Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Int J Health Plann Manage. 2024 Sep;39(5):1456-1481. doi: 10.1002/hpm.3818. Epub 2024 Jul 16.
Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees.
To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China.
A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12-16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay.
A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels.
There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high-risk population groups.
几种类型的人乳头瘤病毒（HPV）疫苗已获准在中国少女中使用。这些疫苗被作为非国家免疫规划疫苗进行监管，是可选的，通常完全由疫苗接种者自费。
通过 eliciting 父母愿意为其女儿接种 HPV 疫苗来评估他们对 HPV 疫苗的需求，并探讨在中国 HPV 疫苗接种需求的决定因素。
在中国东部山东省的三个城市进行了一项条件价值评估调查。我们选择了 11 所具有不同社会经济特征的初中，然后随机在每所学校选择 6 个班级，并向 66 个班级的所有 12-16 岁女孩发放问卷，让其家长填写。采用支付卡法来 eliciting 父母为其女儿接种 HPV 疫苗的意愿支付。我们还收集了广泛的社会经济和心理变量，并应用区间回归来检验父母意愿支付的决定因素。
共纳入 1074 名完成有效问题的合格家长进行分析。超过 85%的家长认为 HPV 疫苗总体上是必要的和有益的。然而，只有约 10%的家长认为他们的女儿会感染 HPV。大约 8%的家长即使疫苗是免费的也不会接受 HPV 疫苗，主要是因为担心潜在的副作用和疫苗的安全和质量问题，而 27.37%的家长只有在疫苗免费的情况下才会接受。中位数意愿支付为 300 元人民币（42 美元）。一些因素与较高的意愿支付呈正相关：收入、城市居住（相对于农村居住）、母亲（相对于父亲）、父母对疫苗益处的看法、是否应该为女儿做决定，以及女儿是否容易感染 HPV。虽然教育水平在主要回归中与意愿支付没有显著相关，但亚组分析揭示了不同收入水平下教育水平与意愿支付之间关系的有趣动态。
中国少女 HPV 疫苗的家长意愿支付与市场价格之间存在较大差距。家长普遍认为 HPV 疫苗是有益和必要的，但当被问及他们的女儿时，尽管在中国 HPV 的患病率很高，但大多数家长并不认为他们的女儿会感染 HPV。未来的重点应放在确保提供关于 HPV 流行率、疫苗质量和安全性的准确健康信息，以促进疫苗接种，针对不同收入群体的宣传工作可能会产生更好的效果。政府参与谈判更广泛可接受和负担得起的价格或补贴可能是保护高危人群的必要条件。
