tips for Visitors to Japan.
COVID-19 vaccine boosters at a glance
Below is a simplified overview of how boosters typically look in 2025. Exact rules vary by municipality and may change, but this table gives you a starting point based on current research and government guidance.
| Group (Resident in Japan) | Typical Booster Timing (2024–2025) | Likely Cost Situation | Where to Get It | Notes for Expats |
|---|---|---|---|---|
| Age 65+ | Once per year, mainly autumn–winter | Usually free or heavily subsidized | Mass venues, local clinics, some hospitals | High priority; watch for vouchers. |
| Age 60–64 with serious underlying conditions | Once per year, coordinated with flu shot | Subsidized as “routine” vaccination | Designated clinics and hospitals | Check with your specialist. |
| Adults under 60 with chronic conditions | Recommended; timing decided with doctor | Partly funded or self-pay, depends on city | Primary care clinic / hospital | Ask your regular doctor about coverage. |
| Healthcare workers and care home staff | Annual or per workplace policy | Usually covered by employer or public funds | Workplace programs, contracted clinics | Check internal guidelines. |
| Healthy adults under 60 | Optional booster based on personal risk | Often self-pay unless city subsidizes | Private clinics, some municipal programs | Good idea if you live with high-risk family. |
| Short-term visitors / tourists | Only at some private clinics as self-pay | Fully self-funded | International clinics in major cities | Better to vaccinate before travel if possible. |
If you get COVID-19 in Japan in 2025
Testing options
Because COVID-19 is now “normal” in the system, testing is also more flexible:
- Antigen self-test kits: Government-approved rapid antigen kits are widely available at pharmacies and some convenience stores. They give results in about 15–30 minutes.
- Clinic or hospital tests: If you have high fever, breathing problems, are pregnant, or have chronic disease, a clinic can perform a professional antigen or PCR test and examine you at the same time.
Pharmacies in Japan: Buying Medicine Over the Counter and How to Use an English-Speaking Pharmacy in Japan walk through how OTC testing and medicines work for foreigners.
Isolation and “stay home” guidance
With the move to Class 5, strict legal isolation rules ended, but the government still gives clear advice:
- People with COVID-19 shed virus for about 7–10 days after symptoms start.
- The risk of infecting others is highest in the first 5 days.
Because of this, MHLW recommends that:
- You avoid going out for about 5 days after symptoms begin or after a positive test.
- If you must go out after that, you wear a mask, avoid crowded places, and stay away from high-risk people until at least 10 days have passed.
These are guidelines, not fines or policing. However, following them is a sign of respect for others and matches Japan’s social norms.
When to see a doctor or call an ambulance
Go to a clinic or hospital if you:
- Have trouble breathing or chest pain
- Cannot keep food or water down
- Have a high fever that does not improve
- Have serious underlying illnesses and your symptoms are getting worse
If you need urgent help, you can call 119 for an ambulance. For advice in English on where to go, you can use:
- The JNTO Medical Assistance Call Center (24/7, multilingual)
- The Tokyo Medical Information Site for Foreign Tourists and Residents (if you are in Tokyo)
Telemedicine in Japan: Remote Healthcare Options explains how to book an online consultation, which can be very helpful if you are isolating at home.
Healthcare changes since the pandemic that matter for expats
COVID-19 pushed several long-term reforms forward in Japan. As an expat in 2025, you benefit from some of them directly.
Telemedicine is now mainstream
During the pandemic, more than 10,000 clinics offered online consultations to reduce infection risk, and the government has since updated rules to integrate telemedicine into regular care.
Today, telemedicine is used for:
- Mild COVID-19 and other respiratory infections
- Chronic disease check-ups
- Prescription refills and follow-up visits
Many platforms and clinics offer English support, and telemedicine is generally covered by Japanese health insurance if the clinic is approved. Telemedicine in Japan: Remote Healthcare Options and Understanding Japan’s Healthcare System: Challenges for Foreign Residents explain how to use these services as a foreigner.
More multilingual information and support
Japan now maintains a multilingual COVID-19 information portal with English, Chinese and “easy Japanese” pages, and professional bodies like the Japan Medical Association link foreign residents to COVID-19 consultation hotlines and foreigner-friendly facilities.
Tokyo and other big cities operate separate medical information sites for foreigners, which explain how to find clinics, how insurance works, and what to do if you get sick.
These tools pair well with Japan Handbook articles like Medical Forms in Japan: How to Fill Out Clinic and Hospital Paperwork and Overcoming Language Barriers at the Hospital: Using Interpreters & Translation Services.
COVID-19, flu, and other vaccines: how to plan your 2025 schedule
WHO now recommends treating COVID-19 vaccination as part of routine adult immunization, alongside vaccines like flu and pneumococcal, especially for older adults and high-risk groups.
If you are 50+ or have chronic conditions, your yearly vaccine plan in Japan may look like this:
| Vaccine | Typical Timing in Japan | Main Target Groups | Notes |
|---|---|---|---|
| COVID-19 updated booster | Autumn–winter (e.g., October–January) | Adults 65+, 60–64 with certain conditions, some high-risk adults | Usually coordinated with flu shot; variant-adapted (e.g., JN.1). |
| Seasonal influenza | Autumn–winter | Children, older adults, chronic illness, healthcare workers | Many clinics offer joint flu + COVID campaigns. |
| Pneumococcal (lung infection) | Once in adulthood, sometimes with booster later | Mainly adults 65+ and high-risk adults | Often subsidized; ask at your city office. |
| Herpes zoster (shingles) | Usually once from age 50 or 60 | Adults 50+ (varies by product) | Recommended for those who had chickenpox. |
Vaccinations and Health Check-ups for Expats in Japan and Flu Season in Japan: Vaccines and Prevention Tips for Expats can help you turn this table into a personal plan.
Practical checklist for expats in 2025
You do not need to obsess about COVID-19, but a few simple steps can make life smoother and safer in Japan.
- Confirm your current vaccine status
- Check when you last had a COVID-19 shot or infection.
- If you are 65+, have chronic illness, or live with someone vulnerable, plan for an autumn booster.
- Find your local information sources
- Bookmark your city or ward’s health page and the national MHLW COVID-19 site.
- Note any English information sites (for example, Tokyo’s Medical Information Site for Foreign Residents).
- Know how to get care if you feel sick
- Identify at least one nearby clinic or hospital that accepts foreign residents.
- Save the JNTO Medical Assistance Call Center number in your phone.
- Learn when to call 119 for emergencies; see Navigating Emergency Medical Services in Japan (Dial 119, ER Tips).
- Keep basic supplies at home
- A thermometer, fever medicine, and a few antigen test kits from a pharmacy.
- Masks, especially if you live with an older person or work in crowded spaces.
- Use telemedicine when it makes sense
- For mild symptoms or follow-up questions, consider online consultations through services described in Telemedicine in Japan: Remote Healthcare Options.
- Stay positive and balanced
- Remember that Japan has strong vaccination coverage, growing experience with COVID-19, and a robust healthcare system.
- Focus on simple habits: handwashing, staying home when sick, and keeping up with your routine vaccines.
The bottom line for expats
In 2025, COVID-19 in Japan has moved from emergency to managed risk. For expats, the main tasks are to:
- Understand who should get a yearly booster and how funding works in your city.
- Know how to test and seek care if you feel unwell.
- Take advantage of telemedicine, multilingual information, and expat-friendly clinics.
With a little preparation, you can treat COVID-19 as one more health topic to manage calmly—right alongside flu shots, regular check-ups, and everyday wellbeing—while enjoying your life in Japan with confidence.
