Surveillance and risk assessment of health screening for vaccine-preventable diseases among international students in Japan: A cross-sectional study in 2020

Figures & data

Table 1. Regular health checkups for international students across Japanese universities and Japanese language schools.

	University			Language school
Answer items	(N=69)			(N=137)
	n	%	95% CI	n	%	95% CI	P-value
Location of educational institutions							.558
Tokyo	42	60.9	48.4-72.4	93	67.9	59.4-75.6
Osaka	18	26.1	16.3-38.1	31	22.6	15.9-30.6
Fukuoka	9	13.0	6.1-23.3	13	9.5	5.1-15.7
Do you have a medical checkup within a month of admission?							<.01
yes	58	84.1	73.3-91.8	74	54.0	45.3-62.6
no	9	13.0	6.1-23.3	62	45.3	36.7-54.0
not answered	2	2.9	0.4-10.1	1	0.7	0-4.0
Do you offer a medical checkup to short-term (3 months to less than 1 year) international students?							<.01
yes	26	37.7	26.3-50.2	86	62.8	54.1-70.9
no	29	42.0	30.2-54.5	22	16.1	10.3-23.3
none of the above	8	11.6	5.1-21.6	25	18.2	12.2-25.7
not answered	6	8.7	3.3-1.8	4	2.9	0.8-7.3
Does the medical checkup include a chest X-ray?							.098
yes	65	94.2	85.8-98.4	127	92.7	87.0-96.4
no	0	0.0	0-5.2	7	5.1	2.1-10.2
not answered	4	5.8	1.6-14.2	3	2.2	0.5-6.3
Does the medical checkup include a blood test?							.088
yes	17	24.6	15.1-36.5	21	15.3	9.7-22.5
no	48	69.6	57.3-80.1	112	81.8	74.3-87.8
not answered	4	5.8	1.6-14.2	4	2.9	0.8-7.3

Abbreviations: CI, confidence interval

Statistical analyses were performed with the EZR software version 1.53

Table 2. Requirement for vaccination certificates in Japanese universities and Japanese language schools.

	University			Language school
Answer items	(N=69)			(N=137)
	n	%	95% CI	n	%	95% CI	P-value
Do you require student submission of vaccination or antibody certificate for admission?							<.01
yes	10	14.5	7.2-25.0	3	2.2	0.5-6.3
required only medical class	1	1.4	0-7.8	1	0.7	0-4.0
required only international students	1	1.4	0-7.8	1	0.7	0-4.0
not required, but recommended	5	7.2	2.4-16.1	11	8.0	4.1-13.9
no	40	58.0	45.5-69.8	117	85.4	78.4-90.8
other	8	11.6	5.1-21.6	3	2.2	0.5-6.3
not answered	4	5.8	1.6-14.2	1	0.7	0-4.0
Are you considering to oblige students to submit a vaccination certificate?							<.01
We are considering it.	3	4.3	0.9-12.2	10	7.3	3.6-13.0
We would like to consider it.	9	13.0	6.1-23.3	61	44.5	36.0-53.3
no plan	37	53.6	41.2-65.7	52	38.0	29.8-46.6
not answered	20	29.0	18.7-41.2	14	10.2	5.7-16.6
Why it is difficult to require students to submit a vaccination or antibody certificate?
(Multiple answers were permitted)
1. The number of candidates may decline							<.01
	7	10.1	4.2-19.8	39	28.5	21.1-36.8
2. The expenses may be higher							.029
	16	23.2	13.9-34.9	53	38.7	30.5-47.4
3. It is not required by law							1.000
	18	26.1	16.3-38.1	35	25.5	18.5-33.7
4. There is no place to keep track of vaccination history							.330
	9	13.0	6.1-23.3	26	19.0	12.8-26.6
5. We do not know where to start							<.01
	7	10.1	4.2-19.8	37	27.0	19.8-35.3
6. Answer 1&2 (questionnaires related to school management)							<.01
	16	23.2	13.9-34.9	64	46.7	38.1-55.4

Abbreviations: CI, confidence interval

Statistical analyses were performed with the EZR software version 1.53

Table 3. VPDs in Japanese universities and Japanese languages schools from 2017 to 2019.

	University			Language school
Answer items	(N=69)			(N=137)
	n	%	95% CI	n	%	95% CI	P-value
Do you recognize students who are absent due to VPDs?							.346
yes	50	72.5	60.4-82.5	112	81.8	74.3-87.8
no	16	23.2	13.9-34.9	24	17.5	11.6-24.9
not answered	3	4.3	0.9-12.2	1	0.7	0-4.0
How do you recognize student absence?
Report from the student.							.756
	47	68.1	55.8-78.8	89	65.0	56.4-72.9
Staff will contact the student when he/she is absent.							<.01
	3	4.3	0.9-12.2	81	59.1	50.4-67.4
Have the students been infected with any VPDs?							<.01
yes	25	36.2	25.0-48.7	58	42.3	33.9-51.1
no	19	27.5	17.5-39.6	68	49.6	41.0-58.3
unknown	19	27.5	17.5-39.6	10	7.3	3.6-13.0
not answered	6	8.7	3.3-18.0	1	0.7	0-4.0

Abbreviations: VPDs, vaccine preventable diseases; CI, confidence interval

Statistical analyses were performed with the EZR software version 1.53

Table 4. The number of international students infected with VPDs by the country of origin.

Country of origin	Number of students
	n	%
Vietnam	75	41.0
China	48	26.2
Sri Lanka	18	9.8
Nepal	16	8.7
Myanmar	11	6.0
Bangladesh	5	2.7
Mongolia	3	1.6
Indonesia	3	1.6
Others	4	2.2
Total	183	100.0

Abbreviations: VPDs, vaccine preventable diseases.

Figure 1. Vaccine-preventable diseases among international students from 2017 to 2019. Black, gray, and white bars represent infected cases for 2017, 2018, and 2019, respectively.