Department of Medical Statistics, Toho University, Ota-ku, Tokyo, Japan.
Vaccines, Medical Affairs, MSD K.K, Tokyo, Japan.
BMJ Open. 2019 Jul 16;9(7):e030197. doi: 10.1136/bmjopen-2019-030197.
The 23-valent pneumococcal polysaccharide vaccine (PPSV23) was included in Japan's national immunisation programme for older adults in 2014. While vaccination coverage has increased following the implementation of the national immunisation programme, little is known about the factors that have influenced changes in PPSV23 uptake in Japan. This study aimed to investigate the effects of municipality-level activities implemented to improve vaccine uptake during the fiscal year 2015 (April 2015-March 2016).
Community-based national survey. A postal and web-based nationwide survey was sent to all municipalities in Japan in June 2016 (n=1741). The survey included questions regarding PPSV23 coverage, out-of-pocket costs by individuals for vaccination and community-level activities implemented to improve and promote PPSV23 uptake. Municipality-level and prefecture-level variables (eg, unemployment rates, average per capita income) retrieved from published sources were also incorporated to explore the impact of social determinants on vaccine uptake.
Japan.
Municipal vaccination officers.
The primary study outcome was PPSV23 coverage among adults aged 65 years in Japanese municipalities.
A total of 1010 municipalities (58.0%) responded to the survey. The median PPSV23 coverage among responding municipalities was 41.8%. Vaccine coverage increased by 18.7% (16.7%-20.7%)%) in municipalities that sent a direct mail notification to the target population of adults compared with municipalities that did not send any notification. Vaccine coverage decreased by 3.02% (2.4%-3.6%)%) for every 1000 JPY increase in out-of-pocket costs. Municipality-level unemployment rates and average per capita income were negatively associated with PPSV23 coverage.
This nationwide survey provides insight into factors that may influence PPSV23 coverage in Japanese municipalities. Reduced out-of-pocket costs and direct mail notifications to the target population were associated with higher PPSV23 coverage in Japanese municipalities.
23 价肺炎球菌多糖疫苗（PPSV23）于 2014 年被纳入日本老年人国家免疫计划。虽然在国家免疫计划实施后，疫苗接种覆盖率有所提高，但对于影响日本 PPSV23 接种率变化的因素知之甚少。本研究旨在调查 2015 财年（2015 年 4 月至 2016 年 3 月）为提高疫苗接种率而在市町村一级开展的活动的效果。
基于社区的全国性调查。2016 年 6 月，向日本所有市町村（n=1741）邮寄并在网上发布了一项调查。该调查包括关于 PPSV23 覆盖率、个人接种疫苗的自费金额以及为提高和促进 PPSV23 接种率而开展的社区一级活动的问题。还纳入了从已发表资料中检索到的市町村和都道府县一级的变量（例如，失业率、人均收入），以探讨社会决定因素对疫苗接种率的影响。
日本。
市町村的疫苗接种官员。
主要研究结果是日本市町村 65 岁以上成年人的 PPSV23 覆盖率。
共有 1010 个市町村（58.0%）对调查做出了回应。在做出回应的市町村中，PPSV23 的中位数覆盖率为 41.8%。与未发送任何通知的市町村相比，向目标人群（成年人）发送直接邮件通知的市町村的疫苗覆盖率增加了 18.7%（16.7%-20.7%）。每增加 1000 日元的自费金额，疫苗覆盖率就会下降 3.02%（2.4%-3.6%）。市町村一级的失业率和人均收入与 PPSV23 覆盖率呈负相关。
这项全国性调查提供了关于可能影响日本市町村 PPSV23 覆盖率的因素的见解。降低自费金额和向目标人群发送直接邮件通知与日本市町村 PPSV23 覆盖率的提高有关。
