Maeda Megumi, Murata Fumiko, Fukuda Haruhisa
Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
BMJ Public Health. 2025 Jul 27;3(2):e002149. doi: 10.1136/bmjph-2024-002149. eCollection 2025.
Japan introduced a routine rotavirus vaccination programme in October 2020, and infants born in or after August 2020 were eligible to be vaccinated under full government subsidy. However, the effects of this programme on vaccination coverage and vaccination factors remain unclear. This study aimed to determine the changes in rotavirus vaccination coverage and factors among infants residing in a Japanese municipality before and after the introduction of routine rotavirus vaccinations.
This retrospective cohort study was conducted using vaccination records, resident register data and medical claims data acquired from a municipality. We identified infants born between April 2019 and February 2022; infants born before August 2020 were analysed as 'pre-introduction', and infants born in or after August 2020 were analysed as 'post-introduction'. The pre-post changes in vaccination coverage were examined using an interrupted time-series analysis. To identify vaccination factors, we analysed the associations of sociodemographic and socioeconomic factors with rotavirus vaccination status using Poisson regression and modified least-squares regression analyses. The risk ratios and risk differences were estimated.
We analysed 26 174 infants (pre-introduction: 12 532, post-introduction: 13 642). The introduction of routine rotavirus vaccinations was immediately followed by an increase of 11.24% in vaccination coverage. These increases were notable among infants with ≥3 siblings (40.47%) and infants covered by public assistance (60.65%). Next, infants with older siblings, younger mothers, single-mother households and use of public assistance were less likely to be vaccinated in the pre-introduction period. The post-introduction period showed generally similar trends in vaccination factors. However, the introduction of routine rotavirus vaccinations substantially reduced the impact of these factors on vaccination status.
The introduction of the routine rotavirus vaccination programme improved vaccination coverage and reduced the impact of sociodemographic and socioeconomic factors on vaccine uptake.
日本于2020年10月推出了常规轮状病毒疫苗接种计划，2020年8月及以后出生的婴儿有资格在政府全额补贴下接种疫苗。然而，该计划对疫苗接种覆盖率和接种因素的影响仍不明确。本研究旨在确定在日本一个城市引入常规轮状病毒疫苗接种前后，婴儿轮状病毒疫苗接种覆盖率和相关因素的变化。
本回顾性队列研究使用了从一个城市获取的疫苗接种记录、居民登记数据和医疗理赔数据。我们确定了2019年4月至2022年2月期间出生的婴儿；2020年8月之前出生的婴儿被分析为“引入前”，2020年8月及以后出生的婴儿被分析为“引入后”。使用中断时间序列分析检查疫苗接种覆盖率的前后变化。为了确定接种因素，我们使用泊松回归和修正最小二乘回归分析，分析社会人口统计学和社会经济因素与轮状病毒疫苗接种状况之间的关联。估计风险比和风险差异。
我们分析了26174名婴儿（引入前：12532名，引入后：13642名）。引入常规轮状病毒疫苗接种后，疫苗接种覆盖率立即提高了11.24%。在有≥3个兄弟姐妹的婴儿（40.47%）和获得公共援助的婴儿（60.65%）中，这些增幅尤为显著。其次，在引入前阶段，有年长兄弟姐妹、年轻母亲、单亲家庭以及获得公共援助的婴儿接种疫苗的可能性较小。引入后阶段在接种因素方面总体呈现相似趋势。然而，常规轮状病毒疫苗接种的引入大幅降低了这些因素对疫苗接种状况的影响。
常规轮状病毒疫苗接种计划的引入提高了疫苗接种覆盖率，并降低了社会人口统计学和社会经济因素对疫苗接种率的影响。
