Abstract
OBJECTIVES: The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is included in the routine immunisation programme for adults aged 65 years and those aged 60-64 years with serious chronic medical conditions (CMCs). To improve the vaccination coverage rates, a catch-up subsidy programme was implemented by the Japanese government from October 2014 to March 2024, which resulted in no improvement in the coverage rates. For further facilitation of pneumococcal vaccination, research is warranted to understand public attitudes toward pneumococcal vaccination by assessing coverage rates and reasons for vaccination among not only the subsidy-eligible population but also in individuals aged 19-64 years with CMCs who self-pay for pneumococcal vaccination. DESIGN: Nationwide, cross-sectional survey. SETTING: A web-based questionnaire study using a validated consumer panel in Japan. PARTICIPANTS: Japanese adults aged 19-64 years with CMCs and those aged ≥65 years registered in the consumer panel as of March 2023. PRIMARY AND SECONDARY OUTCOME MEASURES: Vaccine coverage rates, reasons for receiving or not receiving the vaccination, willingness of unvaccinated individuals to receive the vaccine in the future under the current vaccination programme and factors associated with pneumococcal vaccination coverage rates. RESULTS: Vaccination coverage rates were 12.4% in those aged 19-49 years, 3.2% in those aged 50-59 years and 4.0% in those aged 60-64 years with CMCs and 55.1% in those aged ≥65 years (61.6% and 52.9% in those with and without CMCs, respectively). The majority (89.1%) of unvaccinated participants aged 19-64 years with CMCs had a positive or neutral attitude towards receiving future pneumococcal vaccinations. Among vaccinated individuals, 79.0% of those aged 19-64 years with CMCs and 56.0% of those aged ≥65 years reported that they had received a doctor's recommendation. Doctors' recommendation was the most common reason for receiving the vaccine among participants aged 19-64 years with CMCs (35.1%), whereas notification from the municipality was the most important reason among those aged ≥65 years (46.1%). CONCLUSIONS: Data from this study suggest that recommendations from doctors are crucial for increasing coverage rates of pneumococcal vaccines, particularly among adults aged 19-64 years with CMCs. The majority of unvaccinated participants in this group had a positive or neutral attitude towards future vaccination, highlighting the importance of strong recommendations by doctors. TRIAL REGISTRATION NUMBER: jRCT1030220606.