ABSTRACT
<b>Introduction</b> : Recommendations from healthcare providers are considered by vaccinees and their parents when they decide whether to receive an immunization. However, in Japan, the attitudes of primary care physicians toward vaccination are unknown. We assessed some practices and recommendations of, and barriers to, primary care physicians regarding vaccinations in Japan.<br><b>Methods</b> : A self-administered questionnaire was mailed (in 2012) to 3000 randomly selected physician-members of the Japan Primary Care Association. Excluded were physicians within two years after graduation, living abroad or retired. We described respondent practices, recommendations, and barriers to the provision of routine and voluntary vaccinations.<br><b>Results</b> : The overall response rate was 25.8%. The rates at which physicians gave routine and voluntary vaccines in their own practices were 29.0-91.4% and 15.2-89.5%, respectively. The vaccine recommendation rates for routine and voluntary vaccines were 58.2-70.2% and 14.1-50.9%, respectively. The physicians reported that their barriers to recommendation of routine vaccines were vaccination schedule complexity (32.9%), opinions of vaccinees and parents (28.9%), and vaccine safety (27.7%). They also reported that perceived vaccine safety (62.1%), lack of understanding of vaccine-preventable diseases (55.7%), and complexity of vaccine schedules (44.4%) were reasons given by vaccinees and parents for noncompliance. Physicians' barriers to recommendation of voluntary vaccines were cost (45.3%), safety (35.1%), and lack of information (30.1%). They reported that vaccinees and parents expressed concern about cost (61.8%), safety (51.8%), and lack of vaccine information (50.7%).<br><b>Conclusion</b> : We clarified practices, recommendations, and barriers to primary care physicians regarding routine and voluntary vaccination in Japan.