Community acceptance and willingness-to-pay for a hypothetical Zika vaccine: A cross-sectional study in Indonesia

Harapan H 1 , Mudatsir M 2 , Yufika A 3 , Nawawi Y 3 , Wahyuniati N 4 , Anwar S 5 Show all authors , Yusri F 6 , Haryanti N 7 , Wijayanti NP 8 , Rizal R 9 , Fitriani D 10 , Maulida NF 11 , Syahriza M 12 , Ikram I 4 , Fandoko TP 13 , Syahadah M 14 , Asrizal FW 15 , Aletta A 3 , Jamil KF 16 , Rajamoorthy Y 17 , Hadisoemarto PF 18 , Wagner AL 19 , Groneberg DA 20 , Kuch U 20 , Sasmono RT 21 , Müller R 22 , Imrie A 23

Affiliations 

  • 1 Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia. Electronic address: harapan@unsyiah.ac.id
  • 2 Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
  • 3 Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
  • 4 Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
  • 5 Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
  • 6 School of Medicine, Malikussaleh University, Lhokseumawe, Aceh, Indonesia
  • 7 Community Health Centre of Meurah Mulia, North Aceh, Aceh, Indonesia
  • 8 Community Health Centre of Tapaktuan, South Aceh, Aceh, Indonesia
  • 9 Bunda Hospital, Lhokseumawe, Aceh, Indonesia
  • 10 Community Health Centre of Teunom, Aceh Jaya, Aceh, Indonesia
  • 11 Meuraxa Hospital, Banda Aceh, Aceh, Indonesia
  • 12 Department of Public Health and Community Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
  • 13 Community Health Centre of Gunung, Padang Panjang, West Sumatra, Indonesia
  • 14 Community Health Centre of Lima Kaum, Tanah Datar, West Sumatra, Indonesia
  • 15 Community Health Centre of Tanjung Paku, Solok, West Sumatra, Indonesia
  • 16 Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia; Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
  • 17 Department of Economics, Universiti Tunku Abdul Rahman, Selangor, Malaysia
  • 18 Graduate Program of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
  • 19 Department of Epidemiology, University of Michigan, Ann Arbor, USA
  • 20 Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
  • 21 Eijkman Institute for Molecular Biology, Jakarta, Indonesia
  • 22 Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany; Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp, Belgium
  • 23 School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia, Australia
Vaccine, 2019 03 07;37(11):1398-1406.
PMID: 30739794 DOI: 10.1016/j.vaccine.2019.01.062

Abstract

BACKGROUND: Understanding people's perceptions of the economic benefits of a potential Zika vaccine (ZV) is critical to accelerating its introduction into either public sector programs or private market. The aim of this study was to assess the acceptance and willingness-to-pay (WTP) for a hypothetical ZV and the associated explanatory variables in Indonesia.

METHODS: We conducted a health facility-based cross-sectional study in Aceh and West Sumatra province from 1 February to 13 June 2018. Patients who visited outpatient departments, have had children or were expecting their first child, were approached and interviewed to collect information on acceptance, WTP, demographic and socio-economic variables and attitudes towards childhood vaccines. Associations of explanatory variables influencing acceptance and WTP were assessed using logistic regression and linear regression analysis, respectively.

RESULTS: In total, 956 respondents were included in the final analysis of acceptance, of whom 338 (35.3%) expressed their WTP. We found that 757 (79.1%) of the respondents were likely to be vaccinated and to recommend their partner to be vaccinated. Higher educational attainment, having a job, having heard about Zika and a good attitude towards childhood vaccination were associated with ZV acceptance in the univariate analyses. In the multivariate analysis, attitude towards childhood vaccination was the strongest predictor for ZV vaccination. We found the geometric mean and median of WTP was US$ 13.1 (95% CI: 11.37-15.09) and US$ 7.0 (95% CI: 4.47-10.98), respectively. In the final model, having heard about Zika, having a job, and higher income were associated with a higher WTP.

CONCLUSION: Although the acceptance rate of the ZV is relatively high in Indonesia, less than 40% of respondents are willing to pay, underscoring the need for a low-cost, high-quality vaccine and public sector subsidies for Zika vaccinations in the country.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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