This study aimed to 1) determine the prevalence and contents of vaccine hesitancy among pregnant women during the coronavirus disease 2019 (COVID-19) pandemic and 2) evaluate its association with maternal sociodemographic factors. A cross-sectional survey was conducted between August and December 2020 among pregnant women between 28 and 32 weeks of gestation who received antenatal care at four clinics and hospitals in Niigata City, Japan. Vaccine hesitancy was assessed using the Parent Attitudes about Childhood Vaccines survey, and associations between vaccine hesitancy and sociodemographic factors were analyzed. In total, 113/200 (56.5%) subjects responded to the survey. Overall, 46/113 (40.7%) pregnant women were resistant or hesitant to receive the vaccine. Women with vaccine hesitancy were more likely to fear adverse reactions (concern 79.6%, not concerned 15.9%, and not sure 4.4%), safety (concerned 69.0%, not concerned 23.9%, and not sure 7.1%), and efficacy (concerned 47.8%, not concerned 35.4%, and not sure 16.8%) compared to those without vaccine hesitancy (P < .01, < .01, and <.01, respectively). In the multivariate logistic regression analyses, primipara women had higher rates of vaccine hesitancy than multipara pregnant women (odds ratio: 2.38, P = .04). In conclusion, the prevalence of vaccine hesitancy among pregnant Japanese women, especially primipara women, was higher than that in other countries during the COVID-19 pandemic. Their major concerns were adverse reactions, safety, and the efficacy of childhood vaccines. Further strategies are needed to provide appropriate vaccine information to prevent vaccine-preventable diseases in both infants and children.

This study aimed to elucidate the prevalence and characteristics of parental vaccine hesitancy towards routine infant immunizations and COVID-19 vaccines in Japan. A web-based survey was conducted among 3,227 parents of children aged 0–11 years to assess vaccine-related hesitancy for routine infant immunizations and COVID-19 vaccines for children using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Data were collected from January 18 to 25, 2023. Covariates included demographic characteristics, economic status, COVID-19 infection status, decisional conflict scale, and the fear of COVID-19 Scale. Vaccine hesitancy was found to be 52.4% for routine infant immunizations and 73% for COVID-19 vaccines. Significant differences in parental attitudes were observed between general childhood vaccines and COVID-19 vaccines for 12 out of 13 PACV survey items. The COVID-19 vaccines showed higher hesitancy rates in 10 items; largest discrepancies were noticed in schedule adherence (22.5% vs 61%), overall hesitancy (40% vs 55.1%), and trust in pediatric doctors (37.2% vs 53.6%). Safety concerns were high for both vaccine types, exceeding 50%. Multivariable analysis identified decisional conflict (RR: 1.01 95% CI: 1.00–1.02) and COVID-19-related fear (RR: 1.04, 95% CI: 1.02–1.05) as hesitancy predictors for routine immunizations. Vaccine-related hesitancy for COVID-19 was significantly higher than that for routine immunizations, with decisional conflict emerging as a primary predictor for both. Fear of COVID-19 was associated with routine immunization-related hesitancy. These findings provide critical insights for future pandemic preparedness and vaccine acceptance strategies, highlighting the importance of strengthening trust between healthcare providers and parents, providing clear and reliable information, and implementing decision support tools.

Background/Objectives: Healthcare professionals’ (HCPs’) accurate knowledge of and positive attitudes toward immunization greatly influence society’s acceptance of it. Early and appropriate immunization education for HCP students is vital. This study aimed to understand current immunization education and vaccine hesitancy among medical, nursing, and pharmacy students in Japan. Methods: An anonymous self-administered online questionnaire was administered to final-year medical, nursing, and pharmacy students in Japan between 6 and 31 March 2023. Survey items assessed current immunization education, preparedness for clinical practice, immunization knowledge, and the degree of vaccine hesitancy. Results: Overall, 525 students (127 (24.2%) medical, 252 (48.0%) nursing, and 146 (27.8%) pharmacy) responded, of whom 39.8% raised concerns regarding new vaccine risks (24.4%,15.9%, and 23.3%, respectively; p = 0.22) and adverse effects (14.2%, 12.7%, and 17.1%, respectively; p = 0.57), including trust in government information (61.4%, 50/4%, and 56.8%, respectively; p = 0.337) or recommended vaccines (57.5%, 4.7%, and 43.8%, respectively; p = 0.113). Preparedness for future clinical practice varied significantly among schools, with medical students (54%) feeling more prepared compared to nursing (34.3%) and pharmacy students (39.1%) (p < 0.001). The average correct immunization knowledge rate was 59.9%, with significant differences between schools (medical 62.7%, nursing 57.6%, and pharmacy 59.6%; p < 0.001). There was no significant correlation between knowledge level and self-assessed preparedness (r = 0.066, p = 0.132). The HCP students wished to receive more immunization education and sought improvements in comprehensive knowledge, communication skills, and practice-based content. Conclusions: For Japan’s HCP students, the enhancement of immunization education focusing on hesitancy and risk–benefit communication is necessary.

The migrant population of Japan is gradually increasing, but it is not well known how and why diet and physical activity (PA) change post-migration. Therefore, this study used a mixed-method approach to investigate the changes in dietary patterns and PA through a web- and paper-based survey (n = 128) and understand the contextual factors for those changes through semi-structured interviews (n = 21). Descriptive and thematic analyses of quantitative and qualitative data were conducted, respectively. The majority of survey (57.8%) and interview (66.7%) participants were female, and the mean duration of stay in Japan was 5 and 3.6 years, respectively. The survey revealed an increased consumption of foods attached to Japanese culture, frozen and microwavable food, and a reduced consumption of fruits. We identified environmental (availability, accessibility, and affordability of foods; food safety and diet-related information; and climate), individual (living status; post-migration lifestyle; and food preferences and limitations), or socio-cultural (relationships with Japanese people; cultural differences; and religious influences) factors that impact diet changes. Language proficiency and the duration of stay shape dietary behaviors. Determinants of PA changes were climate, lifestyle, and the influence of Japanese culture. In conclusion, immigrants in Japan experience post-migration diet and PA changes, and this study adds knowledge about how and why such changes occur.