Determinants of Vaccination Coverage for the Second Dose of Measles-Rubella Vaccine in Tokyo, Japan

Determinants of Vaccination Coverage for the Second Dose of Measles-Rubella Vaccine in Tokyo, Japan

YOSHIYUKI SUGISHITA,^1,2 JUNKO KURITA,³ TAKANOBU AKAGI,¹ TAMIE SUGAWARA² and YASUSHI OHKUSA²

¹Infectious Disease Control Section, Health and Safety Division, Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Tokyo, Japan
²National Institute of Infectious Diseases, Tokyo, Japan
³Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Inashiki-gun, Ibaraki, Japan

In Japan, some measles outbreaks were initiated by a tourist from oversea and foreign workers recently. Moreover, rubella outbreak emerged since July 2018 mainly in the South Kanto, and the outbreak is currently ongoing in 2019. It is important to maintain a high measles-rubella combined vaccine (MR) coverage for measles-rubella control. Vaccination coverage for the second dose of MR (MR2) is 90.8% in Tokyo in 2016, which was the third worst among all prefectures in Japan. The purpose of this study was to clarify determinant factors of vaccination coverage for MR2 in Tokyo. Data were obtained for 49 wards and cities in Tokyo in 2016. We regressed vaccination coverage of MR2 on the times of notification by mail, the proportion of households receiving welfare payments, and the proportion of non-Japanese elementary school students. In addition to the simplest specification, five factors were included separately as explanatory variables: the proportion of public health nurses; the ratio of the number of pediatric medical facilities to the number of preschool and elementary school children; the moving-in rate; the proportion of households with a single parent; and the proportion of households with husband and wife both working. Results show that a high proportion of households receiving welfare payments, notification by two or more letters, and moving-in rate or a lower proportion of non-Japanese elementary school students improve coverage. In conclusion, the health authorities can exert efforts to reduce burden of time spent for vaccination and provide sufficient information to improve coverage.

Keywords —— information shortage; measles-rubella combined vaccine; notification by mail; time cost; vaccination coverage

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Tohoku J. Exp. Med., 2019, 249, 265-273

Correspondence: Yoshiyuki Sugishita, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.

e-mail: yoshiyuk@gmail.com