Proactive Mumps Immunization Strategies of Local Authorities, Subsidy Policies Based on Citizen-Involved Municipal Collaboration by Sendai City.

In Japan, the measles-mumps-rubella (MMR) vaccine faced voluntary withdrawal in 1993 due to concerns about aseptic meningitis, resulting in a low nationwide mumps vaccination rate of 30-40%. Responding to this, Nagoya City (population 2.32 million) and Sendai City (population 1.09 million) introduced mumps vaccination subsidies for children aged 1-5 in 2010 and for those aged 1-2 in 2013, respectively. Sendai City, with a lower age limit of 2, reached a 97% vaccination rate within just three years. After intensive interviews with stakeholders, we attribute the success of Sendai City to collaborative efforts among pediatric association leadership, citizens and municipal health center. Trust was established through citizen petitions and effective communication strategies involving the media. These efforts rapidly increased immunization rates, underscoring the significance of local vaccine initiatives despite the voluntary vaccination policy mandated by national regulations.