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

  1. Shohei Okamoto
  2. Kazuki Kamimura
  3. Kohei Komamura

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Abstract

While 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.

Design

Cross-sectional study, longitudinal study and conjoint experimental design.

Setting

An online survey conducted in Japan in July 2021.

Participants

A demographically representative sample of 5000 Japanese adults aged 20–74.

Primary outcome measures

COVID-19 vaccination intention

Results

We 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.

Conclusion

With 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.

Article activity feed

  1. Version published to 10.1136/bmjopen-2022-060829
  2. Version published to 10.1101/2021.09.15.21263559v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.09.15.21263559: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were conducted using Stata MP, version 16.1 (StataCorp LLC, College Station, United States of America).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Nevertheless, several limitations should be noted due to caveats. First, our study was based on a hypothetical experiment and not a real situation. Therefore, actual behaviour may diverge from the survey responses. Notwithstanding this limitation, our findings should still be helpful, based on previous reports that more than 80% of the stated and revealed preferences corresponded (de Bekker-Grob et al., 2020; de Bekker-Grob et al., 2019; Lambooij et al., 2015). Second, our findings are based on a single survey. Vaccination intentions may fluctuate due to the pandemic situation and the timing of the survey. Furthermore, our results may not be applicable in other countries, since the pandemic situation, government responses to the pandemic, and reasons for vaccine hesitancy can vary across countries. In Japan, compared to Western countries, the COVID-19 mortality rate is much lower (World Health Organization, 2021b), and government responses to the pandemic are less stringent (Hale et al., 2021); hence, the attitude of the Japanese population toward the vaccine and vaccine passports availability may differ from other countries. Therefore, intertemporal and cross-national evidence needs to be accumulated through further studies. In conclusion, this work offers encouraging findings regarding the vaccination intentions of the Japanese people. Although some individuals hesitate to get vaccinated against COVID-19, this can be reduced by mitigating concerns about vaccine safety and s...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  4. Version published to 10.1101/2021.09.15.21263559v1 on medRxiv