Knowledge, Attitudes, and Practices of Japanese Travelers on Infectious Disease Risks and Immunization Uptake

Background. There is concern that Japanese travelers are poorly protected against travel-associated infectious diseases including vaccine-preventable infections. This prompted us to study Japanese travelers for measures taken to reduce their risk of acquiring an infectious disease and their immunization uptake. Methods. During April 2007 to May 2008, a questionnaire study was conducted using the European Travel Health Advisory Board (ETHAB) protocol and targeting Japanese group tour clients as well as individual travelers to developing countries. Results. A total of 302 returned questionnaires were analyzed. While the majority (87.4%) sought general information on their destination, few (38.7%) sought the travel health information. Very few (2.0%) got the health information from travel medicine specialists. More than half were either unaware of the risks or thought there was no risk of hepatitis A, hepatitis B, and typhoid fever in their destination. Only half (50.7%) thought vaccines provided sufficient protection and very few (13.6%) believed that vaccines were safe. For most of the vaccine-preventable diseases, only fewer than 10% had received the vaccines. Conclusions. There is a need for specialized travel health services in Japan and health professionals should be encouraged to expand these services. Japanese travelers should be made aware of the importance of seeking pre-travel health advice and information on the health risks at their destination. Travel health professionals should provide a balanced view of the risks and benefits of immunization, and misperceptions about immunization should be addressed.