Machida Masaki, Inoue Shigeru
Department of Preventive Medicine and Public Health, Tokyo Medical University.
Department of Infection Prevention and Control, Tokyo Medical University Hospital.
Nihon Koshu Eisei Zasshi. 2023 Aug 29;70(8):474-482. doi: 10.11236/jph.23-004. Epub 2023 May 10.
Definition and present status Vaccine hesitancy, defined as "delay in acceptance or refusal of vaccination despite availability of vaccination services," is a global public health concern. Specifically, COVID-19 and human papillomavirus (HPV) vaccine hesitancy remains a major social challenge in Japan, and effective preventive strategies are urgently required. In this review, we discuss previous studies that have described vaccine hesitancy.Associated factors Vaccine hesitancy is affected by several factors, primarily psychological variables (referred to as the "3Cs" comprising confidence, complacency, and convenience regarding individuals' perceptions of vaccination) and sociodemographic variables (age, sex, socioeconomic status, race, and social capital). "Behavioral and Social Drivers of Vaccination Framework", developed recently by the World Health Organization, has focused on vaccination-specific beliefs and reports that programs may affect and are likely to have wide applicability in the development of effective interventions.Measurement Identification of psychological factors associated with vaccination hesitancy is important to establish strategies to increase vaccine uptake. Many scales are available to measure vaccine hesitancy and psychological factors that affect vaccine hesitancy. These scales include different evaluation items, validity, reliability, and availability of validated Japanese versions. Therefore, careful selection of scales based on their intended purpose and the target population in whom the desired intervention is intended are important. A representative 7C scale is widely used globally. It has been translated into more than 10 languages, including Japanese.Approach Several studies and articles, mainly developed for the European and American populations provide guidelines for selection of evidence-based strategies and interventions to increase vaccine uptake. Evidence-based strategies may be broadly classified into the following categories: (1) Strengthening the healthcare system through implementation of the principles of behavioral science. (2) Development of tailored approaches using systematic listening activities. (3) Provision of evidence-based resources to support healthcare personnel. (4) Utilization of media. Based on findings described by previous studies discussed in this report, it may be important to plan strategies to improve the uptake of each vaccine in Japan, such as those for COVID-19, HPV, and also childhood vaccines.
定义与现状 疫苗犹豫被定义为“尽管有疫苗接种服务，但仍延迟接受或拒绝接种疫苗”，这是一个全球公共卫生问题。具体而言，在日本，对新冠病毒疫苗和人乳头瘤病毒（HPV）疫苗的犹豫仍然是一项重大社会挑战，迫切需要有效的预防策略。在本综述中，我们讨论了此前描述疫苗犹豫的研究。
相关因素 疫苗犹豫受多种因素影响，主要是心理变量（被称为“3C”，包括个人对疫苗接种的信心、自满和便利感）以及社会人口统计学变量（年龄、性别、社会经济地位、种族和社会资本）。世界卫生组织最近制定的“疫苗接种的行为和社会驱动因素框架”聚焦于特定疫苗接种信念，并报告称这些方案可能会产生影响，且在制定有效干预措施方面可能具有广泛适用性。
测量 识别与疫苗犹豫相关的心理因素对于制定提高疫苗接种率的策略很重要。有许多量表可用于测量疫苗犹豫以及影响疫苗犹豫的心理因素。这些量表包括不同的评估项目、效度、信度以及经过验证的日文版本的可用性。因此，根据量表的预期用途和期望干预的目标人群仔细选择量表很重要。一种具有代表性的7C量表在全球广泛使用。它已被翻译成包括日语在内的10多种语言。
方法 主要为欧美人群开展的多项研究和文章为选择基于证据的策略和干预措施以提高疫苗接种率提供了指导方针。基于证据的策略大致可分为以下几类：（1）通过实施行为科学原则加强医疗保健系统。（2）利用系统的倾听活动制定量身定制的方法。（3）提供基于证据的资源以支持医护人员。（4）利用媒体。根据本报告中讨论的先前研究的结果，针对日本提高每种疫苗（如新冠病毒疫苗、HPV疫苗以及儿童疫苗）接种率的策略进行规划可能很重要。
