According to a nationwide study published in the journal npj Vaccines, just 53.1% of residents in Japan report a willingness to receive a vaccine during a hypothetical future pandemic. Conducted by researchers in Japan, the findings reveal that while the country achieved high immunization rates during the COVID-19 health crisis, future public health campaigns will face substantial hesitancy driven by demographic factors, trust gaps, and specific vaccine conditions.
Future Pandemic Vaccine Acceptance Drops Below COVID-19 Uptake Levels
During the COVID-19 pandemic, more than 700 million cases and 7 million deaths were reported globally by December 2025, underscoring the critical role of immunization in mitigating disease spread and severity. In Japan, 75.9% of survey participants—totaling 19,027 individuals—received at least one dose of a COVID-19 vaccine, according to data from the Japan COVID-19 and Society Internet Survey (JACSIS). However, the new research demonstrates a sharp decline in projected willingness for a future outbreak.
When researchers evaluated 24,577 valid responses gathered between December 2024 and January 2025, only 53.1% indicated they would accept a vaccine for a hypothetical pathogen with a case-fatality rate comparable to COVID-19 (0.1% to 2%). Among those who previously received a COVID-19 vaccine, 35.8% fell into a “Did–Won’t” category, signifying prior cooperation paired with future hesitancy. Meanwhile, 84.9% of individuals who skipped COVID-19 immunization remained in a “Didn’t–Won’t” group for future scenarios.
Demographic Shifts and Psychological Triggers Shaping Public Decisions
Statistical analyses adjusted for age, sex, income, and educational attainment highlight distinct demographic divides in vaccine acceptance. According to the study, lower vaccination intentions strongly correlate with being between 20 and 40 years old, female sex, lower household income, and reduced educational background. Conversely, individuals maintaining regular contact with older adults and those with a designated regular physician reported significantly higher willingness to immunize.
Did you know? Having a regular physician and frequent contact with elderly family members or community members significantly increases an individual’s stated willingness to accept a future pandemic vaccine, according to findings published in npj Vaccines.
Health status and psychological orientation also heavily influence public response. Participants managing cardiometabolic conditions—such as hypertension, diabetes, and dyslipidemia—alongside those with mental disorders, showed significantly higher odds of vaccination intent. Additionally, lower general anxiety, reduced fear of COVID-19, and stronger individual agency orientations strongly linked to vaccine avoidance, whereas greater communion orientation and thorough knowledge of infectious diseases correlated with higher acceptance.
Disease Severity, Vaccine Protection Durability, and Information Sources
Public willingness is not static; it shifts dynamically depending on the perceived deadliness of the pathogen and the protective capability of the pharmaceutical intervention. When researchers modeled a scenario where a future case-fatality rate exceeded 20%, the proportion of COVID-19-vaccinated respondents stating they “probably won’t” vaccinate dropped from 25.6% down to 15.5%. Similarly, extending vaccine protection durability from 2 to 3 months to a lifelong span reduced hesitancy among the previously vaccinated group from 31.0% to 16.6%. Unvaccinated respondents, however, showed minimal movement under identical severe scenarios.
Information channels play a definitive role in shaping these choices. Relying on traditional authorities—including the government, healthcare professionals, medical experts, television, and newspapers—associated with lower hesitancy. Conversely, after multivariate adjustment, obtaining news and guidance from friends, celebrities, video-sharing platforms, and social media aligned with lower vaccine acceptance. Beliefs that another pandemic will not strike within 100 years further compounded hesitation.
Population Subgroups and Preferred Vaccination Conditions
To unpack divergent public priorities, researchers evaluated 20 specific vaccination-related conditions using unsupervised clustering. Across almost all demographic splits, free vaccination, empirical clinical-trial evidence, and direct physician recommendations emerged as universally valued necessities. However, other preferences fractured along distinct fault lines. Recommendations from the World Health Organization (WHO) and the Japanese government held heavy influence primarily among willing populations, whereas domestic vaccine development and domestic manufacture proved critical for hesitant subgroups.
Clustering models isolated eight distinct priority profiles across the surveyed population. Cluster 1 alone accounted for 47.3% of participants and captured the highest concentration of vaccine-resistant individuals. Other clusters emphasized varying combinations of domestic production, vaccine technology modality, geographical accessibility, family influence, and professional guidance, signaling that a single, uniform public health messaging framework will likely fail during future public health emergencies.
Frequently Asked Questions
- What was the primary data source for this research on future pandemic vaccination?
Researchers utilized the Japan COVID-19 and Society Internet Survey (JACSIS), conducted via Rakuten Insight from December 2024 to January 2025, analyzing 24,577 valid responses from residents aged 15 to 84. - How did prior COVID-19 vaccination status affect future intentions?
While 75.9% of respondents received at least one COVID-19 dose, 35.8% of those individuals reported future hesitancy (“Did–Won’t”) for a hypothetical pandemic, while 84.9% of unvaccinated individuals remained hesitant (“Didn’t–Won’t”). - What factors consistently increased willingness to vaccinate?
Regardless of demographic divides, participants consistently prioritized free vaccination, robust clinical-trial evidence, and recommendations from trusted physicians.
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