Acceptance of Vaccinations in Pandemic Outbreaks: A Discrete Choice Experiment

Abstract

BackgroundPreventive measures are essential to limit the spread of new viruses; their uptake is key to their success. However, the vaccination uptake in pandemic outbreaks is often low. We aim to elicit how disease and vaccination characteristics determine preferences of the general public for new pandemic vaccinations.MethodsIn an internet-based discrete choice experiment (DCE) a representative sample of 536 participants (49% participation rate) from the Dutch population was asked for their preference for vaccination programs in hypothetical communicable disease outbreaks. We used scenarios based on two disease characteristics (susceptibility to and severity of the disease) and five vaccination program characteristics (effectiveness, safety, advice regarding vaccination, media attention, and out-of-pocket costs). The DCE design was based on a literature review, expert interviews and focus group discussions. A panel latent class logit model was used to estimate which trade-offs individuals were willing to make.ResultsAll above mentioned characteristics proved to influence respondents’ preferences for vaccination. Preference heterogeneity was substantial. Females who stated that they were never in favor of vaccination made different trade-offs than males who stated that they were (possibly) willing to get vaccinated. As expected, respondents preferred and were willing to pay more for more effective vaccines, especially if the outbreak was more serious (€6–€39 for a 10% more effective vaccine). Changes in effectiveness, out-of-pocket costs and in the body that advises the vaccine all substantially influenced the predicted uptake.ConclusionsWe conclude that various disease and vaccination program characteristics influence respondents’ preferences for pandemic vaccination programs. Agencies responsible for preventive measures during pandemics can use the knowledge that out-of-pocket costs and the way advice is given affect vaccination uptake to improve their plans for future pandemic outbreaks. The preference heterogeneity shows that information regarding vaccination needs to be targeted differently depending on gender and willingness to get vaccinated.

Are Healthcare Choices Predictable? The Impact of Discrete Choice Experiment Designs and Models

“…Elderly in the Netherlands, aged 60 years and older, have 2 options regarding influenza vaccination: to opt for vaccination or to opt out. To determine the attributes and levels for the influenza vaccination alternatives, literature, [34][35][36][37][38] interviews with experts in the field of influenza vaccination (n = 4), and 3 focus groups with patients aged 60 years and older from general practices (n = 21) were used (see de Bekker-Grob et al 39 for more details). Five attributes were determined as relevant for subjects to choose to vaccinate or not: vaccination effectiveness (levels: 20%, 40%, 60%, and 80%), risk of severe side effects (levels: 1, 10, and 100 in every million persons), risk of mild side effects (levels: 1, 3, and 5 in every 10 persons), protection duration (levels: 3, 6, and 12 months), and absorption time (levels: 2 and 4 weeks).…”

Public preferences for vaccination programmes during pandemics caused by pathogens transmitted through respiratory droplets – a discrete choice experiment in four European countries, 2013

“…No suggestions were given. More details of the DCE for the current study have been described elsewhere [27].…”

Willingness to pay for an early warning system for infectious diseases

“…The four papers in the field of health that empirically valued interventions increasing health safety, all used a form of stated preference methodology. These papers aimed to estimate the value of reducing mortality risks [6], preventing child maltreatment deaths [7], reducing the risk of sexually transmitted diseases [8] and vaccinations in pandemic outbreaks [9]. The first three papers used willingness to pay (WTP) contingent valuation method, while the last paper used a discrete choice experiment to elicit valuations.…”