COVID-19 vaccine hesitancy and vaccine passports: a cross-sectional conjoint experiment in Japan

Abstract

ObjectivesWhile the development of vaccines against the Novel Coronavirus (COVID-19) brought hope of establishing herd immunity and ending the global pandemic, vaccine hesitancy can hinder the progress towards herd immunity. In this study, by analysing the data collected when citizens undergo public health restrictions due to the pandemic, we assess the determinants of vaccine hesitancy, reasons for hesitation and potential effectiveness of vaccine passports used to relax public health restrictions on mitigating vaccine hesitancy.DesignCross-sectional study, longitudinal study and conjoint experimental design.SettingAn online survey conducted in Japan in July 2021.ParticipantsA demographically representative sample of 5000 Japanese adults aged 20–74.Primary outcome measuresCOVID-19 vaccination intentionResultsWe found that about 30% of respondents did not intend to get vaccinated or had not yet decided, with major reasons for vaccine hesitancy relating to concerns about the safety and side effects of the vaccine. In line with previous findings, younger age, lower socioeconomic status, and psychological and behavioural factors such as weaker COVID-19 fear were associated with vaccine hesitancy. Easing of public health restrictions such as travel, wearing face masks and dining out at night was associated with an increase in vaccine acceptance by 4%–10%. Moreover, we found that more than 90% of respondents who intended to get vaccinated actually received it while smaller proportions among those undecided and unwilling to get vaccinated did so.ConclusionWith a major concern about vaccine safety and side effects, interventions to mitigate against these may help to reduce vaccine hesitancy. Moreover, when citizens are imposed with restrictions, vaccine passports that increase their freedom may be helpful to increase vaccination rates.

The Relationship between Daily Behavior Changes and Vaccine Attitudes at the Early Stage of the COVID-19 Pandemic among Japanese People from Different Demographics: A Retrospective and Exploratory Examination Using a Free-Response Survey

“…Participants who reported the greater magnitude of behavior change in the present study were women, younger generations, those without children, and those with higher incomes. Apart from income, those demographic categories correspond to the population who reported a hesitant attitude towards the vaccines at the early stage of the Japanese vaccine program [ 17 , 21 , 22 , 23 ]. It can be interpreted that individuals who were unwilling to receive vaccines were more motivated to prevent virus transmission through behavior change.…”

“…In contrast, those who were reluctant to change behaviors were more willing to receive vaccines. It is reported that the most common reasons for vaccine hesitancy in Japan were side effects and uncertain safety [ 23 ]. Individuals accepting these risks appeared to have prioritized maintaining pre-pandemic behaviors as much as possible, while those who were unwilling to take risks associated with the vaccines chose to prevent the illness through behavior changes.…”

“…The younger generations, women, and people without children showed a significantly greater magnitude of behavior change than their counterparts in each demographic category. They were the groups with more hesitant attitudes toward vaccines [ 17 , 21 , 22 , 23 ]. The COVID-19-related behavior changes and vaccine attitudes are highly likely to be related in such a way that people who are reluctant to change behaviors are willing to receive vaccines, while those who are concerned about vaccination risks favor behavior changes for illness prevention.…”

“…Therefore, only research measuring vaccine attitudes no later than July 2021 have been referred to. According to the literature, demographic groups with hesitant attitudes were women, younger generations, individuals with low income or assets, and those without children [ 17 , 21 , 22 , 23 ].…”

“…The obtained results were then contrasted with the vaccine attitude using the literature which reported the attitudes among Japanese at roughly the same time as the data collection of the present research (see details in Section 2.4 ). It was consistently found that demographic characteristics associated with hesitant attitudes at that time were: being women, being young, having low income or assets, and having no children [ 17 , 21 , 22 , 23 , 24 , 25 ]. In terms of behavior changes, those who were hesitant about the vaccine were likely to choose behavioral strategies to prevent viral spread.…”