Attitudes toward COVID-19 vaccination during the state of emergency in Osaka, Japan.

BACKGROUND: COVID-19 vaccination for general population started on April 12, 2021, in Osaka, Japan. We investigated public attitudes toward vaccination and associated factors of vaccine hesitancy during the third state of emergency. METHODS: An internet-based, self-reported, cross-sectional survey was conducted in June 2021, using the smartphone health app for residents of Osaka aged ≥18 years. Respondents were asked about their attitudes toward COVID-19 vaccine. Responses "Don't want to receive vaccines" or "Don't know" were defined as vaccine hesitancy (vs. "Received [1st dose]", "Received [2nd dose]", or "Want to receive vaccines"). Multivariable Poisson regression analysis was conducted to examine the associations between hesitancy and population characteristics. RESULTS: 23,214 individuals (8,482 men & 14,732 women) were included in the analysis. Proportions that answered "Received (1st dose)", "Received (2nd dose)", "Want to receive vaccines", "Don't want to receive vaccines", "Don't know", and "Don't want to answer" were 14.6%, 3.8%, 70.6%, 4.3%, 6.1%, and 0.5% among men; and 11.3%, 6.0%, 64.9%, 6.2%, 11.0%, and 0.6% among women. Factors associated with vaccine hesitancy included being a woman (aPR = 1.33; 95%CI = 1.23-1.44), age 18-39 (aPR = 7.00; 95%CI = 6.01-8.17) and 40-64 years (aPR = 4.25; 95%CI = 3.71-4.88 vs. 65+ years), living alone (aPR = 1.19; 95%CI = 1.08-1.30 vs. living with 3+ members), non-full-time employment and unemployment (aPRs ranged 1.12 to 1.49 vs. full-time employment), cardiovascular diseases/hypertension (aPR = 0.72; 95%CI = 0.65-0.81), and pregnancy (women of reproductive age only) (aPR = 1.35; 95%CI = 1.03-1.76). CONCLUSIONS: Most respondents expressed favorable attitudes toward COVID-19 vaccination while hesitancy was disproportionately high in certain populations. Efforts are needed to ensure accessible vaccine information resources and healthcare services.

Economic Hardships and Self-reported Deterioration of Physical and Mental Health Under the COVID-19 Pandemic: A Cross-sectional Study, 2020, Japan.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has disproportionately affected the most vulnerable populations. We assessed the prevalence and disparities of economic hardships and their impact on health deterioration in Japan. METHODS: Data were obtained from a nation-wide, cross-sectional, internet-based, self-reported survey conducted during August-September, 2020 with individuals aged 15-79 years in Japan (n = 25,482). Economic hardships and changes in various physical and mental health status were measured using sample-weighted data. Adjusted prevalence ratios (APRs) were estimated to investigate the associations between economic hardships and health outcomes. RESULTS: During April-September, 2020 in Japan, 25.0%, 9.6%, 7.9%, and 3.1% of the respondents experienced income loss, money shortage, financial anxiety and financial exploitation, respectively, with higher prevalence among workers (vs non-workers). Stratifying by sex and working status, income loss was associated with physical health deterioration (APRs ranged from 1.45-1.95), mental health deterioration (APRs ranged from 1.47-1.68), and having serious psychological distress (APRs ranged from 1.41-2.01) across all strata. Shortage of money and financial anxiety were also associated with increased likelihood of all adverse health outcomes assessed, regardless of whether the hardships were pre-existing or experienced first time. Among non-working individuals, financial exploitation was associated with physical health deterioration among males (APR 1.88) and mental health deterioration among both males (APR 1.80) and females (APR 2.23), while such associations were not observed among working individuals. CONCLUSIONS: During the early phase of the COVID-19 epidemic, COVID-19-related economic hardships were associated with physical and mental health deterioration in Japan, particularly among the vulnerable populations. Timely and prompt responses are warranted to mitigate both economic and health burdens.

Factors associated with serious psychological distress during the COVID-19 pandemic in Japan: a nationwide cross-sectional internet-based study.

OBJECTIVE: To investigate the factors associated with serious psychological distress (SPD) during the COVID-19 pandemic in Japan. DESIGN: Nationwide cross-sectional study using survey data. SETTING: Internet survey using sampling weights for national estimates conducted between 25 August and 30 September 2020 in Japan. EXPOSURES: Demographics (age, gender), socioeconomic status (income level, employment type, educational attainment, marital status, family composition and caregiving burden); the experience of domestic violence (DV), the state of emergency and fear of and stigma related to COVID-19. MAIN OUTCOME MEASURES: Prevalence of SPD, defined as Kessler 6 Scale score ≥13. RESULTS: Among 25 482 respondents, 10.0% met the criteria of SPD. Overall, women (adjusted OR (aOR) 1.59; 95% CI 1.17 to 2.16; p=0.003), ages 15-29 (aOR 2.35 compared with ages 45-59 years; 95% CI 1.64 to 3.38; p<0.001), low-income level (aOR 1.70 compared with intermediate income; 95% CI 1.16 to 2.49; p=0.007), providing caregiving to family members (aOR 5.48; 95% CI 3.51 to 8.56; p<0.001), experiencing DV (aOR 5.72; 95% CI 3.81 to 8.59; p<0.001) and fear of COVID-19 (aOR 1.96; 95% CI 1.55 to 2.48; p<0.001) were associated with SPD. Among women aged 15-29 years, who have a higher risk of suicide during the COVID-19 pandemic in Japan, caregiving, DV, fear of COVID-19 and COVID-19-related stigma were associated with SPD. CONCLUSIONS: Economic situation, caregiving burden, DV and fear of COVID-19 were independently associated with SPD during the COVID-19 pandemic. Among young women, similar factors, except economic situation, were associated with SPD. Targeted interventions based on age and gender may be more effective in mitigating the negative impact of the COVID-19 pandemic on the population's mental health.

Health-Related Quality of Life during COVID-19 Pandemic: Assessing Impacts of Job Loss and Financial Support Programs in Japan.

This cross-sectional study examined the association between job loss during the coronavirus disease 2019 (COVID-19) pandemic and health-related quality of life (HRQOL) in the Japanese working population and whether universal financial support program has a protective influence on the HRQOL. Two self-reported internet surveys were used to determine job loss during the pandemic: one was conducted between February and March 2020, just before the COVID-19 emergency declaration by the Japanese government (April 2020), and the other was conducted between August and September 2020. For the dependent variable, we used the EQ-5D-5L utility score (QOL utility score), which was assessed between August and September 2020. The independent variables were job loss after the state of emergency was declared and two types of government financial support (either universal support or support targeting child-raising households). The Tobit regression model was applied, adjusting for covariates. Job loss during the pandemic was negatively associated with the QOL utility score in the fully adjusted model; the coefficient (95% confidence interval [CI]) for job loss during the pandemic was -0.07 (-0.11 to -0.03). For the government financial support variables, the universal financial support program was associated with a better QOL utility score of the coefficient (95% CI), 0.05 (0.03 to 0.08). Job loss during the COVID-19 pandemic is negatively associated with HRQOL, while universal financial support is positively associated with HRQOL. Our study results imply that universal financial support during the COVID-19 era has a protective influence on an individual's HRQOL. Supplementary Information: The online version contains supplementary material available at 10.1007/s11482-021-09918-6.

Public perspective on the governmental response, communication and trust in the governmental decisions in mitigating COVID-19 early in the pandemic across the G7 countries.

The COVID-19 pandemic poses a threat to global health and security inciting governments with the responsibility to respond with measures that ensure the health and safety of their communities. We assessed public attitudes towards governmental actions to combat the COVID-19 pandemic in the G7 countries. Data were collected during 19th-21st March 2020, from 7005 Kantar's online panelists aged >16 years across the G7 countries: Canada, France, Great Britain, Germany, Italy, Japan, and the United States. Data were post-stratified and weighted to match population distributions of the respective countries. Descriptive and multivariable analyses were conducted. Amongst the G7, Japan had the lowest level of approval of governmental response to the pandemic, rating governmental communication as good, and trusting governmental decisions (35.0%, 33.6%, and 38.0%, respectively), followed by the U.S. (52.9%, 64.6%, and 59.9%, respectively). Understanding of which measures one can personally take to help limit the spread of the coronavirus was significantly associated with approving governmental response (aOR = 2.88), rating government communication as good (aOR = 2.70) and trust in future governmental decisions (aOR = 2.73). Those who reported government/politicians and friends/family as their most trusted information source were more likely to report approval, higher rating, and/or trust toward governmental actions. Public attitudes towards governmental actions against COVID-19 varied substantially across the G7 countries and were associated with the understanding of measures and source of information that respondents most trusted. Timely and accurate communication is essential to enhance public engagement to control the COVID-19 pandemic.