COVID-19 Vaccination Coverage by Company Size and the Effects of Workplace Vaccination Program in Japan: a Cohort Study

Overview

Journal Environ Health Prev Med

Specialties Environmental Health
Public Health

Date 2022 Jul 5

PMID 35786684

Authors

Koji Mori

Takahiro Mori

Tomohisa Nagata

Hajime Ando

Ayako Hino

Seiichiro Tateishi

Mayumi Tsuji

Keiji Muramatsu

Yoshihisa Fujino

Affiliations

Soon will be listed here.

Abstract

Background: Vaccination is considered the most effective control measure against COVID-19. Vaccine hesitancy and equitable vaccine allocation are important challenges to disseminating developed vaccines. To promote COVID-19 vaccination coverage, the government of Japan established the workplace vaccination program. However, while it appears that the program was effective in overcoming vaccine hesitancy, the program may have hindered the equitable allocation of vaccines because it mainly focused on employees of large companies. We investigated the relationship between company size and COVID-19 vaccination completion status of employees and the impact of the workplace vaccination program on this relationship.

Methods: We conducted an internet-based prospective cohort study from December 2020 (baseline) to December 2021. The data were collected using a self-administered questionnaire survey. Briefly, 27,036 workers completed the questionnaire at baseline and 18,560 at follow-up. After excluding ineligible respondents, we finally analyzed the data from 15,829 participants. At baseline, the participants were asked about the size of the company they worked for, and at follow-up they were asked about the month in which they received their second COVID-19 vaccine dose and the availability of a company-arranged vaccination opportunity.

Results: In each month throughout the observation period, the odds of having received a second COVID-19 vaccine dose were significantly lower for small-company employees than for large-company employees in the sex- and age-adjusted model. This difference decreased after adjusting for socioeconomic factors, and there was no significant difference after adjusting for the availability of a company-arranged vaccination opportunity.

Conclusions: The workplace vaccination program implemented in Japan to control the COVID-19 pandemic may have been effective in overcoming vaccine hesitancy in workers; however, it may have caused an inequitable allocation of vaccines between companies of different sizes. Because people who worked for small companies were less likely to be vaccinated, it will be necessary to enhance support of vaccination for this population in the event of future infectious disease outbreaks.

Trial Registration: Not applicable.

Citing Articles

Understanding COVID-19 Vaccine Hesitancy among the General Population in Japan from Public Health Ethical Perspectives: Findings from a Narrative Review.

Kuroda M, Ahmed M, Kuroda K, Lane S Asian Bioeth Rev. 2025; 17(1):141-165.

PMID: 39896082 PMC: 11785853. DOI: 10.1007/s41649-024-00310-8.

Distribution of COVID-19 mitigation measures by industry and work arrangement-US blood donors, May 2021-December 2021.

Shi D, Rinsky J, McDonald E, Shah M, Groenewold M, de Perio M Am J Ind Med. 2024; 67(8):764-771.

PMID: 38856006 PMC: 11265519. DOI: 10.1002/ajim.23626.

Presenteeism in front-line physicians involved in COVID-19-related clinical practice: a national survey of employed physician members of the Japan Medical Association.

Ishimaru T, Yoshikawa T, Okawara M, Kido M, Nakashima Y, Nakayasu A Environ Health Prev Med. 2023; 28:13.

PMID: 36740269 PMC: 9922563. DOI: 10.1265/ehpm.22-00194.

References

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H . Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020; 395(10224):565-574. PMC: 7159086. DOI: 10.1016/S0140-6736(20)30251-8. View

Hak E, Schonbeck Y, de Melker H, van Essen G, Sanders E . Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program. Vaccine. 2005; 23(24):3103-7. DOI: 10.1016/j.vaccine.2005.01.074. View

Dorman C, Perera A, Condon C, Chau C, Qian J, Kalk K . Factors Associated with Willingness to be Vaccinated Against COVID-19 in a Large Convenience Sample. J Community Health. 2021; 46(5):1013-1019. PMC: 8033546. DOI: 10.1007/s10900-021-00987-0. View

Mori K . Current Status and Issues for the Role of Occupational Health Physicians in Japan. JMA J. 2021; 1(1):15-21. PMC: 7969842. DOI: 10.31662/jmaj.2018-0011. View

Sallam M . COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines (Basel). 2021; 9(2). PMC: 7920465. DOI: 10.3390/vaccines9020160. View

Luz P, Johnson R, Brown H . Workplace availability, risk group and perceived barriers predictive of 2016-17 influenza vaccine uptake in the United States: A cross-sectional study. Vaccine. 2017; 35(43):5890-5896. DOI: 10.1016/j.vaccine.2017.08.078. View

Fujino Y, Ishimaru T, Eguchi H, Tsuji M, Tateishi S, Ogami A . Protocol for a Nationwide Internet-based Health Survey of Workers During the COVID-19 Pandemic in 2020. J UOEH. 2021; 43(2):217-225. DOI: 10.7888/juoeh.43.217. View

Okubo R, Yoshioka T, Ohfuji S, Matsuo T, Tabuchi T . COVID-19 Vaccine Hesitancy and Its Associated Factors in Japan. Vaccines (Basel). 2021; 9(6). PMC: 8234307. DOI: 10.3390/vaccines9060662. View

Gargano L, Painter J, Sales J, Morfaw C, Jones L, Murray D . Seasonal and 2009 H1N1 influenza vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination among secondary school teachers and staff. Hum Vaccin. 2011; 7(1):89-95. PMC: 3062243. DOI: 10.4161/hv.7.1.13460. View

10.

Agranov M, Elliott M, Ortoleva P . The importance of Social Norms against Strategic Effects: The case of Covid-19 vaccine uptake. Econ Lett. 2021; 206:109979. PMC: 8252706. DOI: 10.1016/j.econlet.2021.109979. View

11.

King W, Rubinstein M, Reinhart A, Mejia R . COVID-19 vaccine hesitancy January-May 2021 among 18-64 year old US adults by employment and occupation. Prev Med Rep. 2021; 24:101569. PMC: 8474804. DOI: 10.1016/j.pmedr.2021.101569. View

12.

Ishimaru T, Okawara M, Ando H, Hino A, Nagata T, Tateishi S . Gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan. Hum Vaccin Immunother. 2021; 17(11):3975-3981. PMC: 8827630. DOI: 10.1080/21645515.2021.1947098. View

13.

Kang G, Culp R, Abbas K . Facilitators and barriers of parental attitudes and beliefs toward school-located influenza vaccination in the United States: Systematic review. Vaccine. 2017; 35(16):1987-1995. PMC: 5401629. DOI: 10.1016/j.vaccine.2017.03.014. View

14.

Lazarus J, Ratzan S, Palayew A, Gostin L, Larson H, Rabin K . A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2020; 27(2):225-228. PMC: 7573523. DOI: 10.1038/s41591-020-1124-9. View

15.

Betsch C, Schmid P, Heinemeier D, Korn L, Holtmann C, Bohm R . Beyond confidence: Development of a measure assessing the 5C psychological antecedents of vaccination. PLoS One. 2018; 13(12):e0208601. PMC: 6285469. DOI: 10.1371/journal.pone.0208601. View

16.

Hiraoka K, Nagata T, Mori T, Ando H, Hino A, Tateishi S . Association between willingness to receive the COVID-19 vaccine and sources of health information among Japanese workers: a cohort study. Environ Health Prev Med. 2022; 27:2. PMC: 9093620. DOI: 10.1265/ehpm.21-00284. View

17.

MacDonald N . Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015; 33(34):4161-4. DOI: 10.1016/j.vaccine.2015.04.036. View

18.

Wang K, Wong E, Ho K, Cheung A, Yau P, Dong D . Change of Willingness to Accept COVID-19 Vaccine and Reasons of Vaccine Hesitancy of Working People at Different Waves of Local Epidemic in Hong Kong, China: Repeated Cross-Sectional Surveys. Vaccines (Basel). 2021; 9(1). PMC: 7832291. DOI: 10.3390/vaccines9010062. View

19.

Jin Y, Hou C, Li Y, Zheng K, Wang C . mRNA Vaccine: How to Meet the Challenge of SARS-CoV-2. Front Immunol. 2022; 12:821538. PMC: 8813741. DOI: 10.3389/fimmu.2021.821538. View

20.

Larson H, Jarrett C, Eckersberger E, Smith D, Paterson P . Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine. 2014; 32(19):2150-9. DOI: 10.1016/j.vaccine.2014.01.081. View