Mistrust surrounding vaccination recommendations by the Japanese government: results from a national survey of working-age individuals

Background: Considering that public attitudes on vaccine safety and effectiveness are known to influence the success of vaccination campaigns, an increased understanding of socio-demographic characteristics might help improve future communication strategies and lead to greater rates of vaccination uptake. This study investigated associations between mistrust for governmental vaccine recommendations and the socio-demographic characteristics of working-age individuals in Japan. Methods: A web-based, cross-sectional survey of vaccination attitudes was conducted among 3140 Japanese people aged 20 to 69 years. Multiple logistic regression analysis was used to examine statistical associations between vaccination attitudes and socio-demographic characteristics, including the participant's most trusted information resources, demographic factors and general health conditions. Results: A total of 893 (28.4%) individuals reported a general mistrust towards the Japanese government's recommendations for vaccination. Respondents who did not trust official government sources were more likely to consider friends, the internet and books (for both genders); family members and newspapers (among women only); and television (among men only), as the most trusted resources for vaccination-related information. Relatively poor health in men was associated with a general mistrust of vaccination recommendations (adjusted Odds Ratio (aOR): 1.37, 95% Confidence Interval (95% CI): 1.07-1.69). A trend towards worsening general health was also associated with decreasing trust in vaccination recommendations by female respondents as follows: those reporting relatively good health (aOR: 1.24, 95% CI: 1.02-1.47); relatively poor health (aOR: 1.55, 95% CI: 1.22-1.90); and poor health (aOR: 2.10, 95% CI: 1.41-2.63) (p for trend < 0.05). Conclusions: Overall, this study suggests that communication strategies for rebuilding public trust in vaccination safety need to be urgently addressed in Japan. Such protocols must consider the information sources that working-age populations are most likely to utilize in this country, as well as their general health conditions, especially among females.