Verelst Frederik, Kessels Roselinde, Willem Lander, Beutels Philippe
Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Wilrijk, 2610 Antwerp, Belgium.
Department of Data Analytics and Digitalization, Maastricht University, 6200 MD Maastricht, The Netherlands.
Vaccines (Basel). 2021 Mar 16;9(3):264. doi: 10.3390/vaccines9030264.
Increased vaccine hesitancy and refusal negatively affects vaccine uptake, leading to the reemergence of vaccine preventable diseases. We aim to quantify the relative importance of factors people consider when making vaccine decisions for themselves, or for their child, with specific attention for underlying motives arising from context, such as required effort (accessibility) and opportunism (free riding on herd immunity). We documented attitudes towards vaccination and performed a discrete choice experiment in 4802 respondents in The United Kingdom, France and Belgium, eliciting preferences for six attributes: (1) vaccine effectiveness, (2) vaccine preventable disease burden, (3) vaccine accessibility in terms of copayment, vaccinator and administrative requirements, (4) frequency of mild vaccine-related side-effects, (5) vaccination coverage in the country's population and (6) local vaccination coverage in personal networks. We distinguished adults deciding on vaccination for themselves from parents deciding for their youngest child. While all attributes were found to be significant, vaccine effectiveness and accessibility stood out in all (sub)samples, followed by vaccine preventable disease burden. We confirmed that people attach more value to severity of disease compared to its frequency, and discovered that peer influence dominates free-rider motives, especially for the vaccination of children. These behavioral data are insightful for policy and are essential to parameterize dynamic vaccination behavior in simulation models. In contrast to what most game theoretical models assume, social norms dominate free-rider incentives. Policy-makers and healthcare workers should actively communicate on high vaccination coverage, and draw attention to the effectiveness of vaccines while optimizing their practical accessibility.
疫苗犹豫和拒绝现象的增加对疫苗接种率产生了负面影响，导致疫苗可预防疾病再度出现。我们旨在量化人们在为自己或孩子做出疫苗决策时所考虑因素的相对重要性，特别关注因背景因素产生的潜在动机，如所需努力（可及性）和机会主义（搭群体免疫的便车）。我们记录了对疫苗接种的态度，并在英国、法国和比利时的4802名受访者中进行了离散选择实验，得出了对六个属性的偏好：（1）疫苗有效性，（2）疫苗可预防疾病负担，（3）从自付费用、接种人员和行政要求方面衡量的疫苗可及性，（4）与疫苗相关的轻微副作用的频率，（5）该国人口的疫苗接种覆盖率，以及（6）个人社交网络中的当地疫苗接种覆盖率。我们区分了为自己决定是否接种疫苗的成年人和为最小的孩子做决定的父母。虽然所有属性都被发现具有显著性，但疫苗有效性和可及性在所有（子）样本中最为突出，其次是疫苗可预防疾病负担。我们证实，与疾病发生频率相比，人们更看重疾病的严重程度，并且发现同伴影响胜过搭便车动机，尤其是在儿童疫苗接种方面。这些行为数据对政策制定具有参考价值，并且对于在模拟模型中参数化动态疫苗接种行为至关重要。与大多数博弈论模型的假设相反，社会规范主导着搭便车动机。政策制定者和医护人员应积极宣传高疫苗接种覆盖率，并在优化疫苗实际可及性的同时，关注疫苗的有效性。
