title: A review of factors affecting vaccine preventable disease in Japan.
abstract: Japan is well known as a country with a strong health record. However its incidence rates of vaccine preventable diseases (VPD) such as hepatitis B, measles, mumps, rubella, and varicella remain higher than other developed countries. This article reviews the factors that contribute to the high rates of VPD in Japan. These include historical and political factors that delayed the introduction of several important vaccines until recently. Access has also been affected by vaccines being divided into government-funded "routine" (eg, polio, pertussis) and self-pay "voluntary" groups (eg, hepatitis A and B). Routine vaccines have higher rates of administration than voluntary vaccines. Administration factors include differences in well child care schedules, the approach to simultaneous vaccination, vaccination contraindication due to fever, and vaccination spacing. Parental factors include low intention to fully vaccinate their children and misperceptions about side effects and efficacy. There are also provider knowledge gaps regarding indications, adverse effects, interval, and simultaneous vaccination. These multifactorial issues combine to produce lower population immunization rates and a higher incidence of VPD than other developed countries. This article will provide insight into the current situation of Japanese vaccinations, the issues to be addressed and suggestions for public health promotion.
authors: Pediatric Residency Program, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (NK).
authors: Norimitsu
authors: N
authors: Kuwabara
authors: Pediatric Residency Program, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (NK).
authors: Michael S L
authors: MS
authors: Ching
mesh_terms: D003140:Communicable Disease Control / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D007564:Japan / Q000453:epidemiology; D009313:National Health Programs / Q000458:organization & administration; D012307:Risk Factors; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000008:administration & dosage*
chemical_list: D014612:Vaccines
keywords: Japan; immunization; vaccination rates; vaccine preventable disease; voluntary vaccines
references: Lancet. 2011 Jan 22;377(9762):299
references: 21256381
references: J Public Health Manag Pract. 1996 Winter;2(1):18-25
references: 10186652
references: Kansenshogaku Zasshi. 2013 Sep;87(5):603-7
references: 24195170
references: J Infect Dis. 2004 May 1;189 Suppl 1:S48-53
references: 15106089
references: Vaccine. 2005 Apr 27;23(23):3053-60
references: 15811652
references: Clin Infect Dis. 2007 Jun 15;44(12):e104-8
references: 17516388
references: J Epidemiol. 2003 May;13(3):136-41
references: 12749600
references: Vaccine. 2012 Jul 6;30(32):4752-6
references: 22521841
references: MMWR Recomm Rep. 2000 Oct 6;49(RR-9):1-35
references: 11055835
references: J Infect Chemother. 2013 Oct;19(5):876-9
references: 23512615
references: Pediatr Int. 2008 Jun;50(3):300-5
references: 18533941
references: J Infect Dis. 2013 Jul 15;208(2):275-83
references: 23568174
references: Vaccine. 2011 Apr 5;29(16):3089-92
references: 20870055
references: Kansenshogaku Zasshi. 2012 Sep;86(5):582-91
references: 23198578
references: Pediatr Infect Dis J. 2011 Jan;30(1 Suppl):S30-4
references: 21183838
references: MMWR Morb Mortal Wkly Rep. 2013 Jun 14;62(23):457-62
references: 23760185
references: Hum Vaccin Immunother. 2012 Feb;8(2):184-8
references: 22426372
references: Prev Med. 2013 Jun;56(6):398-405
references: 23524116
references: Asia Pac J Public Health. 2015 Mar;27(2):NP1409-20
references: 23674825
references: Lancet. 2012 Feb 11;379(9815):520
references: 22325660
references: Lancet. 2004 Jul 24-30;364(9431):328-9
references: 15276387
references: MMWR Morb Mortal Wkly Rep. 2002 Feb 15;51(6):120-3
references: 11898926
references: Infect Control Hosp Epidemiol. 2004 Jul;25(7):591-4
references: 15301032
references: BMC Public Health. 2013;13:647
references: 23849209
references: J Health Econ. 2011 Sep;30(5):966-76
references: 21715035
references: MMWR Recomm Rep. 2011 Jan 28;60(2):1-64
references: 21293327
references: Vaccine. 2012 Aug 24;30(39):5740-7
references: 22796375
references: Biologicals. 1999 Jun;27(2):61-9
references: 10600185
references: J Infect Chemother. 2013 Oct;19(5):787-98
references: 23835871
references: MMWR Surveill Summ. 2009 May 22;58(3):1-27
references: 19478727
references: MMWR Recomm Rep. 1998 May 22;47(RR-8):1-57
references: 9639369
references: Vaccine. 2006 Mar 20;24(13):2395-402
references: 16406171
references: MMWR Morb Mortal Wkly Rep. 2008 Sep 26;57(38):1049-52
references: 18818586
references: J Infect Dis. 2004 May 1;189 Suppl 1:S43-7
references: 15106088
references: PLoS One. 2012;7(7):e42261
references: 22848753
references: J Infect Dis. 2004 May 1;189 Suppl 1:S27-35
references: 15106086
references: JAMA. 1987 Mar 13;257(10):1351-6
references: 3820444
references: Scand J Infect Dis. 1987;19(6):617-21
references: 3441747
references: Vaccine. 2009 Mar 10;27(11):1724-8
references: 19186205
references: Lancet. 2013 Aug 31;382(9894):768
references: 23993189
references: Am J Public Health. 2000 Oct;90(10):1521-5
references: 11029981
references: Hepatol Res. 2011 Jan;41(1):39-45
references: 21108704
references: J Infect Chemother. 2013 Feb;19(1):34-41
references: 22806445
references: Acta Paediatr Jpn. 1996 Jun;38(3):205-11
references: 8741307