School for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Duke University School of Medicine, Duke University, Durham, NC, USA.
Glob Health Sci Pract. 2021 Sep 30;9(3):523-531. doi: 10.9745/GHSP-D-20-00480.
Hepatitis B virus (HBV) infection is endemic in Vietnam and can be transmitted from mother to child. Vaccination of women of reproductive age (WRA) can reduce this transmission. Because adult HBV vaccination in Vietnam follows a fee-for-service model, research is needed to determine the effect of household income on willingness to pay (WTP) to ensure equitable access to the vaccine.
A cross-sectional study was performed in Hanoi, Vietnam, in April 2018, among WRA. Questionnaires were administered to assess household income, HBV history, vaccination status, vaccine awareness, and WTP for the vaccine. Multivariable logistic and interval regression were performed to assess the impact of household income on WTP for HBV vaccine.
This study found that 62.3% of all participants were willing to pay for the HBV vaccine with no differences in WTP across income quintiles. There were significant differences among household income levels in awareness of HBV vaccination and WTP amount beyond US$4.50 with the lowest awareness and WTP amount among women from the lowest income quintiles.
Our data suggest the need to subsidize HBV vaccination for low-income women to ensure more equitable access to HBV vaccination. We propose that a sliding-scale payment method may be an effective strategy in light of limited funding to support vaccination expansion. An education campaign focusing on lower-income households should also be implemented in conjunction with this program. Further research would be required to evaluate consumer acceptance of this payment scheme and to develop an appropriate sliding scale to maximize vaccine uptake.
乙型肝炎病毒（HBV）感染在越南流行，可通过母婴传播。对育龄妇女（WRA）进行疫苗接种可以减少这种传播。由于越南的成人乙型肝炎疫苗接种采用按服务收费模式，因此需要研究家庭收入对支付意愿（WTP）的影响，以确保公平获得疫苗。
2018 年 4 月在越南河内进行了一项横断面研究，对象为 WRA。问卷调查评估家庭收入、HBV 史、疫苗接种状况、疫苗意识和对疫苗的支付意愿。采用多变量逻辑和区间回归分析评估家庭收入对 HBV 疫苗支付意愿的影响。
本研究发现，所有参与者中有 62.3%愿意支付 HBV 疫苗费用，但在收入五分位数中，支付意愿没有差异。在 HBV 疫苗接种意识和支付意愿金额（超过 4.50 美元）方面，家庭收入水平存在显著差异，收入最低五分位数的女性意识和支付意愿最低。
我们的数据表明，需要为低收入妇女补贴 HBV 疫苗接种，以确保更公平地获得 HBV 疫苗接种。鉴于有限的资金支持扩大疫苗接种，我们建议采用滑动付费方法可能是一种有效的策略。还应结合该方案实施针对低收入家庭的教育运动。还需要进一步研究以评估消费者对这种支付方案的接受程度，并制定适当的滑动比例，以最大限度地提高疫苗接种率。
