In The Lancet Regional Health – Western Pacific, Shuhei Nomura and colleagues reported their interesting findings of a large-scale survey in Japan on COVID-19 vaccination intentions [[1]Nomura Shuhei et al.Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people: A large cross-sectional national survey.Lancet Reg Health West Pac. 2021; https://doi.org/10.1016/j.lanwpc.2021.100223Summary Full Text Full Text PDF PubMed Scopus (55) Google Scholar]. It is one of the largest surveys studying factors associated with the vaccination intention [[2]Robinson E Jones A Lesser I Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples.Vaccine. 2021 Apr 8; 39: 2024-2034Crossref PubMed Scopus (218) Google Scholar,[3]Al-Amer R, Maneze D, Everett B, Montayre J, Villarosa AR, Dwekat E, Salamonson Y. COVID-19 vaccination intention in the first year of the pandemic: A systematic review. J Clin Nurs. 2021 Jul 6.Share of people vaccinated against COVID-19, Jul 19, 2021. Our World Data https://ourworldindata.org/covid-vaccinations (accessed July 21, 2021).Google Scholar. As the COVID-19 pandemic enters its second year, countries strive for herd immunity via achieving a high vaccination coverage. Nevertheless, since the rollout of vaccination programmes around the globe, disparities on coverage are obvious among continents and regions. In July 2021, with the exceptions like Singapore, countries in the Western Pacific region are generally having lower coverages as compared with the western countries [[4]Paul E Steptoe A Fancourt D. Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications. The Lancet Regional Health.Europe. 2021; 1100012Scopus (418) Google Scholar]. To date, there are only few studies on COVID-19 vaccine acceptance or hesitancy being conducted in the Western Pacific region [[2]Robinson E Jones A Lesser I Daly M. International estimates of intended uptake and refusal of COVID-19 vaccines: A rapid systematic review and meta-analysis of large nationally representative samples.Vaccine. 2021 Apr 8; 39: 2024-2034Crossref PubMed Scopus (218) Google Scholar,[3]Al-Amer R, Maneze D, Everett B, Montayre J, Villarosa AR, Dwekat E, Salamonson Y. COVID-19 vaccination intention in the first year of the pandemic: A systematic review. J Clin Nurs. 2021 Jul 6.Share of people vaccinated against COVID-19, Jul 19, 2021. Our World Data https://ourworldindata.org/covid-vaccinations (accessed July 21, 2021).Google Scholar. The study conducted by Shuhei Nomura and colleagues, therefore, provides valuable insights on the issue from the Western Pacific perspectives. Firstly, this study reaffirmed demographic factors associated with low vaccination intention being seen in other parts of the world were also observed in this region. These included younger age [[5]Pulcini C Massin S Launay O Verger P. Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: a 2010 survey.Vaccine. 2013; 31: 3943-3949Crossref PubMed Scopus (52) Google Scholar], female gender [[6]Sherman SM Smith LE Sim J et al.COVID-19 vaccination intention in the UK: results from the COVID- vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey.Hum Vaccin Immunother. 2020; : 1-10PubMed Google Scholar], lower education level and income [[7]Lu PJ Srivastav A Amaya A et al.Association of provider recommendation and offer and influenza vaccination among adults aged >=18 years—United States.Vaccine. 2018; 36: 890-898Crossref PubMed Scopus (64) Google Scholar]. The authors also looked into the effects of information source on COVID-19 vaccination intention. Physicians, nurses and medical information websites were the three information sources consistently associated with lower odds of “not sure” or “no” responses for vaccination intention. These findings, to certain extent, have reaffirmed the importance of healthcare providers’ recommendations in promoting vaccines uptake, which has been a well-known factor in vaccine acceptance studies [[8]Kunin M Engelhard D Thomas S Ashworth M Piterman L. General practitioners’ challenges during the 2009/A/H1N1 vaccination campaigns in Australia, Israel and England: a qualitative study.Aust Fam Physician. 2013; 42: 811-815PubMed Google Scholar,[9]Loomba S de Figueiredo A Piatek SJ de Graaf K Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA.Nat Hum Behav. 2021; 5 (Mar): 337-348Crossref PubMed Scopus (503) Google Scholar. The value of engaging healthcare professionals in vaccine promotion campaigns, therefore, cannot be overemphasised. Intriguingly, this survey also revealed that using internet news sites or YouTube as information source was associated with an uncertain intention (i.e. “not sure”) for COVID-19 vaccination. While “medical information websites” was showing opposite results, it indicated that the contents rather than the channels matter. The authors also pointed out the importance of public authorities making use of the internet and social media in disseminating public health messages. This would, on one hand, increase coverage of the messages and, on the other hand, counteract misinformation on these channels. Misinformation, especially those scientific-sounding ones, has been shown to undermine vaccination intent.10 It is imperative for public authorities to combat myths and rumours on vaccine safety or effectiveness in a timely manner before they go viral, and utilizing multiple risk communication channels would be the key to success. Moreover, this survey showed that while using television as information source was associated with lower odds of responding “no”, the higher the level of trust in information from television was associated with higher odds of responding “not sure”. These apparently unreconciled results should prompt further studies on effects of the exact contents of information on vaccination intention. Besides, Shuhei Nomura and colleagues reported an overall 56.1% of respondents answering “yes” regarding their intention to have COVID-19 vaccination, which was said to be comparable to the results in similar surveys in western countries [[1]Nomura Shuhei et al.Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people: A large cross-sectional national survey.Lancet Reg Health West Pac. 2021; https://doi.org/10.1016/j.lanwpc.2021.100223Summary Full Text Full Text PDF PubMed Scopus (55) Google Scholar]. However, such intention, seemingly, has not been effectively translated into actual vaccination coverage which still fell short of 40% in Japan in July 2021 [[4]Paul E Steptoe A Fancourt D. Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications. The Lancet Regional Health.Europe. 2021; 1100012Scopus (418) Google Scholar]. There are certainly gaps between vaccination intention and actions. Further research on the bridge in-between or factors that can make intention into action is needed. Finally, with the advantage of its large sample size, this study was able and attempted to stratify and analyse differences among young and older adults with or without underlying diseases. Although the authors summarised that “the relationship of psychological characteristic with COVID-19 vaccination intention was basically similar among the stratified four Groups”, older adults with underlying diseases gave a different picture on the association between anxiety over COVID-19 and vaccination intention as well as demand for information on compatibility of the vaccines with personal health condition. In addition to overall vaccination rates, discrepancies in age-specific coverage were also observed among different countries or regions [[4]Paul E Steptoe A Fancourt D. Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications. The Lancet Regional Health.Europe. 2021; 1100012Scopus (418) Google Scholar]. Coverage among older adults, who are one of the vulnerable groups for severe COVID-19 disease, is not as good in some countries as the others. Despites the fact that policy differences on vaccination priority groups may contribute to the discrepancies, age- or group-specific psychological or behavioural factors affecting COVID-19 vaccination intention should still warrant further studies. I declare no competing interest. Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people: A large cross-sectional national surveyOur findings suggest that public health messaging based on the sociodemographic and psychological characteristics of those who are unsure or unwilling regarding intention to be vaccinated against COVID-19 vaccine may help to increase vaccine uptake amongst this population. Full-Text PDF Open Access