[Inquiries] Shibuya Ward Novel Coronavirus Vaccine Call Center (Phone: 0120-045-405 )
[Inquiries] Regional Health Division Vaccination Section (Phone: 03-3463-1269)

We will issue a vaccination certificate that proves that you have been vaccinated against the new coronavirus. The new coronavirus infection vaccination certificate is issued to those who are planning to travel abroad.
The new coronavirus infection vaccination certificate (hereinafter referred to as the “vaccination certificate”) is a record of vaccinations (including vaccinations outside the address) conducted by the municipality for residents from the person who has been vaccinated. Based on the application, it will be issued and issued by the municipality where the vaccination was carried out. The certificate of vaccination contains the record of vaccination against COVID-19 (type of vaccine, date of vaccination, etc.) and information about the person vaccinated (name, date of birth, etc.).

• [Sample] New Coronavirus Infectious Disease Vaccination Certificate (for domestic use) (PDF 461KB)
• [Sample] New Coronavirus Infectious Disease Vaccination Certificate (for overseas) (PDF 532KB)

(Note) There are domestic and overseas vaccination certificates, and some of the required documents are different. Please make sure that all required documents are complete.
(Note) Please refer to the Ministry of Foreign Affairs Overseas Safety Website (external site) for specific countries/regions that can be used and mitigation measures.
(Note) If you do not have a passport and need an English version of the certificate, please contact the Regional Health Division Immunization Section (Phone: 03-3463-1269).
(Note) “Certificate of vaccination” is issued to those who have lost their certificate of vaccination or who have a vaccination record and wish to be issued a certificate of vaccination.
(Note) If you have a certificate of vaccination or a vaccination record at hand, you can continue to use it in Japan, so please keep it in a safe place.

Delivery method

A person with a My Number card and a smartphone

By saving and printing the image of the vaccination certificate issued on the dedicated smartphone app, you can obtain a paper vaccination certificate without applying to the city.

Image save method

Image preservation method (PDF 468KB) of inoculation certificate

1. Download the COVID-19 vaccination certificate app
2. Reissue the vaccination certificate on the app
3. After reissuing, tap "Details" on the vaccination certificate
4. Tap "Save this certificate as an image" at the bottom of the page
5. Tap Save as "Image"

About automatic issuance service at convenience stores

Acquisition method (PDF 1,302KB) of inoculation certificate

Automatic issuance of certificates (convenience store issuance) started on July 26, 2022 at specific convenience stores.
(Note) To issue a certificate, an issuance fee equivalent to the actual cost is required.
(Note) Refunds are not available after issuance, except in the case of printing defects. You will be asked to confirm the contents of the ticket yourself before it is issued using a terminal at a convenience store. Confirmation can be done smoothly. If there are any discrepancies in the content displayed on the screen, be sure to contact the ward office before issuing it. We cannot respond to refunds after issuance.

Required documents

• my number card
• Certificate issuance fee (120 yen)

(Note) For those who have not issued an overseas vaccination through the COVID-19 vaccination certificate app or an application to the city after July 21, 2022, [For convenience store delivery] VRS (Vaccination Record System) ) Passport information, etc. Please see registration application (link in the page) .

Convenience stores available

For a detailed list of convenience stores, please see About the new coronavirus infectious disease vaccination certificate (vaccination certificate) (Ministry of Health, Labor and Welfare website) .

Those who do not have a My Number card or a smartphone

Issuance application to ward is necessary. Please enclose the necessary documents and mail them to the New Corona Vaccination Certificate Application Window, Community Health Division, 7F, Shibuya Ward Office, 150-8010 (no address required).

Delivery method

It will be delivered in writing by mail. It takes about 5 business days after the application documents arrive.
(Note) Same-day issuance at the window is not possible.
(Note) If the application documents are incomplete, we may not be able to accept your application.
(Note) As it is assumed that the certificate of vaccination should be presented only, rather than submitted, only a portion of the vaccination certificate will be issued per application.
(note) vaccination certificate is made with A4 size.
(Note) If 3 months have passed since the issuance of the vaccination certificate, it will be automatically discarded.

Required documents

Documents commonly required for both domestic and overseas applications

1. Inoculation certificate issuance application form
   Please download and use the application form format (EXCEL 30KB) or the application form format (PDF 625KB) . Vaccination certificate issuance application forms are also available at the Ward Office 7th Floor Regional Health Division New Corona Vaccine Counter, Branch Offices and Residents Service Centers.
   (Note) Please note that we do not accept applications at branch offices or city resident service centers.

2. A copy of any of the following documents that can confirm the fact of vaccination

• New coronavirus vaccination certificate
• COVID-19 vaccination certificate
• Inoculation record of medical staff, etc.
• preliminary examination slip

3. A copy of an identification document with the return address (driver's license, health insurance card, etc.)

When applying for domestic use, please attach a document with your name in Kanji and date of birth.
If the return address cannot be confirmed on the identity verification documents, or if you wish to have it sent to an address other than the one listed on the identity verification documents, please attach a postal item addressed to the person with the return address written on it. .
(Note) If the person applying for overseas use entrusts the receipt to an agent, the person's identity verification document is not required. However, identification documents of the agent who knows the return address are required.

4. Nagagata No. 3 size self-addressed envelope

Please write your name and address and be sure to attach a stamp. (However, if you wish to use express mail or simple registered mail, please affix a stamp corresponding to the type of mail.)
If the mailing address is different from the address on your resident card, be sure to state the reason on the application form.
(Note) If you wish to send the documents to a different address than the one where you registered as a resident, please attach a copy of a document (such as a business card) describing the reason for changing the address and confirming the change.

Documents required only for overseas application

5. Copy of passport (within expiration date)

• Check the name, expiration date, passport number, etc.
• If your maiden name, alternate name, or alias is listed, please attach a document that confirms your maiden name, alternate name, or alias. (Driver's license with maiden name, family register, copy of resident card, etc.)

(Note) However, this does not apply if the maiden name, alternate name, or alias is originally written in Roman letters and the information can be confirmed only with the passport.

In the case of an application by an agent (whether for domestic or overseas use)

If the person currently entrusting the application is the applicant's agent, it is necessary to submit a "power of attorney" and "identity verification documents of the agent" in addition to the application documents.
(Note) A power of attorney is not required when a parent or guardian applies for a child under the age of 15, but a copy of a document that shows the parent-child relationship (medical certificate, insurance card, maternal and child health handbook, etc.) and a proxy Please attach a copy of your identity verification document.

6. power of attorney

   Power of attorney format (WORD 78KB) / English power of attorney format (WORD28KB)
   
   (Note) The power of attorney must be prepared by the person who entrusted it, and the original must be made within 3 months.
   (Note) A power of attorney is required even for a family member if the application is made by someone other than the applicant.

   In addition to the attached "Power of Attorney Format", if the following items are in order, the format and form do not matter.

   • [Title] Power of Attorney (certificate of vaccination against new coronavirus infection)
   • [Address] Shibuya Ward Mayor
   • [Date] Date of creation of power of attorney
   • [Representative] Address and name
   • [Delegation] I appoint the above person as my agent and authorize him to apply for and receive a certificate of vaccination against COVID-19.
   • [Purpose of use] To use for overseas travel
   • [Destination country name or region name] 〇〇 country
   • [Author] Address, name (signature), phone number
7. A copy of the identity verification document of the agent (a copy of the identity verification document that includes the return address if the representative is also receiving the documents)

   (Note) If you wish to have the certificate sent to an address other than the one listed on your identity verification document, please attach a copy of a document that verifies the residence and work of the agent or recipient.

About issuance of inoculation certificate by inoculation in frame

A certificate of vaccination will be issued only when the following three points can be confirmed for vaccinations equivalent to vaccinations administered to residents by municipalities (hereinafter referred to as vaccinations within the framework).

• The fact that you were inoculated by presenting a record, etc.
• Applicant must be a resident of Shibuya Ward as of the date of application
• It is appropriate to prove the fact of inoculation

(Note) If Shibuya City cannot confirm your resident registration at the time of application, or Shibuya City determines that it is not appropriate to prove the fact that you have been vaccinated, we may not be able to issue a certificate of vaccination.
(Note) For vaccination certificates for out-of-frame vaccinations, if the vaccination record is registered in the local government's VRS, it is possible to issue the new corona vaccination certificate app or at a convenience store.

Inoculation corresponding to out-of-frame vaccination and required documents

Documents that can confirm the fact of vaccination should be submitted together with other required documents so that there are no defects.

• Vaccination by new corona vaccination project for Japanese living overseas
  • COVID-19 vaccination record
  • Vaccination certificate in the name of the Minister of Foreign Affairs of Japan and the Minister of Health, Labor and Welfare of Japan

(Note) Both documents are required.

• Vaccination provided by the US Forces Japan to employees working at US Forces Japan bases hired by the Minister of Defense
  • Presentation of vaccination certificate in the name of the Minister of Defense. Or the vaccination record (CDC card) issued by the US military in Japan and the certificate of the Japanese military employee (residence factor health insurance union minister or basic labor contract (MLC), agency labor agreement (IHA) or seafarer contract (MC) Introductory pass to a documented U.S. military facility in Japan)

• Clinical trials conducted by pharmaceutical companies, etc.
  • New Corona vaccination record issued by medical institutions

Considerations

About inoculation abroad

We cannot issue a new corona vaccine vaccination certificate for vaccinations received overseas (inoculations not based on the Japanese Vaccination Act).

About the municipality to apply for

If you move in or out between the first and second vaccinations, you can apply for the vaccination certificate at the municipality where you were registered as a resident at the time of the vaccination.

[For convenience store issuance] Application for registration of passport information, etc.

Required documents

• Registration application format for passport information (WORD 34KB) / Registration application format for passport information (PDF 441KB)
• Copy of valid passport (page with name, expiration date, and passport number)

Documents required in some cases

• If you have any vaccinations for which you have not been issued a certificate of vaccination so far Documents that can confirm the fact of vaccination (new coronavirus infection vaccination certificate, new corona vaccination record, new corona vaccination preliminary examination slip) ) copy
• If your passport has a different name, alias, or maiden name A copy of your identity verification document (driver's license, family register, resident card, etc.) that includes your different name, alias, or maiden name
• If the name on the certificate of vaccination is different from the name on your passport (passport, etc.) A copy of a document (resident card, etc.) that can confirm the correspondence between the real name and the nickname on the passport

Application method

• Electronic application
  You can make corrections from the VRS passport information registration application form (external site) .

• Postal application destination: 〒150-8010 (No address required) Shibuya Ward Office 7th Floor Community Health Section New Corona Vaccination Certificate Section

Inquiry

About issuance of certificates in Shibuya City

Shibuya Ward Novel Coronavirus Vaccine Call Center (Phone: 0120-045-405 )

About the certificate system in general

Ministry of Health, Labor and Welfare Novel Coronavirus Vaccine Call Center (Phone: 0120-761-770 )

Postal application destination: 〒150-8010 (No address required) Shibuya Ward Office 7th Floor Community Health Section New Corona Vaccination Certificate Section