A Socio-Demographic Examination of Adults Responding to Governmental Vaccination Recommendations during the Japanese Rubella Outbreak of 2013

Abstract

BackgroundIn 2013 a rubella outbreak occurred among Japanese people of working-age which resulted in 14,357 reported cases. The Japanese government subsequently recommended voluntary vaccination or rubella antibody testing for young women (15–49 years of age) who were planning to conceive and for adult men, children, and other persons in potential contact with pregnant women at home. However, the expense and time involved for vaccination, antibody testing and visiting a clinic may represent a major barrier to voluntary compliance among this busy demographic. The aim of the current study was, therefore, to examine potential relationships between the social background of Japanese working-age individuals affected by the 2013 voluntary vaccination campaign.MethodsA web-based survey of 1,889 Japanese men and women aged 20–49 years was conducted in early 2014. Statistical analyses were used to explore the associations between social background and testing for rubella antibody and / or vaccination uptake during the previous year.ResultsTwenty-four percent of respondents who were planning a pregnancy had been tested for rubella antibody or vaccinated in 2013. However, among those without a current desire for pregnancy, 3% of men and 7% of women, respectively, were tested or vaccinated. Regardless of whether they were planning to conceive, testing for rubella antibodies or vaccination was statistically associated with having acquaintances who had been vaccinated, understanding the government recommendations, and being able to confirm their lack of rubella vaccination history using Maternal and Child Health Handbook records in both men and women.ConclusionTo help eliminate rubella in Japan, additional initiatives need to target Japanese individuals who cannot envisage a direct benefit from vaccination. The results of this study suggest that disseminating the government recommendation to all potentially affected subpopulations, along with maintaining life-time vaccination records might offer a solution to encourage vaccination uptake among working-age adults in Japan, as elsewhere.

Factors Associated With Participation in an Ongoing National Catch-up Campaign Against Rubella: A Cross-sectional Internet Survey Among 1,680 Adult Men in Japan

“…The present study found that partner's current desire for pregnancy did not affect adult men's participation in the rubella catch-up program. This nding is in contrast to our previous study conducted in 2014, which found that partner's current desire for pregnancy was a major factor associated with adult men's voluntary rubella antibody testing and vaccination [14]. This difference in results is reasonable because, at the time of the rst survey, during the 2013-2014 rubella outbreak, the government recommendation for voluntary rubella vaccination targeted only women and men with a desire to conceive who could not con rm a rubella vaccination history [4].…”

“…Being able to con rm a rubella vaccination history was also signi cantly associated with antibody testing. These results are consistent with our previous report of the results of a 2014 survey [14]. In the present study, we also found that awareness of congenital rubella syndrome was not signi cantly associated with rubella antibody testing in the multivariate analyses.…”

“…Japan periodically faces rubella outbreaks among adult men who did not have the opportunity to be immunized against rubella in childhood [1]. In 2013, a rubella outbreak in Japan resulted in 14,344 reported rubella cases and 45 newborns with congenital rubella syndrome [2]. At the time, the Japanese government set the goal of eliminating rubella by 2020 [3] and recommended voluntary rubella antibody testing or vaccination for women intending to conceive, as well as for their family members [4].…”

Reconstructing the transmission dynamics of rubella in Japan, 2012-2013

“…Spatial heterogeneity in susceptibility could act as the key to discriminating the metapopulation model from homogeneous models, and our approach was unable to capture that aspect. It should be remembered that the susceptible pocket was observed mainly among males aged 35–49 years in Japan [ 19 , 20 ], which we intend to address in the forthcoming study with age structured model. The fraction of this “high risk” subpopulation may vary by prefecture and heterogeneous contact patterns would also differ.…”

Comparing catch-up vaccination programs based on analysis of 2012–13 rubella outbreak in Kawasaki City, Japan

“…The enlightenment activity promoting vaccinations for the unimmunized people in these generations would be vital for elimination of rubella. A research suggested that additional initiatives for persons who do not believe that they directly benefit from vaccination is needed [ 36 ]. In Japan, most full-time workers can hardly find time to get vaccinations in week days [ 7 ].…”