Occupational Disparities in COVID-19 Vaccine Hesitancy in Japan

Background: We examined occupational disparities in COVID-19 vaccine hesitancy in Japan.Methods: Cross-sectional online surveys were conducted among of residents living in Iwate Prefecture from July 2 to 4 and from October 1 to 3 in 2021 (total n=22,531). Intention to get vaccinated for COVID-19 was assessed by self-report questions. We calculated odds ratios (OR) for vaccine hesitancy among occupational groups using logistic regression models controlling for covariates and stratified by age and sex groups.Findings: The overall prevalence of vaccine hesitancy was 4.6% in our sample of working-age adults. Women < 40 years were also 1·6 times more likely to be vaccine hesitant, citing concerns about adverse effects on pregnancy or breastfeeding. Among people aged 40–59 years, three groups – viz., workers in the service industry, manufacturing industry, and the unemployed –were significantly more likely to express vaccine hesitancy regardless of sex. Young service workers viewed themselves as being more vulnerable to risk of infection but less susceptible to getting severe disease, whilst exhibiting low levels of vaccine knowledge. Middle-aged (40-59 years) workers in the manufacturing industry underestimated both vulnerability to infection and disease severity, as well as demonstrated low knowledge of vaccines and practice of preventive measures.Interpretation: While complex and heterogeneous reasons for COVID-19 vaccine hesitancy have been cited in Western countries (e.g., mistrust of government, medical mistrust, and conspiracy beliefs), the situation in Japan may be more amenable to educational interventions targeting specific occupations. Policymakers should provide targeted interventions adapted to high risk occupations. Funding Information: The work was supported by JSPS KAKENHI Grant Numbers 20K18858.Declaration of Interests: All authors have no conflicts of interest to disclose.Ethics Approval Statement: The surveys were conducted in accordance with applicable Japanese law and Iwate Prefectural Government policy. Since this study was a secondary analysis using anonymized data from Iwate Prefecture, the study was exempt from IRB review.