Background and objective:
While Japan tops the charts in terms of healthy life expectancy across the world, uptake of vaccination remains surprisingly low. COVID-19 vaccination uptake has been high but other adult immunisations are trailing behind. This innovative ethnographic project, led by the International Longevity Centre UK (ILC-UK) and Stripe Partners, has worked to identify, develop, and refine two implementation-ready interventions designed to increase the uptake of vaccinations for people aged 65 and over in Japan, with lessons for countries across the region.

Methods:
ILC-UK and Stripe Partners conducted ethnographic research and face-to-face interviews with older adults, doctors, pharmacists, and health system actors in urban and rural Japan to understand the barriers to vaccination and develop innovative solutions to improve uptake.

Results:
From healthy eating to exercise, older people in Japan engage in their health and want to stay independent for as long as possible. However, a combination of historical cautiousness from national and local government in promoting life course immunisation, practical barriers including supply issues, a lack of shared electronic health records and attitudinal barriers, push down uptake.

Conclusion:
The success of the COVID vaccination rollout shows that people are willing to get vaccinated when there is urgency and systems are designed to integrate into people’s lives. Heeding these lessons could create some easy wins in increasing uptake of other routine immunisations.