Publication date: Feb 14, 2025

Financial accessibility has emerged as a significant barrier to vaccine uptake following the cessation of universal public funding for coronavirus disease 2019 (COVID-19) vaccination programs. This investigation assessed the intention and determinant factors of COVID-19 vaccination among healthcare workers in Japan in the 2024-2025 pre-season. A retrospective survey was conducted utilizing data collected from hospital staff at Okayama University Hospital, Japan, to inform the COVID-19 vaccination strategy in October 2024. The analysis evaluated demographic characteristics, vaccine intention, perceived barriers to vaccination, and maximum acceptable out-of-pocket expenditure. The study population of 3,417 respondents comprised 843 medical doctors (24. 7%), 1,131 nurses (33. 1%), 320 other medical staff (9. 4%), 286 dental doctors (8. 4%), and 627 administrative officers (18. 3%). At full cost, 2,109 (61. 7%) indicated no intention to receive vaccination, while only 4. 4% expressed willingness to be vaccinated and 33. 9% remained undecided. With total self-payment, the vaccination acceptance rates were the highest and lowest among medical doctors (11. 4%) and nurses (1. 0%), respectively. Cost (38. 1%), followed by safety issues (29. 5%) and concerns regarding efficacy or medical necessity (20. 3%), emerged as the primary barrier. The projected vaccination intention increased to 43. 9% and 54. 9% at reduced self-pay costs of 3,000 JPY and 5,000 JPY, respectively. Addressing financial constraints through policy interventions could be effective strategies in increasing overall vaccination coverage among healthcare workers. In addition, providing tailored education on vaccine safety, efficacy, and necessity may further facilitate increased vaccine uptake within this critical population.

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