Huang Aodi, Tang Lin, Huang Lifang, Li Jun, Zhang Xue, Liu Jiajie, Zhou Yang, Zhang Bingling, Wang Lei, Zhang Qian, Xu Xia, Zhou Zemei, Wang Yu, Wang Xiaoqi, Liu Qianqian, Liu Siyu, Yin Zundong, Wang Fuzhen
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China.
Vaccine X. 2024 Dec 12;22:100602. doi: 10.1016/j.jvacx.2024.100602. eCollection 2025 Jan.
China's Expanded Program on Immunization (EPI) provides vaccinations against 12 vaccine preventable diseases (VPDs) at no cost to families. For some VPDs, parents may opt to substitute equivalent non-program vaccines, including combination vaccines, for EPI vaccines; substitute vaccines must be paid for by the family. Although parents have several choices for vaccinating their children, their preferences for vaccines and immunization schedules have not been systematically evaluated. We used a discrete choice experiment to evaluate four attributes of vaccines for routine immunization: number of injections, risk of mild side-effects, out-of-pocket cost, and location of manufacturer (domestic or imported).
In a questionnaire-based survey conducted in vaccination clinics, guardians were asked to select their preferred vaccination schedule from five options in ten choice sets with the four attributes. We used a mixed logit model to determine parental preferences for vaccination schedules, relative importance of attributes, and predict the likelihood of successful vaccination under different scenarios.
A total of 581 parents from seven provinces and cities in China participated in the survey, and 488 respondents had internally consistent responses and were included in the analysis. The number of injections in the schedule was the most important attribute for predicting uptake, followed by risk of mild side-effects. Preferences varied by region and parental role. Predicted uptake in the preferred vaccination scenario relative to base-case schedule uptake was a 99.55 % increase.
Number of injections and risk of mild side-effects were the two most important attributes of the routine immunization schedule. Results from this study can help optimize the immunization schedule in China to improve coverage of childhood vaccines.
中国扩大免疫规划（EPI）为家庭免费提供针对12种疫苗可预防疾病（VPDs）的疫苗接种。对于某些VPDs，家长可以选择用等效的非规划疫苗（包括联合疫苗）替代EPI疫苗；替代疫苗必须由家庭自行付费。尽管家长在为孩子接种疫苗时有多种选择，但他们对疫苗和免疫接种程序的偏好尚未得到系统评估。我们采用离散选择实验来评估常规免疫接种疫苗的四个属性：注射次数、轻度副作用风险、自付费用以及生产商所在地（国产或进口）。
在接种门诊进行的一项基于问卷的调查中，要求监护人从十个包含四个属性的选择集中的五个选项中选择他们偏好的免疫接种程序。我们使用混合逻辑模型来确定家长对免疫接种程序的偏好、属性的相对重要性，并预测不同情况下成功接种疫苗的可能性。
来自中国七个省市的581名家长参与了调查，488名受访者的回答具有内部一致性并被纳入分析。免疫接种程序中的注射次数是预测接种率的最重要属性，其次是轻度副作用风险。偏好因地区和家长角色而异。相对于基础免疫程序接种率，预测的首选免疫接种方案接种率提高了99.55%。
注射次数和轻度副作用风险是常规免疫接种程序的两个最重要属性。本研究结果有助于优化中国的免疫接种程序，以提高儿童疫苗接种率。
