School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
Department of Pharmacy, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.
JMIR Public Health Surveill. 2024 Nov 14;10:e57798. doi: 10.2196/57798.
Several important vaccines, such as the Haemophilus influenzae type b vaccine, rotavirus vaccine, pneumococcal conjugate vaccine, and influenza vaccine, have not been included in China's National Immunization Program (NIP) due to a prolonged absence of updates and limited resources. Public engagement could identify concerns that require attention and foster trust to ensure continuous support for immunization.
This study aimed to identify public preferences for vaccine inclusion in the NIP and to determine the desired vaccine funding priorities in the Chinese population.
A dual-response discrete choice experiment was utilized to estimate the relative importance of 6 attributes, including incidence of vaccine-preventable diseases, mortality of vaccine-preventable diseases, vaccine effectiveness, vaccine cost, vaccinated group, and vaccine coverage. Participants were recruited through the Wenjuanxing platform using a census-based quota sample of the nationwide population aged 18 years and older. A mixed logit model was used to estimate the coefficient of attribute preferences and predict the selection probability. Subgroups and interaction effects were analyzed to examine the heterogeneity in preferences.
In total, 1258 participants completed the survey, of which 880 were involved in the main analysis and 1166 in the sensitivity analysis. The relative importance and model estimates of 2 attributes, vaccine cost and vaccination group, varied between the unforced- and forced-choice settings. All 6 vaccine attributes significantly influenced the preferences for vaccine inclusion, with vaccine effectiveness and coverage as the most important factors, followed by the vaccinated group and mortality of vaccine-preventable diseases in the unforced-choice settings. The top vaccines recommended for China's NIP included the varicella vaccine, Haemophilus influenzae type b vaccine, enterovirus 71 vaccine, and influenza vaccine for preschoolers and school-aged children. The current analysis also revealed distinct preference patterns among different subgroups, such as gender, age, education, and income. The interaction analysis indicated that the region and health status of participants contribute to preference heterogeneity.
Public preferences for including vaccines in the NIP were primarily influenced by vaccine effectiveness and coverage. The varicella vaccine should be prioritized for inclusion in the NIP. The public preferences could provide valuable insights when incorporating new vaccines in the NIP.
由于缺乏更新和资源有限，乙型流感嗜血杆菌疫苗、轮状病毒疫苗、肺炎球菌结合疫苗和流感疫苗等几种重要疫苗尚未纳入中国国家免疫规划（NIP）。公众参与可以确定需要关注的问题，并建立信任，以确保对免疫接种的持续支持。
本研究旨在确定公众对纳入 NIP 的疫苗的偏好，并确定中国人群对所需疫苗资金的优先考虑。
使用双响应离散选择实验来估计 6 个属性的相对重要性，包括疫苗可预防疾病的发病率、疫苗可预防疾病的死亡率、疫苗有效性、疫苗成本、接种人群和疫苗覆盖率。通过 Wenjuanxing 平台，采用全国范围内 18 岁及以上人群的基于普查的配额样本招募参与者。使用混合对数模型估计属性偏好系数并预测选择概率。分析亚组和交互作用以检验偏好的异质性。
共有 1258 名参与者完成了调查，其中 880 名参与了主要分析，1166 名参与了敏感性分析。在非强制和强制选择设置下，疫苗成本和接种人群这两个属性的相对重要性和模型估计值有所不同。6 个疫苗属性对疫苗纳入偏好均有显著影响，其中疫苗有效性和覆盖率最为重要，其次是接种人群和疫苗可预防疾病的死亡率。建议纳入中国 NIP 的顶级疫苗包括水痘疫苗、乙型流感嗜血杆菌疫苗、肠道病毒 71 疫苗和流感疫苗，用于学龄前儿童和学龄儿童。目前的分析还揭示了不同亚组（如性别、年龄、教育程度和收入）之间的明显偏好模式。交互分析表明，参与者的地区和健康状况导致偏好异质性。
公众对将疫苗纳入 NIP 的偏好主要受疫苗有效性和覆盖率的影响。水痘疫苗应优先纳入 NIP。公众的偏好可为将新疫苗纳入 NIP 提供有价值的见解。
