Epidemiology and Clinical Research, Japan Anti-Tuberculosis Association Research Institute of Tuberculosis, Kiyose, Tokyo, Japan
Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
BMJ Open. 2023 Nov 1;13(11):e073008. doi: 10.1136/bmjopen-2023-073008.
We examined the association between social isolation and loneliness, increasingly recognised but neglected social determinants of health, with being unvaccinated against COVID-19.
This was a cross-sectional study.
A representative cohort of 22 756 individuals (aged 15-81 years) from the general Japanese population who responded to both the Japan COVID-19 and Society Internet Survey 2021 and Japan Society and New Tobacco Internet Survey 2022.
We calculated the ORs of remaining unvaccinated against COVID-19 in 2022, attributable to social isolation as assessed by the Lubben Social Network Scale, or loneliness as evaluated by the University of California, Los Angeles Loneliness Scale version 3. Reasons for abstaining from vaccination were solicited from the unvaccinated respondents. A multivariable logistic regression model was conducted with adjustments for demographic variables. Propensity score-matched comparisons were conducted as part of the sensitivity analysis.
Individuals with social isolation were more likely to be unvaccinated (OR 1.48, 95% CI 1.37 to 1.60), while individuals with loneliness were not (OR 0.96, 95% CI 0.88 to 1.05). Socially isolated individuals were significantly less likely to receive information from people who had been vaccinated (11% vs 15%) and less likely not to trust the vaccine approval process (19% vs 27%) compared with those who were not socially isolated.
Despite not harbouring negative perceptions of the vaccine, socially isolated individuals exhibited lower rates of COVID-19 vaccination. Socially isolated individuals are important targets to reach to increase the number of vaccinated individuals.
我们研究了社会隔离和孤独感这两个日益受到关注但被忽视的健康决定因素与未接种 COVID-19 疫苗之间的关系。
这是一项横断面研究。
来自日本一般人群的具有代表性的队列 22756 人（年龄 15-81 岁），他们同时回答了日本 COVID-19 和社会互联网调查 2021 年和日本社会和新烟草互联网调查 2022 年的问题。
我们根据卢本社会网络量表评估的社会隔离或加利福尼亚大学洛杉矶分校孤独感量表 3 版评估的孤独感，计算了 2022 年未接种 COVID-19 疫苗的个体仍未接种疫苗的 OR。从未接种疫苗的受访者中征集了不接种疫苗的原因。进行了多变量逻辑回归模型分析，并进行了人口统计学变量调整。作为敏感性分析的一部分，进行了倾向评分匹配比较。
社会隔离者更有可能未接种疫苗（OR 1.48，95%CI 1.37-1.60），而孤独者则不然（OR 0.96，95%CI 0.88-1.05）。与非社会隔离者相比，社会隔离者从接种疫苗的人那里获得信息的可能性明显较小（11%比 15%），而且不太可能不信任疫苗批准过程（19%比 27%）。
尽管对疫苗没有负面看法，但社会隔离者的 COVID-19 疫苗接种率较低。社会隔离者是增加接种人数的重要目标人群。
