Attribute nonattendance in COVID-19 vaccine choice: A discrete choice experiment based on Chinese public preference

Objectives

The global coronavirus disease 2019 (COVID‐19) pandemic has not been well controlled, and vaccination could be an effective way to prevent this pandemic. By accommodating attribute nonattendance (ANA) in a discrete choice experiment (DCE), this paper aimed to examine Chinese public preferences and willingness to pay (WTP) for COVID‐19 vaccine attributes, especially the influence of ANA on the estimated results.

Methods

A DCE was designed with four attributes: effectiveness, protection period, adverse reactions and price. A random parameter logit model with an error component (RPL‐EC) was used to analyse the heterogeneity of respondents' preferences for COVID‐19 vaccine attributes. Two equality constraint latent class (ECLC) models were used to consider the influence of ANA on the estimated results in which the ECLC‐homogeneity model considered only ANA and the ECLC‐heterogeneity model considered both ANA and preference heterogeneity.

Results

Data from 1,576 samples were included in the analyses. Effectiveness had the highest relative importance, followed by adverse reactions and protection period, which were determined by the attributes and levels presented in this study. The ECLC‐heterogeneity model improved the goodness of fit of the model and obtained a lower probability of ANA. In the ECLC‐heterogeneity model, only a small number of respondents (29.09%) considered all attributes, and price was the most easily ignored attribute (64.23%). Compared with the RPL‐EC model, the ECLC‐homogeneity model obtained lower WTPs for COVID‐19 vaccine attributes, and the ECLC‐heterogeneity model obtained mixed WTP results. In the ECLC‐heterogeneity model, preference group 1 obtained higher WTPs, and preference groups 2 and 3 obtained lower WTPs.

Conclusions

The RPL‐EC, ECLC‐homogeneity and ECLC‐heterogeneity models obtained inconsistent WTPs for COVID‐19 vaccine attributes. The study found that the results of the ECLC‐heterogeneity model considering both ANA and preference heterogeneity may be more plausible because ANA and low preference may be confused in the ECLC‐homogeneity model and the RPL‐EC model. The results showed that the probability of ANA was still high in the ECLC‐heterogeneity model, although it was lower than that in the ECLC‐homogeneity model. Therefore, in future research on DCE (such as the field of vaccines), ANA should be considered as an essential issue.

Public Contribution

Chinese adults from 31 provinces in mainland China participated in the study. All participants completed the COVID‐19 vaccine choice questions generated through the DCE design.

Changes of public risk perception in China: 2008-2018

This paper characterizes the risk acceptance of the Chinese public based on a psychometric paradigm and documents its change by conducting a nationally representative longitudinal survey spanning 10 years. We explore key factors that influence the acceptance of seven typical risks: drinking water pollution, interior decoration, electromagnetic radiation, air pollution, chemical plants, public transportation, and natural hazards, reflecting the general and referential changes in risk perception. The results show a general decrease in the acceptance of all of these risks in the examined decade, especially in economically developed areas. Different types of risk perception varied, but environmental risks had similar trends of perception. The perceived benefits from these risks and local GDP had the greatest impact on risk acceptance. The interaction between the changing perspectives of the emerging middle class and the evolving hazard risk landscape may be the reasons for the reduction in risk acceptance. The main findings offer insights for effective risk education and communication as well as sustainable risk management strategy.

Public preference for COVID-19 vaccines in China: A discrete choice experiment

Background

As the coronavirus disease 2019 (COVID‐19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public's preference for the uptake of the COVID‐19 vaccine in China.

Methods

An online discrete choice experiment (DCE) survey was administered to a sample of China's general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated.

Results

Data of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID‐19 vaccine.

Conclusions

The strong public preferences detected in this study should be considered when developing COVID‐19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy.

Patient or Public Contribution

The design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio‐economic backgrounds. Without their participation, the study would not be possible.

Why does the Chinese public accept evolution?

A substantial proportion of Chinese nationals seem to accept evolution, and the country is sometimes held up to show that the sorry state of evolution acceptance in the United States is not inevitable. Attempts to improve evolution acceptance generally focus on improving communication, curricular reform, and even identifying cognitive mechanisms that bias people against evolution. What is it that the Chinese scientific community did so well, and can it be generalized? This paper argues that evolution acceptance in China has a very specific history, one that other countries are very unlikely to emulate. We show that the interactions among science, education, mass media, social and political movements, and ideological arguments about evolution greatly influenced the Chinese public's understanding and acceptance of evolution. We find that it was not just formal education, but many more ideologically motivated methods of evolution exposure that contributed to the high rate of acceptance. But since the purpose of evolution dissemination has moved beyond merely teaching biology, the Chinese public persists with substantial misunderstandings of the theory. Thus, bottom line percentage of acceptance figures can be misleading; the details and the history really matter.