Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people: A large cross-sectional national survey

Shuhei Nomura, PhD; Akifumi Eguchi, PhD; Daisuke Yoneoka, PhD; Takayuki Kawashima, PhD; Yuta Tanoue, PhD; Michio Murakami, PhD; Haruka Sakamoto, PhD; Keiko Maruyama-Sakurai, MPH; Stuart Gilmour, PhD; Shoi Shi, PhD; Hiroyuki Kunishima, PhD; Satoshi Kaneko, PhD; Megumi Adachi, BN; Koki Shimada, PhD; Yoshiko Yamamoto, PhD; Hiroaki Miyata, PhD

The Lancet Regional Health. Western Pacific (Sep 2021)

Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people: A large cross-sectional national survey

Shuhei Nomura, PhD,
Akifumi Eguchi, PhD,
Daisuke Yoneoka, PhD,
Takayuki Kawashima, PhD,
Yuta Tanoue, PhD,
Michio Murakami, PhD,
Haruka Sakamoto, PhD,
Keiko Maruyama-Sakurai, MPH,
Stuart Gilmour, PhD,
Shoi Shi, PhD,
Hiroyuki Kunishima, PhD,
Satoshi Kaneko, PhD,
Megumi Adachi, BN,
Koki Shimada, PhD,
Yoshiko Yamamoto, PhD,
Hiroaki Miyata, PhD

Affiliations

Shuhei Nomura, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Corresponding author. Shuhei Nomura, PhD. Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Tel.: +81-35363-3774.
Akifumi Eguchi, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
Daisuke Yoneoka, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
Takayuki Kawashima, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
Yuta Tanoue, PhD: Institute for Business and Finance, Waseda University, Tokyo, Japan
Michio Murakami, PhD: Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Japan
Haruka Sakamoto, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Keiko Maruyama-Sakurai, MPH: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
Stuart Gilmour, PhD: Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
Shoi Shi, PhD: Department of Systems Pharmacology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Laboratory for Synthetic Biology, RIKEN Center for Biosystems Dynamics Research, Osaka, Japan
Hiroyuki Kunishima, PhD: Department of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan
Satoshi Kaneko, PhD: Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
Megumi Adachi, BN: Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Koki Shimada, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
Yoshiko Yamamoto, PhD: National Center for Child Health and Development, Tokyo, Japan
Hiroaki Miyata, PhD: Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Corresponding author. Shuhei Nomura, PhD. Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Tel.: +81-35363-3774.

Journal volume & issue: Vol. 14
p. 100223

Abstract

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Summary: Background: Identifying and understanding reasons for being unsure or unwilling regarding intention to be vaccinated against coronavirus disease (COVID-19) may help to inform future public health messages aimed at increasing vaccination coverage. We analyzed a broad array of individual's psychological dispositions with regard to decision-making about COVID-19 vaccination in Japan. Methods: A nationally representative cross-sectional web survey was conducted with 30053 Japanese adults aged 20 years or older at the end of February 2021. In addition to the question on the individual's intention to be vaccinated against COVID-19, respondents were asked about their sociodemographic, health-related, and psychological characteristics as well as information sources about COVID-19 and their levels of trust. Also, those who responded ‘not sure’ or ‘no’ regarding intention to take COVID-19 vaccine were asked why. Multinomial logistic regression with sparse group Lasso (Least Absolute Shrinkage and Selection Operator) penalty was used to compute adjusted odds ratios for factors associated with the intention (not sure/no versus yes). Findings: The percentages of respondents who answered ‘not sure’ or ‘no’ regarding intention to be vaccinated against COVID-19 vaccine were 32.9% and 11.0%, respectively. After adjusting for covariates, the perceived risks of COVID-19, perceived risk of a COVID-19 vaccine, perceived benefits of a COVID-19 vaccine, trust in scientists and public authorities, and the belief that healthcare workers should be vaccinated were significantly associated with vaccination intention. Several sources of information about COVID-19 were also significantly associated with vaccination intention, including physicians, nurses, and television, medical information sites with lower odds of being unsure or unwilling, and internet news sites, YouTube, family members, and scientists and researchers with higher odds. The higher the level of trust in television as a source of COVID-19 information, the higher the odds of responding ‘not sure’ (odds ratio 1.11, 95% confidence interval 1.01–1.21). We also demonstrated that many respondents presented concerns about the side effects and safety of a COVID-19 vaccine as a major reason for being unsure or unwilling. To decide whether or not to get the vaccine, many respondents requested more information about the compatibilities between the vaccine and their personal health conditions, whether other people had been vaccinated, the effectiveness of vaccines against variants, and doctors’ recommendations. Interpretation: Our findings suggest that public health messaging based on the sociodemographic and psychological characteristics of those who are unsure or unwilling regarding intention to be vaccinated against COVID-19 vaccine may help to increase vaccine uptake amongst this population. Funding: The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).

Published in The Lancet Regional Health. Western Pacific

ISSN: 2666-6065 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanwpc/home

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