Nationwide survey for household preparedness and vaccination acceptance during a novel influenza pandemic scenario in Japan, 2025.
Okubo Yusuke Y, Honjyo Risa R, Uda Kazuhiro K, Miyairi Isao I
Pandemics and associated mitigation measures can disrupt children's daily lives and shift substantial burden to households. However, families' actionable preparedness for future pandemics remains insufficiently understood, including caregiving capacity and vaccination acceptance. We conducted an anonymous nationwide online cross-sectional survey in November 2025 among Japanese parents residing with at least one child aged 0-18 years (N = 4961). Respondents were presented with standardized hypothetical influenza pandemic scenarios and asked to report anticipated impacts of school/childcare closures and willingness to receive a novel influenza pandemic vaccine with profiles varying in effectiveness, out-of-pocket cost, and type. We used latent profile analyses to classify households' preparedness and examined factors associated with vaccination acceptance using generalized estimation equations. In the school/childcare closure scenario, 43.6% reported being able to maintain children's learning activities, 40.5% physical activity, 41.9% emotional support, and 52.9% restrict non-essential outings. Latent profile analysis identified three preparedness profiles (high 36.1%, moderate 47.2%, low 16.7%), with a monotonic gradient across the four items. Low preparedness was more common among households with younger children, lower income, and among dual full-time working parents. Out-of-pocket cost (4000 JPY) was inversely associated with willingness to vaccinate (RR 0.77, 95% CI 0.75-0.79), whereas recent influenza vaccination history was positively associated with willingness (RR 1.58, 95% CI 1.51-1.66). Household pandemic preparedness appears to be constrained by time and financial constraints, leading to systematic gaps. Policymakers should prioritize reducing financial barriers and reinforcing importance of seasonal influenza vaccination to reduce annual morbidity and mortality and prepare for future pandemics.