Flu Shot Subsidies 2026 in Japan's 20 Designated Cities

All 20 designated cities: out-of-pocket cost and period for those 65 and over

Checked on each city's official page for FY2026 on 18 October 2026. All end dates fall in 2027. Eligible: people aged 65 and over, and people aged 60–64 with a severe disability of the heart, kidneys, respiratory system or immune system. People on public assistance or receiving support benefits for Japanese left behind in China are free in every city. The subsidy covers one shot within the period; further shots are paid in full. Each city's page is listed in the sources at the end.

In Tokyo's 23 wards, 7 wards are free, 8 are free for those 75 and over, and 8 charge ¥2,500. The ward-by-ward list is in flu shot subsidies in Tokyo's 23 wards.

Households exempt from resident tax: free, half price, or not covered

16 of the 20 cities make the shot free for households exempt from resident tax. The other four do it differently.

• Niigata and Kyoto: free only for people on public assistance or receiving support benefits for Japanese left behind in China. Even tax-exempt households pay ¥1,650 in Niigata and ¥1,000 or ¥1,500 in Kyoto.
• Chiba: tax-exempt households pay half, ¥900. It is limited to people in long-term care insurance premium tiers 1–3, and the city has issued a notice that this arrangement is new this year[Chiba City (in Japanese)].
• Okayama: tax-exempt households pay ¥900. You must apply in advance and receive a subsidy voucher[Okayama City (in Japanese)].

Even if you qualify for a free shot, unless you hand in a document showing your tax-exempt status at the clinic on the day, you pay the out-of-pocket amount there and then. Fukuoka states that it will not refund amounts paid without the document[Fukuoka City (in Japanese)].

This year, choosing the right document also needs care. In FY2026, a special rule on long-term care premiums means some people are in premium tier 4 or above even though every member of their household is tax-exempt. Sapporo, Kawasaki, Shizuoka, Kitakyushu, Hiroshima and others therefore advise that the long-term care premium notice alone may not get you the exemption. If you are unsure whether your notice is enough, getting the exemption document (a confirmation certificate) from your ward office in advance is the safe option. You can check whether you are tax-exempt in conditions for households exempt from resident tax.

Different periods: Yokohama ends on 31 December, three cities run to March

16 of the 20 cities end on 31 January. Only Yokohama closes on 31 December, a month earlier than the rest[Yokohama City (in Japanese)]. Niigata, Kitakyushu and Fukuoka accept shots until 31 March.

As for start dates, the early flu season led eight cities to begin before 1 October.

Sapporo states that shots given in September are voluntary vaccinations, not routine vaccinations, and are not subsidised[Sapporo City (in Japanese)]. In many cities the pre-vaccination questionnaire (予診票) is kept at participating clinics and is not mailed to your home. The high-dose vaccine for those 75 and over is not part of routine vaccination in FY2026.

Only Nagoya and Kobe subsidise children

Nagoya mails coupons in mid-September[Nagoya City (in Japanese)]. Kobe covers shots from 1 October 2026 to 31 January 2027[Kobe City (in Japanese)].

Osaka, Kyoto, Chiba and Kitakyushu officially state that they do not subsidise children's flu shots. Sapporo and Sagamihara describe them as voluntary vaccinations paid by the family. For the remaining 12 cities, we could not find a children's subsidy on their official websites. Every one of Tokyo's 23 wards subsidises children, so this is a big difference.

Children under 13 receive two doses. Clinics set their own prices, and about ¥3,000 to ¥3,500 per dose is a rough guide. Where the city offers no subsidy, your employer's health insurance society may be the main source of help. Examples of health insurance society subsidies and how to find them are in the health insurance section of the 23-ward article.

Routine COVID-19 vaccination costs ¥5,000 to ¥11,800

The COVID-19 vaccine for people 65 and over is also a routine vaccination, and the out-of-pocket cost differs by more than double between cities. You can receive it at the same visit as the flu shot if your doctor agrees.

Based on each city's official pages and press materials (Yokohama: press release of 16 September 2026; Osaka: overview for medical institutions; Hamamatsu: Koho Hamamatsu, September issue). Many cities treat tax-exempt households the same as for flu, but Chiba charges ¥4,000 and Okayama ¥2,700.

Tax treatment: not deductible as a medical expense

Vaccination is spending on prevention, not treatment, so it is not covered by the medical expense deduction. However, getting a flu shot counts as one of the "specified health efforts" required to use the self-medication tax scheme (a deduction for spending on eligible over-the-counter medicines above ¥12,000 a year). Keep the receipt or a copy of the pre-vaccination questionnaire[National Tax Agency No. 1129 (in Japanese)]. Where the line falls against the medical expense deduction is explained in how to calculate the medical expense deduction.

Summary

• In the 20 designated cities, people 65 and over pay ¥1,400 to ¥2,300. 10 cities charge ¥1,500, Yokohama and Kawasaki ¥2,300, and Kyoto ¥1,000 for those 75 and over
• Households exempt from resident tax are free in 16 cities. Chiba and Okayama charge ¥900; Niigata and Kyoto do not include them in the free group. Some cities give no refund if you do not hand in the document on the day
• 16 cities end on 31 January, Yokohama alone on 31 December, and Niigata, Kitakyushu and Fukuoka on 31 March. Eight cities moved the start forward into September
• Only Nagoya (free at ages 12, 15 and 18) and Kobe (¥2,000 per dose) subsidise children. In the other 18 cities families pay
• Routine COVID-19 vaccination costs ¥5,000 to ¥11,800. Vaccination is not deductible as a medical expense, but it counts as a health effort for the self-medication tax scheme

References (sources)