Moving the needle: Improving uptake of adult vaccination in Japan
About
The COVID-19 pandemic has put the widespread need for immunisation into sharp focus and is shining a light on the need to drive forward the global agenda on preventing ill health.
For a wealthy and ageing country, Japan remains an outlier in terms of attitudes to adult vaccination, with surveys showing that just 4.7% of adults in Japan agreed that vaccines were important, 25.1% agreed they were safe and 9.9% agreed they were effective.
Despite grappling with a flu epidemic in 2019, Japan is still struggling to significantly raise vaccination uptake rates among people aged 65 and over. And COVID-19 has presented a number of new challenges and opportunities to increasing vaccination uptake in Japan.
This innovative ethnographic project, led by ILC and Stripe Partners, will work to identify, develop and refine two implementation-ready interventions designed to increase the uptake of vaccinations for people aged 65 and over in Japan.
We will achieve this by:
- Collecting the evidence on healthy ageing and immunisation uptake policy in Japan and across the world to understand what works and doesn’t.
- Conducting ethnographic research and design ‘studios’ to understand the barriers to uptake and co-design culturally appropriate interventions which address these needs and barriers;
- Working with Japanese partners who can implement the interventions and raise awareness of the importance of adult immunisation in Japan.
This project has been made possible by a grant from Pfizer Japan Inc.
Current events
Report launch – Moving the needle: Improving uptake of adult vaccination in Japan
Date: Tuesday, 28 March 2023
Time: 9.00am – 10.30am BST (5.00pm – 6.30pm JST)
Join the International Longevity Centre UK (ILC) for the launch of the Moving the needle report, produced in partnership with Stripe Partners. This event will be chaired by Dr Noriko Cable, Honorary Senior Research Fellow, Institute of Epidemiology & Health, UCL. Speakers include:
- Dr Michael Hodin, CEO, Global Coalition on Aging
- Arabella Trower, Senior Consultant, Stripe Partners
- Lily Parsey, Head of Projects, ILC
- Dr Charles Alessi, Chief Clinical Officer, éditohealth
- Jason James, Director General, Daiwa Anglo-Japanese Foundation
Past events
Dinner debate: Healthy ageing in Japan – Lessons from COVID-19 for the future of adult immunisation
Date: Tuesday, 25 January 2022
Time: 6.30pm GMT
During this dinner debate, we spoke about our plans to conduct field research in Japan and gathered ideas from academics, industry experts and policymakers.
During our discussion, we spoke about:
- Attitudes to healthy ageing and immunisation in Japan;
- Opportunities and policy levers in the Japanese context, including learnings from COVID-19;
- Lessons from across the world on what works and doesn’t in addressing low immunisation uptake rates.
Virtual roundtable: Adult immunisation in Japan
Date: Monday, 29 March 2021
Time: 11.00am – 1.00pm BST / 7.00pm-9.00pm JST
On Monday 29 March, we hosted a roundtable via Zoom to discuss the challenges and opportunities of vaccination uptake in Japanese adults aged 65 and over. We spoke with a number of academics and policy experts who specialise in healthy ageing and immunisation in Japan.
To get involved in future events and research on this project, please email Patrick Swain.
News
26/07/2021
Send me a postcard – what does adult vaccination look like in Japan?
ILC and Stripe Partners have launched a new “postcards” initiative aimed at gathering views on vaccines in Japan. This initiative aims to learn about what people in Japan and beyond are hearing, seeing or thinking about the efforts to vaccinate the adult population against Covid-19 and what this might mean for flu, and other vaccinations, in the future.
11/02/2021
Increasing adult vaccination uptake rates in Japan
As Japan is still facing the consequences of a winter spike in COVID-19 infections, a new programme of work will seek to design innovative interventions to increase the uptake of vaccinations for people aged 65 and over in Japan.
Blog
22/04/2021
Why is adult vaccination uptake low in Japan?
The number of coronavirus cases has been increasing in Japan over the past six weeks, but vaccination progress continues to be relatively slow. Just around one million people or 1% of the population have been vaccinated against COVID-19 in the country.
10/02/2021
Can the Olympics prompt a change in Japanese attitudes to vaccination?
This year’s Olympics in Japan could attract 11,000 athletes and around 1 million overseas ticket holders. But as Japan invites the world to their place, the COVID-19 pandemic has put the widespread need for adult immunisation into sharp focus.
Postcards
Travel restrictions mean we can’t travel to Japan right now – but we’re keen to understand what is happening with vaccinations in the country.
Specifically, we’re interested to learn what people are hearing, seeing or thinking about the efforts to vaccinate the adult population against Covid-19 and what this might mean for flu, pneumococcal and other vaccinations in the future.
We want to collect people’s observations which we will collate and share on our project website. We aren’t necessarily looking for experts, but we want people with a perspective and experience of Japan to share their views with us.
We’re inviting people to contribute observations. These could be in any form:
- Photographs of Covid and vaccination-related scenes
- ‘Diary’ style reflections and observations based on personal experience, conversations with friends or colleagues
- Short pieces of writing
- Video ‘blogs’ / vlogs
- Images of relevant newspapers or magazines.
These observations could respond to these questions or ‘prompts’ but these are start points, not constraints:
- How is vaccination of adults against Covid-19 going?
- Are these efforts seen as successful or not? Why?
- What is the national (or more local) debate about vaccination?
- How is the Covid-19 vaccination debate reflective of or different to the discussion about immunisation in general?
- Is there discussion about vaccine hesitancy?
- Do you feel that Covid-19 vaccination has the potential to change the way Japanese society thinks about flu and other vaccinations e.g. pneumococcal, herpes zoster (shingles), hepatitis?
- Do people in Japan think more about vaccines when they get older, and how has Covid-19 changed this?
T&Cs
Where we intend to publish personal contributions, we will credit all contributors, their writing and photos or videos (unless they specifically ask us not to).
If you are interested, please email Patrick Swain with your ideas.
Submissions
Many thanks to Daisuke Watanabe for sharing this Tweet about receiving the COVID-19 booster jab:
Many thanks to ILC-Japan for the following photo submissions:
Entrance to a COVID-19 vaccination centre in Tokyo.
Signs directing to a COVID-19 vaccination centre.
A Japanese COVID-19 vaccination certificate.
Many thanks to ILC-Japan for the following submission on COVID-19 vaccines from interviews with older Japanese adults:
Female, late 70s, rural
“The vaccine will be available in Japan from spring, so I’m going to get it when it is ready. I have never had a flu vaccine, never. But I’m going to have the Corona one. Well, when it’s my turn. I don’t know, I wonder how it will be when I’m on the spot. I think that we have to take it twice, don’t you? I’ve heard that medical staffs have to give it twice. Otherwise, it’s not effective. And they say on TV that it has to be done every three weeks or so, don’t they? They say that if you don’t get it done in a short period, it won’t be effective, so I think it’s better. I’m careful. Well, I am a bit confused. If it’s my turn, I’ll take it.”
Male, early 70s, rural
“Well, I’ll have the vaccine. Positively. I’m not proud of it, but I’ve never had a flu shot. But, you know, I think everyone is washing their hands and gargling thoroughly nowadays. Still, I’ve never heard of anyone getting the flu. But, I’ve never washed my hands so thoroughly before. So, I still feel that if we continue this habit, including disinfection, we will see results not only for coronas but also for influenza.”
Female, early 70s, rural
“It’s been more than half a year since I last spoke to you, and I’m still feeling the same. I still have some pain in my legs, but it’s not getting any worse. I’m going to ask for vaccination when it starts. I don’t go out now, but I’ll feel safer when I get a vaccine.”
Female, late 70s, rural
“It’s about time to start vaccinating, but I can’t decide about it. I’m not sure what I should do because I’ve seen that some people mentioned after-effects on TV. I have a primary care doctor, so I would like to talk to the doctor about what I should do, and then I hope he will say that I can have a vaccination.”
Male, late 60s, urban
“Corona is not airborne like the common cold. There is no need to make such a big issue about it. I think about it compared to the tens of thousands of people who die every year from influenza. So I thought, maybe it’s not such a big issue. But now, at least, corona doesn’t seem to be at a flu-like level anymore. You know, I think that if we do things half-heartedly, it won’t stop until forever. I have the impression that governments are repeatedly dealing with the situation after the fact. People in the medical and welfare sectors are doing their best to protect people’s lives. They are concentrating their knowledge and manpower. They are doing their best to disinfect and wash our hands as much as possible. I’ve never heard of anyone doing too much in the way of frailty prevention. If we need money, we should pay for it, and then we should try different ways to combat frailty. And I think we should be proactive in getting vaccines and treatments that are effective against corona and effective methods against frailty. I’m not a worrier at all. I’m going to have the vaccine, yes. My wife says so too. I don’t know anything about the side effects now, but my mother-in-law is old and has a heart condition, so she’s not very strong. We are still talking about what we should do.”
Male, early 90s, urban
“The older I get, the angrier I get. I’m getting more and more angry as I get older, because I doubt more and more the government policies. I don’t think the government’s response is clear. They tell the people to do this or that, but they have no idea what they are saying. At the same time, I cannot understand what they are saying. It’s like the same thing over and over again, and I don’t evaluate it. I doubt the government is really taking a stand against Corona. Do they really want to protect people’s lives? That feeling is getting stronger and stronger, and it makes me angry. What about the local government? When I asked my doctor what would happen to the vaccine, he said, “We haven’t heard anything”. Yeah. After all, I live in ward XX, not that I’m naming ward XX, but I asked my doctor if he hadn’t heard from the medical association either, or he said that he hadn’t. So, I ask him “when will the vaccine be available?” but, he had no answer. So, I don’t want to rely on them anymore. I have no choice but to protect myself. That’s how I feel now.”
Female, late 80s, urban
“I’m not sure [about the vaccine]. I don’t even know if I can get it. I have shingles. I’ll ask my doctor, and if he says it’s OK, I’ll have it. But they might say it’s better not to have the vaccine. I will ask my doctor when I get the injection. If he says no, I won’t do.”
「コロナワクチン絵手紙活動」
現在渡航制限のため英国から日本への自由な行き来が困難な状況にありますが、私たちムービングニードルプロジェクト(日本における成人ワクチン接種促進プロジェクト)のメンバーは、日本のコロナワクチン接種がどのように進められているか、理解を深めたく思っています。特に、私たちは成人へのコロナワクチン接種の取り組みについて、日本にいる皆様が何を見聞きし、どう考えているのか、またこの接種に向けての取り組みが将来インフルエンザや肺炎などの他のワクチン接種に対してどのような影響を与えるのかを学びたいと思っています。これをふまえ、私たちは皆さんから得られた情報をまとめ、このニードルプロジェクトのウェブサイトで発信していきたいと考えています。必ずしも専門家の見解を求めているわけではなく、一般の方々の声と経験をお聞かせいただきたいと思っています。私たちが特に募集しているのは以下のものです。
＊コロナやコロナワクチン関係の写真
＊個人の経験、友人や同僚との会話をもとにした「日記」形式の振り返りや観察
＊短いエッセイ
＊ビデオ形式のブログ（VLOGS）
＊新聞や雑誌に掲載された関連記事写真の切り抜き
皆様からの情報は私たちが抱える下記の質問に答え、又更なる質問につながるものと期待しています。が、ここであげられたものだけに限らないと考えています。
＊成人に対してのコロナワクチン接種は日本で現在どのように進められているのか？
＊日本におけるワクチン接種を進める取り組みは成功しているのか？そうでなかったら何故か？
＊国や地方レベルでのワクチン接種に対する議論はどのようなものがあるか？
＊国・地方レベルでのワクチン接種に対する議論が、実際の接種にどのような影響を及ぼしているのか？
＊ワクチン接種忌避（ためらい）の動きや忌避を巡る議論はあるか？
＊現在のコロナワクチン接種の取り組みが、今後日本社会における他のワクチン接種（たとえばインフルエンザや肺炎、水疱瘡、肝炎ワクチン）に対する考えを変える契機になると思うか？
＊日本にいる人たちは、高齢になるほどワクチン接種について気にかけているか？またこの傾向は、コロナ禍によりどのように変わったのか？
注：
情報は基本、メールで受け付けています。情報をお寄せくださった皆さまのお名前は原則として公開はしません。が、ご要望がありましたらニードルプロジェクト協力者として開示したいと思っています。この試みにご興味を持ってくださった方、情報を提供したいと思われた方はパトリック・スエインまでメールを下さい。PatrickSwain@ilcuk.org.uk
どうかご協力お願いします。
Evidence review
ILC aims to address the issues affecting low routine vaccination rates in over-65s in Japan. For example, flu vaccine uptake in older Japanese adults is only around 50% (OECD, 2017). Existing ILC research suggests that only 1 in 4 Japanese people agree vaccines are safe and 9.9% agree that they are effective.
As such, we want to identify and design solutions to help improve routine vaccine uptake. The following evidence review aims to:
- Understand existing practices used to help increase vaccine uptake
- Find solutions to the challenges raised in our research
- See which ideas would work in the context of Japan and help us seek new solutions
Fact pack
To better understand adult immunisation in the Japanese context, we have produced a fact pack with information about healthy ageing, longevity and vaccination rates in Japan. This guide has five sections:
- Overview of Japan
- Longevity in Japan
- State of health in Japan
- Immunisation in Japan
- What happens next
Final report
The findings from the Moving the needle project have been summarised and published in our final report.
Get in touch
We want to hear from you if you:
- Have examples of best practice in what works in addressing attitudes to immunisation
- Are an expert in health systems, attitudes to health or service delivery in Japan
- Are interested in becoming an implementation partner for our pilot interventions
- Or just want to get involved in the project.
Get in touch with Patrick Swain.