Nomura Shuhei, Eguchi Akifumi, Yoneoka Daisuke, Kawashima Takayuki, Tanoue Yuta, Murakami Michio, Sakamoto Haruka, Maruyama-Sakurai Keiko, Gilmour Stuart, Shi Shoi, Kunishima Hiroyuki, Kaneko Satoshi, Adachi Megumi, Shimada Koki, Yamamoto Yoshiko, Miyata Hiroaki
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.
Lancet Reg Health West Pac. 2021 Sep;14:100223. doi: 10.1016/j.lanwpc.2021.100223. Epub 2021 Jul 31.
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.
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).
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.
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.
The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).
识别并理解对于接种冠状病毒病（COVID-19）疫苗不确定或不愿意的原因，可能有助于为未来旨在提高疫苗接种覆盖率的公共卫生信息提供参考。我们分析了日本民众在COVID-19疫苗接种决策方面的一系列广泛心理倾向。
2021年2月底，对30053名20岁及以上的日本成年人进行了一项具有全国代表性的横断面网络调查。除了询问个人接种COVID-19疫苗的意愿外，还询问了受访者的社会人口统计学、健康相关和心理特征，以及关于COVID-19的信息来源和他们的信任程度。此外，对于那些回答接种COVID-19疫苗意愿为“不确定”或“不愿意”的人，询问了原因。采用带有稀疏组套索（最小绝对收缩和选择算子）惩罚的多项逻辑回归来计算与接种意愿相关因素的调整比值比（不确定/不愿意与愿意相比）。
回答接种COVID-19疫苗意愿为“不确定”或“不愿意”的受访者比例分别为32.9%和11.0%。在调整协变量后，对COVID-19的感知风险、对COVID-19疫苗的感知风险、对COVID-19疫苗的感知益处、对科学家和公共当局的信任，以及认为医护人员应接种疫苗的信念与接种意愿显著相关。关于COVID-19的几个信息来源也与接种意愿显著相关，包括医生、护士和电视，医学信息网站不确定或不愿意的几率较低，以及互联网新闻网站、YouTube、家庭成员以及科学家和研究人员，其不确定或不愿意的几率较高。作为COVID-19信息来源，对电视的信任程度越高，回答“不确定”的几率越高（比值比1.11，95%置信区间1.01 - 1.21）。我们还表明，许多受访者表示担心COVID-19疫苗的副作用和安全性是不确定或不愿意接种的主要原因。为了决定是否接种疫苗，许多受访者要求提供更多关于疫苗与个人健康状况的兼容性、其他人是否接种过疫苗、疫苗对变异株的有效性以及医生建议的信息。
我们的研究结果表明，基于那些对接种COVID-19疫苗不确定或不愿意的人的社会人口统计学和心理特征开展公共卫生宣传，可能有助于提高这部分人群的疫苗接种率。
本研究部分得到了日本厚生劳动省的资助（H29 - がんたいさく - いっぱん - 009）。
