Factors associated with adults' perceived need to vaccinate against hepatitis B in rural China

Barriers to and Facilitators of Hepatitis B Vaccination among the Adult Population in Indonesia: A Mixed Methods Study

To reach the goals of the Global Hepatitis Elimination 2030 program, Indonesia is now preparing a new regulation for hepatitis B vaccinations for adult population. This study aimed to determine the factors influencing vaccine uptake for hepatitis B in the adult population, and identify barriers to, and facilitators of, hepatitis B vaccination programmes. An explanatory sequential mixed methods design was implemented in this study. We conducted a survey involving 893 participants in the general population followed by 14 in-depth interviews with health providers. The survey found that only 15% (95% confidence interval 13-18%) of participants received at least one dose of the hepatitis B vaccine. Factors associated with vaccine uptake were, living in Yogyakarta compared to living in Aceh, having secondary and higher education compared to primary education, working as a health worker compared to working in other sectors, and having health insurance that covered hepatitis B vaccination compared to not having such health insurance. Our qualitative study also identified several barriers to the adult hepatitis B vaccination programme in Indonesia such as the high cost of vaccination, lack of vaccine availability in certain areas, limited human resources to implement the hepatitis B vaccination programme, and the ineffective dissemination of hepatitis B vaccination. This study highlights that accessibility and affordability of vaccinations are important determinants of vaccination uptake that should be taken into account when planning vaccination campaigns.

Understanding hepatitis B vaccination willingness in the adult population in Indonesia: a survey among outpatient and healthcare workers in community health centers

Aim

This study aimed to assess factors associated with the willingness to be vaccinated against hepatitis B among Indonesia’s adult population, considering cultural and geographic differences by analysing the two provinces of Aceh and Yogyakarta.

Subject and methods

An institution-based cross-sectional survey was conducted in 16 community health centres. A multivariable logistic regression model stratified by province was employed to assess variables associated with the willingness to receive hepatitis B vaccination.

Results

We found that participants from Yogyakarta more often had a higher knowledge and risk perception of hepatitis B and were more often willing to get vaccinated than participants from Aceh. We also found that a high-risk perception of hepatitis B infection was associated with the willingness to be vaccinated against hepatitis B in participants from both Aceh and Yogyakarta. Furthermore, in Yogyakarta, a fair and high knowledge of hepatitis B infection and vaccination, being female, and having health insurance covering hepatitis B vaccination costs were associated with the willingness to be vaccinated. In Aceh, health care workers in high-risk units for hepatitis B had a higher willingness to be vaccinated than those who were not high-risk health care workers.

Conclusion

Given the different factors associated with the willingness to be vaccinated against hepatitis B in Aceh and Yogyakarta, this study also highlights the need of a locally adjusted, culture-based approach to improve the hepatitis B vaccination programme.

Knowledge, Preference, and Willingness to Pay for Hepatitis B Vaccination Services among Woman of Reproductive Age in Vietnam

Background

Hepatitis B virus (HBV) vaccine is a critical approach to prevent HBV transmission from mother to child. However, despite high HBV prevalence, evidence about the preference of women of productive age for HBV vaccine in Vietnam was constrained. This study aims to explore the preference and willingness to pay (WTP) for the HBV vaccine in Vietnamese women in productive age.

Methods

A cross-sectional study was conducted in Hanoi in April 2016. A structured questionnaire was used to collect information about respondents' socioeconomic status and knowledge about HBV vaccination. A contingent valuation approach was employed to measure the WTP for the HBV vaccine. Logistic and interval regressions were used to determine the associated factors.

Results

Among 807 women, 80.8% were willing to have the vaccine injected which had the average price of 108,600 VND (95% CI, 97,580 VND-119,570 VND). Participants not suffering any diseases during pregnancy were more likely to be willing to pay for the HBV vaccine (OR = 3.41, 95% CI = 1.73-6.70). Not having the antenatal examination at central hospitals and working as farmers/workers were positively correlated with willingness to pay for this vaccine, while the number of children of respondents had a negative correlation with WTP.

Conclusions

Our sampled women expressed a high willingness to pay for the vaccine. The price people were willing to pay for the vaccine, however, is equal to half of the actual price. These findings implied needs for better targeted public education interventions about HBV and the involvement of local medical staffs and the media in providing information. Efforts to reduce the price of the vaccine should also be warranted for scaling-up the coverage of this vaccine.

The effects of convenience and quality on the demand for vaccination: Results from a discrete choice experiment

BACKGROUND

Vaccination is an effective way to prevent infectious diseases. Most studies analysed people's vaccine decisions, but few studies have analysed the effects of convenience such as immunisation schedule and distance and the quality of vaccination service on vaccination uptake.

OBJECTIVE

The aim of this paper was to investigate adults' preferences for convenience and quality of vaccination service, calculate the private economic benefit from convenience (vaccination schedule and distance) and quality, and predict the uptake rate for different vaccine scenarios.

METHODS

In our study, we interviewed 266 adults in 2 counties of Shandong province in China. The discrete choice experiment (DCE) was employed to analyse the preference for hepatitis B virus (HBV) vaccination, and a mixed logit model was used to estimate respondent preferences for vaccination attributes included in the DCE.

RESULTS

The protection rate against hepatitis B (HB), duration of protection, risk of side effects, vaccination cost, schedule, and vaccination sites were proved to influence adults' preferences for HBV vaccination. The estimated willingness to pay (WTP) for 1 dose schedule instead of 3 doses and for a third-level vaccination site instead of a first-level site was almost equal (19 RMB). However, if the protection duration of the vaccination programme changed from 5years to 20years, the adults were willing to pay 35.05 RMB, and WTP for a 99% protection rate instead of a 79% rate was 67.71 RMB. The predicted uptake rate is almost 43% for the base case of HBV vaccination.

CONCLUSIONS

Adults made trade-offs between vaccination schedules, vaccination sites, and other characteristics of HBV vaccine. The impact of attributes of the vaccine itself, especially protection rate against HB, duration of protection, and risk of side-effects, is more dramatic than convenience and quality of vaccination service.