Begum Afroza, Uddin Md Azhar, Ahsan Syed M, Islam Md Ahsanul
Department of Statistics University of Chittagong Chittagong Bangladesh.
Institute of Health Economics University of Dhaka Dhaka Bangladesh.
Health Sci Rep. 2025 Jul 18;8(7):e71066. doi: 10.1002/hsr2.71066. eCollection 2025 Jul.
The rapid development and deployment of COVID-19 vaccines have been pivotal in the global battle against the pandemic. However, vaccine acceptance remains a critical determinant of their effectiveness. While numerous studies have explored factors influencing vaccine acceptance, there is a notable dearth of research regarding preferences and willingness to pay (WTP) among individuals with chronic diseases (ChD) who are at heightened risk of severe COVID-19 outcomes. This study addresses this gap by investigating COVID-19 vaccine preferences and WTP among individuals with and without chronic diseases.
Employing a discrete choice experiment (DCE) approach, we interviewed 843 participants to assess their preference for COVID-19 vaccine attributes such as origin, efficacy level, protection duration, and provider. We used a mixed logit model to analyze DCE data and estimated WTP by taking the negative ratio of preference and price parameters. Furthermore, we performed a stratified analysis according to the household head's ChD status.
As expected, vaccines with higher efficacy and longer protection are most preferred. Interestingly, our research shows a preference for European and American vaccines over Chinese vaccines. Additionally, this study reveals a preference for private facilities over government facilities for vaccinations among vaccine seekers. Patients with ChD exhibit higher WTP than those without such conditions, demonstrating the group's urgency in becoming vaccinated.
Vaccine procurement and administration decisions by health authorities should be evidence-based and reflect public preferences regarding acceptance and WTP. Health authorities should prioritize both high efficacy and long-lasting protection in vaccine procurement, ensuring that neither is compromised. This approach addresses the top concerns of both groups-vaccine effectiveness for the ChD group and extended immunity for the NChD group. This study also informs policy decisions regarding vaccine origin and suggests incorporating private facilities as vaccine administration points to reduce pressure on government facilities.
新冠疫苗的快速研发和部署在全球抗击疫情的斗争中发挥了关键作用。然而，疫苗的接受度仍然是其有效性的关键决定因素。虽然众多研究探讨了影响疫苗接受度的因素，但对于新冠重症风险较高的慢性病患者群体的偏好和支付意愿（WTP）的研究却明显不足。本研究通过调查患慢性病和未患慢性病个体对新冠疫苗的偏好和支付意愿来填补这一空白。
我们采用离散选择实验（DCE）方法，对843名参与者进行访谈，以评估他们对新冠疫苗属性（如产地、效力水平、保护时长和接种机构）的偏好。我们使用混合逻辑回归模型分析DCE数据，并通过偏好参数与价格参数的负比率来估计支付意愿。此外，我们根据户主的慢性病状况进行了分层分析。
正如预期的那样，效力更高、保护期更长的疫苗最受青睐。有趣的是，我们的研究表明，相较于中国疫苗，参与者更倾向于欧美疫苗。此外，该研究还揭示，在寻求接种疫苗的人群中，他们更倾向于在私立机构而非政府机构接种。慢性病患者的支付意愿高于非慢性病患者，这表明该群体对接种疫苗的迫切需求。
卫生当局在疫苗采购和接种决策时应以证据为基础，并反映公众对接受度和支付意愿的偏好。卫生当局在疫苗采购中应优先考虑高效力和长期保护，确保两者都不被忽视。这种方法解决了两个群体最关心的问题——慢性病群体关注疫苗效力，非慢性病群体关注延长免疫期。本研究还为有关疫苗产地的政策决策提供了参考，并建议将私立机构纳入疫苗接种点，以减轻政府机构压力。
