Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan
Background: The decline in measles vaccination coverage is a global concern. In Japan, coverage of the first dose of measles vaccine, which had exceeded the target of 95.0% since fiscal year (FY) 2010, fell to 93.5% in FY 2021. Vaccination coverage increased to 95.4% in FY 2022 but varied by municip...
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Japan Epidemiological Association
2025-02-01
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| Series: | Journal of Epidemiology |
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| Online Access: | https://www.jstage.jst.go.jp/article/jea/35/2/35_JE20240129/_pdf |
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| author | Masaki Machida Shinji Fukushima Takahiro Tabuchi Tomoki Nakaya Wakaba Fukushima Shigeru Inoue |
| author_facet | Masaki Machida Shinji Fukushima Takahiro Tabuchi Tomoki Nakaya Wakaba Fukushima Shigeru Inoue |
| author_sort | Masaki Machida |
| collection | DOAJ |
| description | Background: The decline in measles vaccination coverage is a global concern. In Japan, coverage of the first dose of measles vaccine, which had exceeded the target of 95.0% since fiscal year (FY) 2010, fell to 93.5% in FY 2021. Vaccination coverage increased to 95.4% in FY 2022 but varied by municipality. Few studies have focused on regional disparities in measles vaccination coverage. This study aimed to clarify the regional disparities in measles vaccination coverage by municipality in Japan and their associated factors. Methods: In this ecological study, the measles vaccination coverage in FY 2022; population density; area deprivation index (ADI; an indicator of socioeconomic status); proportion of foreign nationals, single-father households, single-mother households, and mothers aged ≥30 years; and number of medical facilities, pediatricians, and non-pediatric medical doctors in 1,698 municipalities were extracted from Japanese government statistics. Negative binomial regression was performed with the number of children vaccinated against measles as the dependent variable, number of children eligible for measles vaccination as the offset term, and other factors as independent variables. Results: Vaccination coverage was less than 95.0% in 54.3% of municipalities. Vaccination coverage was significantly positively associated with population density and negatively associated with the proportion of single-father households, mothers aged ≥30 years, and the ADI (incidence rate ratios: 1.004, 0.976, 0.999, and 0.970, respectively). Conclusion: This study showed regional disparities in measles vaccination coverage in Japan. Single-father households, age of mothers, and socioeconomic status may be key factors when municipalities consider strategies to improve vaccination coverage. |
| format | Article |
| id | doaj-art-f16efbbe996e48e58dc92831b511c5bf |
| institution | Kabale University |
| issn | 0917-5040 1349-9092 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Japan Epidemiological Association |
| record_format | Article |
| series | Journal of Epidemiology |
| spelling | doaj-art-f16efbbe996e48e58dc92831b511c5bf2025-02-05T04:49:20ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922025-02-0135210010510.2188/jea.JE20240129Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in JapanMasaki Machida0Shinji Fukushima1Takahiro Tabuchi2Tomoki Nakaya3Wakaba Fukushima4Shigeru Inoue5Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, JapanTravellers’ Medical Center, Tokyo Medical University Hospital, Tokyo, JapanDivision of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, JapanGraduate School of Environmental Studies, Tohoku University, Sendai, JapanDepartment of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, JapanDepartment of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, JapanBackground: The decline in measles vaccination coverage is a global concern. In Japan, coverage of the first dose of measles vaccine, which had exceeded the target of 95.0% since fiscal year (FY) 2010, fell to 93.5% in FY 2021. Vaccination coverage increased to 95.4% in FY 2022 but varied by municipality. Few studies have focused on regional disparities in measles vaccination coverage. This study aimed to clarify the regional disparities in measles vaccination coverage by municipality in Japan and their associated factors. Methods: In this ecological study, the measles vaccination coverage in FY 2022; population density; area deprivation index (ADI; an indicator of socioeconomic status); proportion of foreign nationals, single-father households, single-mother households, and mothers aged ≥30 years; and number of medical facilities, pediatricians, and non-pediatric medical doctors in 1,698 municipalities were extracted from Japanese government statistics. Negative binomial regression was performed with the number of children vaccinated against measles as the dependent variable, number of children eligible for measles vaccination as the offset term, and other factors as independent variables. Results: Vaccination coverage was less than 95.0% in 54.3% of municipalities. Vaccination coverage was significantly positively associated with population density and negatively associated with the proportion of single-father households, mothers aged ≥30 years, and the ADI (incidence rate ratios: 1.004, 0.976, 0.999, and 0.970, respectively). Conclusion: This study showed regional disparities in measles vaccination coverage in Japan. Single-father households, age of mothers, and socioeconomic status may be key factors when municipalities consider strategies to improve vaccination coverage.https://www.jstage.jst.go.jp/article/jea/35/2/35_JE20240129/_pdfmeasles vaccinationsingle-parent householdarea deprivation indexsocioeconomic statusjapan |
| spellingShingle | Masaki Machida Shinji Fukushima Takahiro Tabuchi Tomoki Nakaya Wakaba Fukushima Shigeru Inoue Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan Journal of Epidemiology measles vaccination single-parent household area deprivation index socioeconomic status japan |
| title | Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan |
| title_full | Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan |
| title_fullStr | Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan |
| title_full_unstemmed | Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan |
| title_short | Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan |
| title_sort | regional disparities in measles vaccination coverage and their associated factors an ecological study in japan |
| topic | measles vaccination single-parent household area deprivation index socioeconomic status japan |
| url | https://www.jstage.jst.go.jp/article/jea/35/2/35_JE20240129/_pdf |
| work_keys_str_mv | AT masakimachida regionaldisparitiesinmeaslesvaccinationcoverageandtheirassociatedfactorsanecologicalstudyinjapan AT shinjifukushima regionaldisparitiesinmeaslesvaccinationcoverageandtheirassociatedfactorsanecologicalstudyinjapan AT takahirotabuchi regionaldisparitiesinmeaslesvaccinationcoverageandtheirassociatedfactorsanecologicalstudyinjapan AT tomokinakaya regionaldisparitiesinmeaslesvaccinationcoverageandtheirassociatedfactorsanecologicalstudyinjapan AT wakabafukushima regionaldisparitiesinmeaslesvaccinationcoverageandtheirassociatedfactorsanecologicalstudyinjapan AT shigeruinoue regionaldisparitiesinmeaslesvaccinationcoverageandtheirassociatedfactorsanecologicalstudyinjapan |