Li Yuan, Kawasaki Hiromi, Cui Zhengai, Nakaoka Sae, Cui Yingai, Rahman Md Moshiur
Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
School of Humanities and Management, Guangdong Medical University, Dongguan, China.
Front Public Health. 2025 Aug 29;13:1621416. doi: 10.3389/fpubh.2025.1621416. eCollection 2025.
Human papillomavirus (HPV) infection constitutes a substantial public health challenge in China. Despite proven vaccine efficacy, coverage remains critically low among high-risk sexually active college students. Out-of-pocket payment requirements contribute to the intention-behavior gap, while health literacy (HL) and vaccine hesitancy (VH) influence payment decisions. This study aims to directly quantify Chinese college students' willingness to pay (WTP) and price sensitivity, examining HL and VH as key determinants.
A convenience sample of 4,928 students at Guangdong Medical University in Dongguan, China was selected to complete a cross-sectional online survey (June 16-July 16, 2024) on the "Wenjuanxing" platform. We assessed socioeconomic status, HPV knowledge, HL, VH, and WTP through the survey and applied the van Westendorp price sensitivity meter (PSM) to quantify HPV vaccine price sensitivity.
A total of 67.6% of the participants expressed a WTP for an out-of-pocket HPV vaccine, with 87.2% preferring nine-valent vaccines. Key factors identified included monthly expenses, medical insurance, HPV knowledge, HL, and the VH items' perceived necessity, importance, and vaccine safety. The van Westendorp PSM indicated that the market prices of the nine-valent vaccines exceeded the college students' acceptable price ranges.
Examination of HL and VH provided a valuable framework for understanding the WTP for HPV vaccines. The van Westendorp PSM confirmed that the price sensitivity of the nine-valent HPV vaccine exceeded its affordability. Integrating vaccines into medical insurance, implementing targeted tiered subsidies (e.g., an optimal subsidy of 269.81 CNY, or at least 126.20 CNY), and conducting tailored education addressing HL/VH should be prioritized as potential solutions.
人乳头瘤病毒（HPV）感染在中国构成了重大的公共卫生挑战。尽管疫苗效果已得到证实，但在性活跃的高危大学生中，疫苗接种覆盖率仍然极低。自费支付要求导致了意愿与行为之间的差距，而健康素养（HL）和疫苗犹豫（VH）会影响支付决策。本研究旨在直接量化中国大学生的支付意愿（WTP）和价格敏感性，将HL和VH作为关键决定因素进行考察。
选取中国东莞广东医科大学的4928名学生作为便利样本，于2024年6月16日至7月16日在“问卷星”平台上完成一项横断面在线调查。我们通过该调查评估社会经济状况、HPV知识、HL、VH和WTP，并应用范·韦斯特多普价格敏感性测量仪（PSM）来量化HPV疫苗的价格敏感性。
共有67.6%的参与者表示愿意自费接种HPV疫苗，其中87.2%的人更倾向于九价疫苗。确定的关键因素包括每月支出、医疗保险、HPV知识、HL以及VH项目的感知必要性、重要性和疫苗安全性。范·韦斯特多普PSM表明，九价疫苗的市场价格超出了大学生可接受的价格范围。
对HL和VH的考察为理解HPV疫苗的WTP提供了一个有价值的框架。范·韦斯特多普PSM证实，九价HPV疫苗的价格敏感性超出了其可承受性。作为潜在解决方案，应优先考虑将疫苗纳入医疗保险、实施有针对性的分层补贴（例如，最佳补贴为269.81元人民币，或至少126.20元人民币）以及开展针对HL/VH的定制教育。
