Tokyo Flu Shot Subsidy 2026: All 23 Wards Compared

All 23 Tokyo wards (2026-27 season) - seniors pay ¥0 or ¥2,500, children ¥0-4,500

* Confirmed on each ward's official page as of 5 October 2026. The cutoff date for "age 75" is either 31 December or 31 March depending on the ward. Recipients of public assistance or support payments for Japanese returnees from China are free in every ward. Children get 2 shots under age 13 and 1 shot from age 13, and the subsidy covers each shot. The nasal spray vaccine (a live attenuated vaccine) is 1 dose from age 2. Each ward's page is listed in the Sources section at the end.

• Seniors: From 1 October, most wards let you use your own ward's questionnaire at any participating clinic within the 23 wards. During the September early-start period, many wards restrict this to clinics within your own ward, so check first.
• Children: Most wards limit this to participating clinics within the ward. Some wards keep the questionnaire at the clinic (Chiyoda, Chuo, Bunkyo, Shinagawa, Meguro, Ota, Setagaya, Suginami, Kita, Itabashi), while others mail it to households (Minato, Shinjuku, Taito, Nakano, Toshima, Nerima, Adachi, Katsushika, Edogawa).
• No ward offers zero subsidy for children. Wards that stop coverage at the 3rd year of junior high school (Taito, Shibuya, Nakano, Toshima, Arakawa, Katsushika) exclude high schoolers.

Who pays for what - wards for seniors and children, health insurance societies for working-age adults

People 65 and older (and those 60-64 with a serious heart, kidney, respiratory or immune disorder) fall under the Immunization Act's routine (Category B) vaccination, where each municipality sets the out-of-pocket fee. Children and working-age adults receive it as a voluntary vaccination, with no national funding. Many municipalities add their own subsidy for children, while working-age adults depend on their employer's health insurance society.

• Typical cost is ¥3,000-3,500 per adult shot, and around ¥8,000 for the nasal spray vaccine (based on clinics' published prices; clinics set their own fees).
• Under 13 get 2 shots, 13 and older get 1. In wards that subsidize both shots, that works out to ¥2,000 x 2 = ¥4,000 back[Ministry of Health, Labour and Welfare, Q9 (in Japanese)].
• Supply is sufficient. The 2026-27 season is projected to have about 51.9 million doses, above the past 3 years' average usage of about 46.89 million. More than 60% had already shipped as of 2 October[MHLW, Production and Distribution Subcommittee, 26 August 2026 (in Japanese)].

Working-age adults: check your health insurance society - TJK ¥2,300, ITS ¥2,000, nothing from the Japan Health Insurance Association

For ages 19-64, who get no ward subsidy, the difference comes down to who issues your health insurance card (or insurance confirmation document). Many health insurance societies offer a vaccination subsidy, but you won't get it back without applying.

• Health insurance society subsidies usually work one of two ways: "Toshinkyo" (deducted at the counter at contracted clinics) or a subsidy application (submit a receipt and get reimbursed later). Deadlines run from the end of the month after vaccination to the end of February.
• For family members 65 and older, the ward's routine vaccination takes priority, and some health insurance societies won't let you use their subsidy voucher (as with Nagoya Yakugyo Kenpo).
• Many societies also cover dependents, so for children it's worth checking both the ward subsidy and the health insurance society's subsidy (whether you can combine them depends on the society).

Tax treatment - not eligible for the medical expense deduction, but it counts as an "initiative" under the self-medication tax scheme

• Not eligible for the medical expense deduction. The National Tax Agency treats preventive costs as not qualifying as medical expenses[National Tax Agency, FAQ on vaccination costs (in Japanese)]. See how the medical expense deduction is calculated for where the line is drawn.
• It counts as a "certain initiative" under the self-medication tax scheme. If you got a flu shot, you can deduct the portion of eligible switch-OTC drugs bought that year above ¥12,000. The vaccination receipt or a copy of the pre-vaccination questionnaire serves as proof of the initiative, so don't throw it away[National Tax Agency, No.1129 (in Japanese)].
• If the employer pays: as long as it's offered to any employee who wants it and the amount is reasonable, it's generally not taxed as salary (per the thinking behind Income Tax Basic Directive 36-29). Covering only executives makes it taxable as salary[Income Tax Basic Directive 36-29 (in Japanese)].
• A sole proprietor's own vaccination cost is a personal expense and not deductible as a business expense. Covering an employee's cost counts as a welfare expense.

For readers outside the 23 wards - designated cities charge ¥1,500-2,500, Yokohama ends in late December

Unlike the 23 wards, many designated cities offer it free to households exempt from resident tax. Search "[your city] influenza vaccination seniors," or check your municipality in the subsidy database. You can check whether you're exempt from resident tax using the conditions for a resident-tax-exempt household. Other subsidies for families with children are in the nationwide guide to child-rearing support.

Summary

• Because the 2026-27 flu season arrived early, most of the 23 wards moved their subsidy start date up to 16-25 September. All wards end on 31 January (Taito's child subsidy ends 28 February)
• For ages 65+, 7 wards (Chiyoda, Minato, Bunkyo, Shinagawa, Shibuya, Arakawa, Adachi) are free, 8 wards are free from age 75 (70 in Meguro, 72 in Kita), and the remaining 8 charge ¥2,500
• For children, Chiyoda, Shibuya and Arakawa are free, Minato subsidizes ¥4,500 per shot, and others subsidize ¥2,000-3,000. Under-13s get 2 shots. 6 wards stop coverage at the 3rd year of junior high school
• Working-age adults get no ward subsidy and must apply to their health insurance society (TJK ¥2,300, ITS ¥2,000). The Japan Health Insurance Association and municipal National Health Insurance offer none
• The vaccination fee doesn't qualify for the medical expense deduction, but it counts as a "certain initiative" under the self-medication tax scheme, so keep the receipt

Sources

• Ministry of Health, Labour and Welfare, "Influenza vaccine (seasonal)" (in Japanese), same, Research and Development / Production and Distribution Subcommittee materials (26 August 2026, PDF) (in Japanese), same, "COVID-19 Vaccine Q&A" (in Japanese)
• National Tax Agency, FAQ "Cost of hepatitis B vaccination" (vaccinations don't qualify for the medical expense deduction) (in Japanese), No.1129 "Self-medication tax scheme" (in Japanese), Income Tax Basic Directive 36-29 (in Japanese)
• TJK, "Influenza vaccination subsidy (FY2026)" (in Japanese), Kanto IT Software Health Insurance Society, "Influenza vaccination" (in Japanese), Zenkoku Doken Kokuho (in Japanese), Japan Health Insurance Association, Gunma Branch, "Subsidy for influenza" (in Japanese)
• Each ward's page for seniors: Chiyoda (in Japanese), Chuo (in Japanese), Minato (in Japanese), Shinjuku (in Japanese), Bunkyo (in Japanese), Taito (in Japanese), Sumida (in Japanese), Koto (in Japanese), Shinagawa (in Japanese), Meguro (in Japanese), Ota (in Japanese), Setagaya (in Japanese), Shibuya (in Japanese), Nakano (in Japanese), Suginami (in Japanese), Toshima (in Japanese), Kita (in Japanese), Arakawa (in Japanese), Itabashi (in Japanese), Nerima (in Japanese), Adachi (in Japanese), Katsushika (in Japanese), Edogawa (in Japanese)
• Each ward's page for children: Chiyoda (in Japanese), Chuo (in Japanese), Minato (in Japanese), Shinjuku (in Japanese), Bunkyo (in Japanese), Taito (in Japanese), Sumida (in Japanese), Koto (in Japanese), Shinagawa (in Japanese), Meguro (in Japanese), Ota (in Japanese), Setagaya (in Japanese), Shibuya (in Japanese), Nakano (in Japanese), Suginami (in Japanese), Toshima (in Japanese), Kita (in Japanese), Arakawa (in Japanese), Itabashi (in Japanese), Nerima (in Japanese), Adachi (in Japanese), Katsushika (in Japanese), Edogawa (in Japanese)

* Amounts and periods are confirmed on each ward's, city's and insurer's official page as of 5 October 2026. Rules can change during the fiscal year, so check the latest conditions in the pre-vaccination questionnaire notice or the official page before getting vaccinated. This article is general information; consult a tax office or tax accountant for individual decisions about taxes.