Community Perspectives on Japanese Encephalitis Risk and Prevention in an Endemic Region of Australia.

Abstract

Objective: Japanese encephalitis (JE) is a mosquito-borne disease caused by JE virus (JEV) infection, detected for the first time in south-eastern Australia in 2022. In New South Wales (NSW), detections of JEV in mosquitoes and animal hosts, human JE cases, and climate and environmental considerations have informed which areas are considered high risk for JEV and which populations are eligible for vaccination (funded by Australian states and territories). However, early evidence indicates slower-than-expected uptake in these high-risk areas. We aimed to explore how community members and healthcare professionals (HCPs), including general practitioners (GPs), pharmacists, and nurses, perceive and have responded to JEV risk through vaccination and personal mosquito-bite prevention practices.

Setting: Tamworth is classified as high-risk for JEV by NSW Health.

Participants: Semi-structured interviews with community participants (n = 15), GPs (n = 7), nurses (n = 3), and pharmacists (n = 3).

Design: An interpretative qualitative study. Data were analysed using an inductive thematic approach.

Results: Three themes were identified: (1) Risk awareness shaped by experience, not policy: "I didn't realise Tamworth was identified as an area as well, I just was totally unaware," (2) Vaccine eligibility does not translate into uptake: "There isn't really much promotion at the moment," and (3) Building community-level preparedness through communication: "Messaging that the whole community knows about."

Conclusion: Despite early public health efforts, awareness of JE and uptake of preventive measures remained limited in a high-risk regional setting. Supporting trusted healthcare providers with clear, consistent communication is critical to optimising JE vaccine uptake.