Parental inquiry behavior and use of web-based information for childhood vaccination in Japan: Implications for communication quality and vaccination schedule adherence

BACKGROUND: Effective risk communication requires an understanding how interactions with healthcare providers influence parental vaccination decisions. In Japan, cultural norms that emphasize respect for authority may discourage parents from asking questions, whereas recent digital information sources increasingly shape how parents perceive vaccines. Using the Behavioral and Social Drivers of Vaccination framework, this study aimed to examine how communication experiences and information pathways related to parental concerns and adherence to childhood vaccination schedule. METHODS: We conducted a nationwide cross-sectional web-based survey of parents of children aged <6 years in Japan (online panel; quota sampling by region, parental age group, and sex). In total, 2400 respondents were included. Measures included vaccine-related concerns, inquiry behavior, the most influential information source (digital/online vs non-digital), perceived quality of communication experience, and schedule adherence. RESULTS: In this cross-sectional survey, vaccine-related concerns were significantly more common among parents with inquiry behavior than among those without; despite having more concerns, these parents also reported significantly higher perceived quality of communication experience (both p < .01).In adjusted models, higher communication experience quality was associated with higher odds of vaccination schedule adherence (OR = 1.49, 95% CI: 1.23-1.81, p < .001), and vaccination-related concerns (ref = no concern) were associated with lower odds of adherence (OR = 0.37, 95% CI: 0.26-0.52, p < .001). Inquiry behavior and reliance on web-based information were not independently associated with adherence. However, web-based information use was positively associated with communication quality (p < .001), suggesting that digital information may serve as a complementary resource in parents' decision-making as measured in this study. CONCLUSIONS: Perceived communication experience quality was associated with childhood vaccination schedule adherence. Supporting question-friendly consultations and integrating reliable digital resources may strengthen risk communication in Japan.