WILLINGNESS TO PAY AND MAXIMUM ACCEPTABLE RISK FOR SIX NON- OR PARTIAL-IMMUNIZATION PROGRAM VACCINES IN CHINA: A DISCRETE CHOICE EXPERIMENT
Author(s)
Wenjie Hu, MMed., Yawen Jiang, PhD.
Dept. of Social Medicine and Healthcare Management, Shenzhen Campus of Sun Yat-Sen University, Shenzhen, China.
Dept. of Social Medicine and Healthcare Management, Shenzhen Campus of Sun Yat-Sen University, Shenzhen, China.
OBJECTIVES: Rotavirus, EV71, varicella, HPV, influenza, and pneumococcal vaccines can be produced domestically in China, yet they are not (or only partially) covered by the National Immunization Program. We employed a discrete choice experiment (DCE) to estimate public willingness to pay (WTP) and maximum acceptable risk (MAR) for these six vaccines, assessing the relative importance of protection rate, duration of protection, adverse reactions, and price.
METHODS: A DCE with a pairwise crossover design was conducted with 2,120 respondents via an online platform in 2025, with quotas matching national age and urban-rural distributions. The vaccines shared common attributes (protection rate, duration, adverse reactions, price) plus vaccine-specific attributes. D-efficient design generated choice sets with quality-control items. Mixed logit models estimated attribute coefficients, incorporating price × income and 100% protection × age interactions. WTP and MAR were computed via Krinsky-Robb simulations (50,000 draws).
RESULTS: Protection rate dominated vaccination preferences across all six vaccines. For rotavirus vaccine, WTP for increasing protection from 0% to 100% reached approximately CNY 3,498, far exceeding WTP for extended duration (CNY 441) or reduced adverse reactions (CNY 142-552). For MAR, when protection rose from 0% to 70%, the acceptable injection-site reaction risk reached 80.60% for EV71 and 94.29% for influenza, both of which were substantially above real-world incidence rates (1-10% and ~20%). Rotavirus vaccine MAR for mild-to-moderate systemic reactions was 29.20%, close to its real-world rate (30-40%). Low-income individuals showed significantly greater price sensitivity; older adults exhibited lower preference for complete protection in influenza and pneumococcal vaccine models.
CONCLUSIONS: Protection rate is the core driver of vaccine preferences, with marginal WTP rising sharply as protection approaches 100%. Maximum acceptable risk for routine adverse reactions substantially exceeds real-world incidence rates, confirming ample clinical safety margins from the public perspective. Significant preference heterogeneity across income and age groups supports differentiated vaccine pricing and communication strategies.
METHODS: A DCE with a pairwise crossover design was conducted with 2,120 respondents via an online platform in 2025, with quotas matching national age and urban-rural distributions. The vaccines shared common attributes (protection rate, duration, adverse reactions, price) plus vaccine-specific attributes. D-efficient design generated choice sets with quality-control items. Mixed logit models estimated attribute coefficients, incorporating price × income and 100% protection × age interactions. WTP and MAR were computed via Krinsky-Robb simulations (50,000 draws).
RESULTS: Protection rate dominated vaccination preferences across all six vaccines. For rotavirus vaccine, WTP for increasing protection from 0% to 100% reached approximately CNY 3,498, far exceeding WTP for extended duration (CNY 441) or reduced adverse reactions (CNY 142-552). For MAR, when protection rose from 0% to 70%, the acceptable injection-site reaction risk reached 80.60% for EV71 and 94.29% for influenza, both of which were substantially above real-world incidence rates (1-10% and ~20%). Rotavirus vaccine MAR for mild-to-moderate systemic reactions was 29.20%, close to its real-world rate (30-40%). Low-income individuals showed significantly greater price sensitivity; older adults exhibited lower preference for complete protection in influenza and pneumococcal vaccine models.
CONCLUSIONS: Protection rate is the core driver of vaccine preferences, with marginal WTP rising sharply as protection approaches 100%. Maximum acceptable risk for routine adverse reactions substantially exceeds real-world incidence rates, confirming ample clinical safety margins from the public perspective. Significant preference heterogeneity across income and age groups supports differentiated vaccine pricing and communication strategies.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR36
Topic
Patient-Centered Research
Disease
STA: Vaccines