Location, Location, Location: A Discrete Choice Experiment to Inform Vaccination Programme Delivery in the UK

Abstract

BackgroundLarge-scale vaccination is fundamental to combatting COVID-19. In March 2021, the UK’s vaccination programme had delivered vaccines to large proportions of older and more vulnerable population groups; however, there was concern that uptake would be lower among young people. This research was designed to elicit the preferences of 18-29-year-olds with respect to key delivery characteristics.MethodsFrom 25 March - 2 April 2021, an online sample of 2,021 UK adults aged 18-29 years participated in a Discrete Choice Experiment. Participants made six choices, each between two SMS invitations to get vaccinated; each choice also had an opt-out. Each invitation had four attributes (1 x 5 levels, 3 x 3 levels): delivery mode, appointment timing, proximity, and SMS sender. These were systematically varied according to a d-optimal fractional factorial design. Order of presentation was randomised for each participant. Responses were analysed using a mixed logit model.ResultsThe logit model revealed a large alternative-specific constant (β = 1.385, SE = 0.067, p <0.001), indicating a strong preference for ‘opting in’ to appointment invitations. Pharmacies were dispreferred to the local vaccination centre (β = -0.256, SE = 0.072, p <0.001), appointments in locations that were 30-45 minutes travel time from one’s premises were dispreferred to locations that were less than 15 minutes away (β = -0.408, SE = 0.054, p <0.001), and, compared to invitations sent by the NHS, SMSs forwarded by ‘a friend’ were dispreferred (β = -0.615, SE = 0.056, p <0.001) but invitations from the General Practitioner were preferred (β = 0.105, SE = 0.048, p = 0.028).ConclusionsThe results indicated that the existing configuration of the UK’s mass vaccination programme was well-placed to deliver vaccines to 18-29-year-olds; however, some adjustments might enhance acceptance. Local pharmacies were not preferred; long travel times were a disincentive but close proximity (0-15 minutes from one’s premises) was not necessary; and either the ‘NHS’ or ‘Your GP’ would serve as adequate invitation sources. This research informed COVID-19 policy in the UK, and contributes to a wider body of Discrete Choice Experiment evidence on citizens’ preferences, requirements and predicted behaviours regarding COVID-19.

The Effectiveness of Interventions for Increasing COVID-19 Vaccine Uptake: A Systematic Review

“…There was mixed evidence for the effect of messengers on intention. An online DCE (pre-print) found that text message reminders were preferred if delivered by the NHS or one’s GP, rather than one’s best friend [ 39 ]. An online RCT (pre-print) found that a Republican endorsement of the vaccine through a video and short essay was more effective than a Democrat endorsement intentions among Republican or Republican leaning participants [ 40 ].…”

“…A DCE found that nearby GP surgeries were the most preferred vaccination location, whilst a nearby pharmacy and drive-thru were the least preferred [ 39 ]. Additionally, an online experiment found that more participants chose to receive their vaccine in 3 weeks at their local GP compared to in 5 days in a mass vaccination centre [ 52 ].…”

“…A DCE found that a vaccination centre that was 15–30 min away was preferable to a centre less than 15 min away and 30–45 min away [ 39 ], which the authors posit could be because individuals had a specific vaccination centre in mind when considering the choices which were more likely to be 15–30 min away. Additionally, more respondents preferred to receive the vaccine within 3 weeks at a centre 10 min away compared to a centre 1 h away within 5 days [ 52 ].…”

“…A DCE found that weekday appointments after-hours were least preferred compared to a weekday 9 a.m.–5 p.m. or a weekend, although this had less of an impact on decision making than factors such as setting and proximity (as detailed above) [ 39 ]. An online experiment found that people preferred to wait 3 weeks for an appointment if they can choose their appointment time compared to receiving the vaccine within 5 days but not finding out their appointment time until the day [ 52 ].…”

The Use of Scheduling in the COVID-19 Pandemic: a Systematic Literature Review

“…Using data from 44 provinces in Thailand, Jarumaneeroj et al (2022) proposed a susceptible, infectious, quarantined, recovered, dead, vaccinated with immunity model that is later combined with a proposed COVID-19 vaccine allocation problem to determine the optimal allocation strategies that minimize total weighted strain on the whole healthcare system. Furthermore, a different contribution was presented by McPhedran et al (2021). They performed an online discrete choice experiment to understand population preferences to get vaccinated, considering four attributes: delivery mode, appointment timing, proximity, and SMS sender.…”