Patterns of HPV vaccine hesitancy among catch-up generations in Japan: A descriptive study

Masaki Machida; Shigeru Inoue

doi:10.1016/j.vaccine.2023.03.061

Patterns of HPV vaccine hesitancy among catch-up generations in Japan: A descriptive study

Vaccine. 2023 May 2;41(18):2956-2960. doi: 10.1016/j.vaccine.2023.03.061. Epub 2023 Apr 4.

Authors

Masaki Machida¹, Shigeru Inoue²

Affiliations

¹ Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan; Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address: machida@tokyo-med.ac.jp.
² Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.

PMID: 37024410
DOI: 10.1016/j.vaccine.2023.03.061

Abstract

Background: Cervical cancer is a preventable disease caused by human papillomavirus (HPV). The HPV vaccine uptake in Japan has been slow since the Ministry of Health, Labour and Welfare suspended the recommendation for proactive HPV vaccination in 2013. In April 2022, Japan initiated catch-up vaccinations for women who missed the opportunity to receive the HPV vaccine. However, as of September 2022, very few women had received catch-up vaccination, raising concerns about vaccine hesitancy in the target population. It is necessary to understand the thinking and motivation of the target population to develop effective strategies to improve vaccination rates. Therefore, using cluster analysis, this study aimed to clarify the pattern of HPV vaccine hesitancy among the catch-up generations in Japan.

Methods: This descriptive study was based on an Internet survey completed by 3,790 women in Japan aged over 18 years who were eligible for catch-up vaccination and had not yet received an HPV vaccine. Participants were asked about their intention and thinking about the HPV vaccine and descriptive norms on vaccination intention. Cluster analysis using k-means clustering was performed to clarify these patterns.

Results: Cluster analysis revealed three hesitancy patterns: acceptance, neutral and refusal. The acceptance group, with high intention, comprised 28.2% of the participants, and students and a high-income level mainly dominated this group. The refusal group, with negative thinking and low intention, accounted for 20.1% and was more prevalent among workers and the unemployed. The neutral group, with neutral thinking and intention, accounted for 51.6%. The perceived effect of descriptive norms on vaccination intention was large in the acceptance group but small in the refusal group.

Conclusion: HPV vaccine awareness promotion strategies must be based on the characteristics of each group and the different distributions of sociodemographic factors.

Keywords: Cluster analysis; Human papillomavirus vaccine; Social norm; Vaccination readiness; Vaccine hesitancy.

MeSH terms

Adult
Female
Health Knowledge, Attitudes, Practice
Humans
Japan
Middle Aged
Papillomavirus Infections* / prevention & control
Papillomavirus Vaccines*
Patient Acceptance of Health Care
Uterine Cervical Neoplasms* / epidemiology
Uterine Cervical Neoplasms* / prevention & control
Vaccination
Vaccination Hesitancy

Substances

Papillomavirus Vaccines