ABSTRACT
Background: We examined occupational disparities in COVID-19 vaccine hesitancy in Japan. Methods: Cross-sectional online surveys were conducted among of residents living in Iwate Prefecture from July 2 to 4 and from October 1 to 3 in 2021 (total n=17,914). Intention to get vaccinated for COVID-19 was assessed by self-report questions. We calculated odds ratios for vaccine hesitancy among occupational groups using logistic regression models controlling for covariates and stratified by age and sex groups. Results: The overall prevalence of vaccine hesitancy was 5.5% in our sample of working-age adults. Women <40 years were also 1.6 times more likely to be vaccine hesitant, citing concerns about adverse effects on pregnancy or breastfeeding. Among people aged 40-59 years, workers in the service industry, manufacturing industry, and the unemployed were significantly more likely to have perceived vaccine hesitancy regardless of sex. Young service workers viewed themselves as being more vulnerable to risk of infection but less susceptible to getting severe disease, whilst exhibiting low levels of vaccine knowledge. Middle-aged (40-59 years) workers in the manufacturing industry underestimated both vulnerability to infection and disease severity, as well as demonstrated low knowledge of vaccines and practice of preventive measures. Conclusions: While complex and heterogeneous reasons for COVID-19 vaccine hesitancy have been cited in Western countries (e.g., mistrust of government, medical mistrust, and conspiracy beliefs), the situation in Japan may be more amenable to educational interventions targeting specific occupations. Policymakers should target interventions for increasing vaccine readiness in high risk occupations.
ABSTRACT
BACKGROUND: There has been no study in which the association between levels of vaccine knowledge and preventive behaviors was examined during the COVID-19 pandemic. We examined the transition to risky (transmission) behavior according to level of vaccine knowledge over a seven-month period when vaccines became widely available in Japan. METHODS: A series of cross-sectional surveys were conducted using rapid online surveys of residents in Iwate Prefecture from December 4 to 7 in 2020 (the first survey) and from July 2 to 4 in 2021 (the fourth survey). We calculated each individual's risk of acquiring SARS-CoV-2 infection using a quantitative assessment tool (the microCOVID calculator). The respondents' level of knowledge regarding the COVID-19 vaccine was assessed by a questionnaire and was divided into four groups: very low level, low level, moderate level, and high level of vaccine knowledge. RESULTS: People with a high-level knowledge about the vaccine had significantly higher odds ratios (ORs) of transitioning to high-risk behavior compared to people with a low level of vaccine knowledge (OR [95% confidence interval (CI)], 1.50 [1.17-1.93]; P = 0.001). There was a dose-response association according to the four levels of vaccine knowledge, while engagement in preventive measures in the first survey was not associated with high-risk behavior in the follow-up survey. CONCLUSIONS: Since new variants of SARS-CoV-2 have evolved, policy makers should continue to communicate strong messages to keep a high level of consciousness and maintain basic preventive measures even after widespread vaccination.
Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Humans , Japan/epidemiology , Pandemics/prevention & control , SARS-CoV-2 , VaccinationABSTRACT
OBJECTIVES: There has been no study in Japan on the predictors of risk for acquiring SARS-CoV-2 infection based on people's behaviour during the COVID-19 pandemic. The aim of this study was to document changes in risk behaviour during the New Year's holiday season in 2021 and to identify factors associated with high-risk behaviour for infection using a quantitative assessment tool. DESIGN: A longitudinal survey. SETTING: Multiphasic health check-ups for the general population in Iwate Prefecture. PARTICIPANTS: Serial cross-sectional data were obtained using rapid online surveys of residents in Iwate Prefecture from 4 to 7 December 2020 (baseline survey) and from 5 to 7 February 2021 (follow-up survey). The data in those two surveys were available for a total of 9741 participants. MAIN OUTCOME MEASURES: We estimated each individual's risk of acquiring SARS-CoV-2 infection based on the microCOVID calculator. We defined four trajectories of individual risk behaviours based on the probabilities of remaining at low risk, increasing to high risk, improving to low risk and persistence of high risk. RESULTS: Among people in the low-risk group in the first survey, 3.6% increased to high risk, while high risk persisted in 80.0% of people who were in the high-risk group at baseline. While healthcare workers were significantly more likely to be represented in both the increasing risk and persistently high-risk group, workers in the education setting were also associated with persistence of high risk (OR 2.58, 95% CI 1.52 to 4.39; p<0.001). CONCLUSIONS: In determining countermeasures against COVID-19 (as well as future outbreaks), health officials should take into account population changes in behaviour during large-scale public events.