Ohyama Katsunori, Isumi Aya, Doi Satomi, Okada Shusho
Department of Health Care Policy Planning, Institute of Science Tokyo, Tokyo, Japan.
Medicine (Baltimore). 2025 Aug 1;104(31):e43614. doi: 10.1097/MD.0000000000043614.
Although increasing coronavirus disease (COVID-19) vaccination coverage is a measure to prevent the spread of severe acute respiratory syndrome coronavirus 2, a certain percentage of people refuse to be vaccinated (i.e., vaccine hesitancy [VH]), and there are various reports on the reasons behind this. Adverse childhood experiences (ACEs) have been reported to reduce trust in health services and may negatively impact lifelong health and well-being. Several studies have examined the effects of protective and compensatory experiences (PACEs) in mitigating the negative impact of ACEs. This study aimed to investigate the association between COVID-19 vaccination status and ACEs and the vaccination status of patients who experienced PACEs. Additionally, we examined whether PACEs influence individuals' vaccination intentions by examining whether those who experienced ACEs as children and subsequently experienced PACEs were more receptive to vaccination than those who did not subsequently experience PACEs. This cross-sectional study investigated the relationship between ACEs and PACEs and the acceptance of COVID-19 vaccination using a questionnaire from the COVID-19 seROprevalence Neighborhood Association study among adults in Utsunomiya City, Tochigi Prefecture, Japan. Individuals with ACEs were significantly more likely to experience VH (odds ratio: 3.66, 95% confidence interval [CI]: 1.31-10.27) than those without. Vaccination coverage tended to be higher among those with PACEs (odds ratio: 0.24, 95% CI: 0.05-1.15) than among those without, though the difference was not statistically significant. In contrast, those who had experienced ACEs and subsequently PACEs showed no difference in vaccination coverage (odds ratio: 0.47, 95% CI: 0.05-4.22) compared with those who had experienced ACEs and subsequently did not experience PACEs. In Japan, a significantly high proportion of patients with VH experienced ACEs. Our findings indicate that PACEs did not enhance vaccination intentions among individuals with ACEs. However, further comprehensive studies are required to establish definitive and robust associations.
尽管提高冠状病毒病（COVID-19）疫苗接种覆盖率是预防严重急性呼吸综合征冠状病毒2传播的一项措施，但仍有一定比例的人拒绝接种疫苗（即疫苗犹豫[VH]），关于其背后的原因有各种报道。据报道，童年不良经历（ACEs）会降低对医疗服务的信任，并可能对终身健康和幸福产生负面影响。多项研究探讨了保护性和补偿性经历（PACEs）在减轻ACEs负面影响方面的作用。本研究旨在调查COVID-19疫苗接种状况与ACEs之间的关联，以及经历过PACEs的患者的疫苗接种状况。此外，我们通过检查童年经历过ACEs且随后经历过PACEs的人是否比未经历过PACEs的人更愿意接种疫苗，来研究PACEs是否会影响个体的接种意愿。这项横断面研究使用来自日本枥木县宇都宫市COVID-19血清流行率社区协会研究的问卷，调查了ACEs和PACEs与COVID-19疫苗接种接受度之间的关系。与没有ACEs的人相比，有ACEs的人经历VH的可能性显著更高（优势比：3.66，95%置信区间[CI]：1.31-10.27）。有PACEs的人的疫苗接种覆盖率往往高于没有PACEs的人（优势比：0.24，95%CI：0.05-1.15），尽管差异无统计学意义。相比之下，与经历过ACEs但随后未经历过PACEs的人相比，经历过ACEs且随后经历过PACEs的人在疫苗接种覆盖率上没有差异（优势比：0.47，95%CI：0.05-4.22）。在日本，经历VH的患者中ACEs的比例显著较高。我们的研究结果表明，PACEs并未增强有ACEs个体的接种意愿。然而，需要进一步的综合研究来确定明确和可靠的关联。
