Acceptance and willingness to pay for pneumococcal vaccination in Vietnam: insights into adult preferences and influencing factors

BACKGROUND: Streptococcus pneumoniae (pneumococcus) causes a significant burden in humans which can be significantly reduced by increasing the uptake of vaccine. Acceptance of the vaccine and willingness to pay (WTP) are two of the important drivers for increasing the vaccination rates and policy making. This study aims to determine the acceptance rates, preferences for the vaccination services and WTP for the pneumococcal vaccine among adults in Vietnam and associated factors.

METHODS: A cross-sectional survey was conducted among adults aged ≥45 years, selected through multistage sampling. Data were collected using a validated questionnaire based on the Health Belief Model, a framework for understanding health behavior and influencing factors, and WTP was evaluated using Contingent Valuation Method.

RESULTS: Among 714 participants, 76.6 % accepted vaccination, and 69.6 % willing to pay a mean of US$35.29 per dose (95 % CI: 33.42-37.16). WTP in 66-75 age group was lower than in those aged 45-55 (aOR = 0.49), while individuals earning >US$268.9 were more willing to pay than those earning <US$115.3 (aOR = 2.79). Higher perceived benefits increased WTP (aOR = 1.15), whereas greater perceived barriers reduced both acceptance (aOR = 0.85) and WTP (aOR = 0.81). More cues to action linked to acceptance (aOR = 1.12) and WTP (aOR = 1.09). Greater perceived efficacy increased acceptance (aOR = 1.21). WTP amounts were positively influenced by income, education, urban residence and perceived susceptibility to infection and complications, but negatively by perceived severity and barriers.

CONCLUSION: The acceptance rate and WTP were relatively high. Future efforts should improve accessibility, reduce costs, enhance perceived risks and benefits, increase cues to action and self-efficacy, and lower barriers to boost adult vaccination rates in Vietnam.