A systematic review of knowledge, attitudes, and behaviour towards Japanese encephalitis vaccination

Three billion people globally are at risk of Japanese Encephalitis (JE), a mosquito-borne disease primarily spread by Culex mosquitoes. Despite the availability of JE vaccine, uptake is limited and a deeper understanding of people's knowledge, attitudes, and behaviours (KABs) towards JE vaccine is needed to improve this. This study systematically reviewed the existing research on KABs towards JE vaccination, with a view to informing JE vaccine program delivery, policy and practice.

Seven bibliometric databases, grey literature and references of included studies were searched for primary studies on KABs towards JE vaccination. Search outputs were independently screened; data were extracted and synthesised descriptively.

Of the 26 studies included, most were conducted in JE endemic countries and examined four participant groups: travellers from non-endemic settings, caregivers of vaccine recipients and non-traveller adults from endemic settings, and vaccine providers/advocates from both settings. Of the few studies, adult vaccine recipients had low knowledge and awareness of the vaccine, whereas caregivers' knowledge and awareness were higher. Attitudes towards JE vaccination were generally positive and KABs were often influenced by health workers, community leaders, risk perception, cost, time constraints, migration, and vaccine availability and accessibility.

There were limited KABs studies regarding JE vaccination using rigorous and consistent methodological approaches. This review highlights the barriers to JE vaccination and the role of health professionals and vaccine advocates in JE vaccination programs. Focusing on empowering these groups is key to increasing JE vaccine uptake across different populations.