A qualitative analysis of the beliefs of Japanese anti-influenza vaccination website authors

Abstract

BackgroundInfluenza vaccine coverage among the Japanese population is less than optimal. Anti-vaccination sentiment exists worldwide, and Japan is no exception. Anti-influenza vaccination activists argue on the internet that influenza vaccine has little or no efficacy and a high risk of side effects, and they warn that people should forgo vaccination. We conducted a qualitative analysis to explore beliefs underlying the messages of anti-influenza vaccination websites, by focusing on the perceived value these beliefs provide to those who hold them.MethodsWe conducted online searches in January 2017 using two major Japanese search engines (Google Japan and Yahoo! Japan). Targeted websites were classified as “pro”, “anti”, or “neutral” depending on their claims. We applied a dual analytic approach—inductive thematic analysis and deductive interpretative analysis—to textual data of the anti websites.ResultsOf the 113 anti websites, we identified two themes that correspond to beliefs: it is necessary to 1) protect others against risks and exploitation related to influenza vaccination, and 2) educate others about hidden truths and self-determination. Authors of anti websites ascribed two values (people's “safety” and one's own “self-esteem”) to their beliefs.DiscussionWebsite authors may engage in anti-vaccination activities because they want to feel they are virtuous, saving people from harm caused by vaccination, and to boost their self-esteem, thinking “I am enlightening uninformed people.” The anti-vaccination beliefs of website authors were considered to be strong. In promoting vaccination, it would be better not to target outright vaccine refusers, such as the authors of anti-vaccination websites; it is preferable to target vaccine-hesitant people who are more amenable to changing their attitudes toward vaccination. We discuss possible means of promoting vaccination in that target population.

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“…Furthermore, the cumulative morbidity rate is relatively low, and behavioral restrictions are limited [ 21 ]. In the case of the influenza vaccine, a qualitative analysis of the beliefs of the authors of a Japanese anti-vaccine website revealed that they were not believers in conspiracy theories but that their anti-vaccine attitudes were motivated by two primary concerns: people’s “safety” and “self-esteem” [ 26 ]. This background peculiarity may be related to the low odds ratio for “Compliance”.…”

“…We obtained approval from the Ethics Committee of Saga University (No: R2-24) to conduct this study. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), 40-49, 50-59, 60-69, 70-79 years), occupation, area of residence, marital status (married, unmarried), presence of children, annual household income category (below or above JPY 4 million), highest educational qualification (high school, vocational school, or university), height and weight, underlying diseases, and smoking status. Participants were also asked whether they or their close relatives had ever been infected with COVID-19, whether they had a history of close contact, and whether they had undergone polymerase chain reaction or antigen testing for detecting COVID-19.…”

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“…There were also concerns about pregnancy and the effects of vaccination on the future fetus, similar to influenza vaccination [26]. Okuhara et al showed that it was more effective to target vaccine-hesitant individuals rather than outright vaccine refusers because their attitudes toward vaccination are more amenable to change [27]. Before the first vaccination, the infection control team, which plays a major role in infection control in hospitals, such as the treatment of infectious diseases and countermeasures against resistant bacteria [28], was not able to provide adequate information on the COVID-19 vaccine to medical staff.…”

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“…According to many reports, inaccurate websites often appear among the top 10 results and provide erroneous information [ 21 , 22 ]. In the United Kingdom, Wikipedia sometimes appears more often in the search results than the National Health Service’s website [ 23 ].…”