TY - JOUR
T1 - Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people
T2 - A large cross-sectional national survey
AU - Nomura, Shuhei
AU - Eguchi, Akifumi
AU - Yoneoka, Daisuke
AU - Kawashima, Takayuki
AU - Tanoue, Yuta
AU - Murakami, Michio
AU - Sakamoto, Haruka
AU - Maruyama-Sakurai, Keiko
AU - Gilmour, Stuart
AU - Shi, Shoi
AU - Kunishima, Hiroyuki
AU - Kaneko, Satoshi
AU - Adachi, Megumi
AU - Shimada, Koki
AU - Yamamoto, Yoshiko
AU - Miyata, Hiroaki
N1 - Funding Information:
Conception/design of the work: S.N. A.E. D.Y. T.K. Y.T. M.M. H.S. K.M.S. H.K. S.K. K.S. Y.Y. and H.M.; acquisition of data: S.N. H.S. K.M.S. H.K. S.K. K.S. and H.M.; analysis of data: S.N. A.E. D.Y. T.K. and Y.T.; interpretation of findings: all authors; drafting of the work: S.N.; substantially revised the work: S.N. A.E. D.Y. T.K. Y.T. M.M. S.G. S.S. M.A. K.S. and Y.Y. The datasets generated during and/or analyzed during the current study are not publicly available due to ethical considerations but are available from the corresponding author on reasonable request. We would like to thank the Japan Epidemiological Association and the Japanese Society of Infectious Diseases as well as those involved in the COVID-19 Information Value Improvement and Link project (CIVIL project) for supervising the questionnaires. This work was partly funded by research grants from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009). The funding source of this study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The views expressed in this paper are solely those of the authors. The results of the survey were partially reported at Medical Note on March 26, 2021, in Japanese, including the proportions of COVID-19 vaccine acceptance, hesitance, and resistance in the pooled analysis: https://medicalnote.jp/nj_articles/210326-003-HG. This work was partly funded by research grants from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009). Ethical approval was granted by the Ethics Committee of Keio University School of Medicine under authorization number 20200340. Respondents had to provide their consent before they proceeded to the questionnaire response page. Editor note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
Funding Information:
We would like to thank the Japan Epidemiological Association and the Japanese Society of Infectious Diseases as well as those involved in the COVID-19 Information Value Improvement and Link project (CIVIL project) for supervising the questionnaires. This work was partly funded by research grants from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009). The funding source of this study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The views expressed in this paper are solely those of the authors. The results of the survey were partially reported at Medical Note on March 26, 2021, in Japanese, including the proportions of COVID-19 vaccine acceptance, hesitance, and resistance in the pooled analysis: https://medicalnote.jp/nj_articles/210326-003-HG .
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/9
Y1 - 2021/9
N2 - 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).
AB - 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).
KW - COVID-19
KW - Japan
KW - attitudes towards vaccinations
KW - information source
KW - psychological dispositions
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U2 - 10.1016/j.lanwpc.2021.100223
DO - 10.1016/j.lanwpc.2021.100223
M3 - Article
AN - SCOPUS:85111526027
SN - 2666-6065
VL - 14
JO - The Lancet Regional Health - Western Pacific
JF - The Lancet Regional Health - Western Pacific
M1 - 100223
ER -