scholarly journals No Such Thing as a Free-Rider? Understanding Drivers of Childhood and Adult Vaccination through a Multicountry Discrete Choice Experiment

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 264
Author(s):  
Frederik Verelst ◽  
Roselinde Kessels ◽  
Lander Willem ◽  
Philippe Beutels
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Vaccination Coverage ◽  
Choice Experiment ◽  
Disease Burden ◽  
Free Rider ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Vaccine Preventable Disease ◽  
Preventable Disease

Increased vaccine hesitancy and refusal negatively affects vaccine uptake, leading to the reemergence of vaccine preventable diseases. We aim to quantify the relative importance of factors people consider when making vaccine decisions for themselves, or for their child, with specific attention for underlying motives arising from context, such as required effort (accessibility) and opportunism (free riding on herd immunity). We documented attitudes towards vaccination and performed a discrete choice experiment in 4802 respondents in The United Kingdom, France and Belgium, eliciting preferences for six attributes: (1) vaccine effectiveness, (2) vaccine preventable disease burden, (3) vaccine accessibility in terms of copayment, vaccinator and administrative requirements, (4) frequency of mild vaccine-related side-effects, (5) vaccination coverage in the country’s population and (6) local vaccination coverage in personal networks. We distinguished adults deciding on vaccination for themselves from parents deciding for their youngest child. While all attributes were found to be significant, vaccine effectiveness and accessibility stood out in all (sub)samples, followed by vaccine preventable disease burden. We confirmed that people attach more value to severity of disease compared to its frequency, and discovered that peer influence dominates free-rider motives, especially for the vaccination of children. These behavioral data are insightful for policy and are essential to parameterize dynamic vaccination behavior in simulation models. In contrast to what most game theoretical models assume, social norms dominate free-rider incentives. Policy-makers and healthcare workers should actively communicate on high vaccination coverage, and draw attention to the effectiveness of vaccines while optimizing their practical accessibility.

scholarly journals No such thing as a free-rider? Understanding multicountry drivers of childhood and adult vaccination

2020 ◽  
Author(s):  
Frederik Verelst ◽  
Roselinde Kessels ◽  
Lander Willem ◽  
Philippe Beutels
Keyword(s):  
Vaccination Coverage ◽  
Peer Influence ◽  
Disease Burden ◽  
Herd Immunity ◽  
Free Rider ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Vaccine Preventable Disease ◽  
Preventable Disease

AbstractBackgroundIncreased vaccine hesitancy and refusal negatively affects vaccine uptake leading to vaccine preventable disease reemergence. We aimed to quantify the relative importance of characteristics people consider when making vaccine decisions for themselves, or for their child, with specific attention for underlying motives arising from context, such as required effort (accessibility) and opportunism (free riding on herd immunity).MethodsWe documented attitudes towards vaccination and performed a discrete choice experiment in 4802 respondents in The United Kingdom, France and Belgium eliciting preferences for six attributes: (1) vaccine effectiveness, (2) vaccine preventable disease burden, (3) vaccine accessibility in terms of co-payment, vaccinator and administrative requirements, (4) frequency of mild vaccine-related side-effects, (5) vaccination coverage in the country’s population and (6) local vaccination coverage in personal networks. We distinguished adults deciding on vaccination for themselves (‘oneself’ group) from parents deciding for their youngest child (‘child’ group).ResultsWhile all six attributes were found to be significant, vaccine effectiveness and accessibility stand out in all (sub)samples, followed by vaccine preventable disease burden. We confirmed that people attach more value to severity of disease compared to its frequency and discovered that peer influence dominates free-rider motives, especially for the vaccination of children.ConclusionsThese behavioral data are insightful for policy and are essential to parameterize dynamic vaccination behavior in simulation models. In contrast to what most game theoretical models assume, social norms dominate free-rider incentives. Therefore policy-makers and healthcare workers should actively communicate on high vaccination coverage, and draw attention to the effectiveness of vaccines, while optimizing their practical accessibility.

scholarly journals Influence of Vaccination Characteristics on COVID-19 Vaccine Acceptance Among Working-Age People in Hong Kong, China: A Discrete Choice Experiment

2021 ◽  
Vol 9 ◽  
Author(s):  
Kailu Wang ◽  
Eliza Lai-Yi Wong ◽  
Annie Wai-Ling Cheung ◽  
Peter Sen-Yung Yau ◽  
Vincent Chi-Ho Chung ◽  
...  
Keyword(s):  
Social Media ◽  
Hong Kong ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Vaccine Uptake ◽  
Preference Heterogeneity ◽  
Significant Information ◽  
Vaccine Acceptance ◽  
General Physicians

Background: Along with individual-level factors, vaccination-related characteristics are important in understanding COVID-19 vaccine hesitancy. This study aimed to determine the influence of these characteristics on vaccine acceptance to formulate promotion strategies after considering differences among respondents with different characteristics.Methods: An online discrete choice experiment was conducted among people aged 18–64 years in Hong Kong, China, from 26 to 28 February 2021. Respondents were asked to make choices regarding hypothetical vaccination programmes described by vaccination-related characteristics—the attributes derived from a prior individual interview. Subgroup analysis was performed to identify the differences in vaccination-related characteristics among respondents with different personal characteristics.Results: A total of 1,773 respondents provided valid responses. The vaccine efficacy and brand were the most important factors affecting acceptance, followed by the exemption of quarantine for vaccinated travelers, safety, venue for vaccination, vaccine uptake of people in their lives, and recommendations by general physicians or government. Frequent exposure to vaccination information on social media has been associated with increasing vaccine refusal. Substantial preference heterogeneity for the attributes was found among people of different ages, incomes, chronic conditions, and previous acceptance of influenza vaccines.Conclusion: The findings provided evidence to formulate interventions to promote vaccine uptake, including the provision of vaccination at housing estate or workplaces, involvement of general physicians and interpersonal communication in vaccine promotion and information dissemination, and exemption of quarantine for vaccinated people. Moreover, social media is a significant information channel that cannot be neglected in the dissemination of official information.

scholarly journals COVID-19 vaccine preferences among university students in Hong Kong: a discrete choice experiment

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Xue Li ◽  
Man Yui Chong ◽  
Ching Yui Chan ◽  
Vindy Wing Sun Chan ◽  
Xinning Tong
Keyword(s):  
Hong Kong ◽  
Health Education ◽  
University Students ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Online Questionnaire ◽  
Conditional Logit

Abstract Objective To promote public health and resume university activities, COVID-19 vaccination has been mandated from an increasing number of universities worldwide. The objective of the study is to understand the factors that impact preference and willingness to take the vaccine among university students in Hong Kong universities utilizing an online questionnaire. The findings will be imperative for health education and the success of the vaccination program. Results We conducted a discrete choice experiment survey among university students in Hong Kong and applied conditional logit regression to estimate their vaccine preference and the weight of each attribute. Regression results showed adverse reactions, efficacy, origin of the vaccine, required number of doses and out-of-pocket price are significant determinants for the choice of vaccine, ranked from the most to least important. Similar preference weighting results were observed after adjusting age, sex, monthly household income, studying medical-related subjects and recent influenza vaccination. Safety, efficacy and origin of the vaccine are key drivers for vaccination decisions among young adults in Hong Kong. Health education and communication focused on these factors are urgently needed to overcome vaccine hesitancy and improve the vaccine uptake.

scholarly journals Parental preferences for a mandatory vaccination scheme in England; a discrete choice experiment

2021 ◽  
Author(s):  
Louise E Smith ◽  
Ben Carter
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Day Care ◽  
Choice Experiment ◽  
Vaccine Uptake ◽  
Compensation Scheme ◽  
Parental Preferences ◽  
Vaccination Scheme ◽  
Unvaccinated Child ◽  
Mandatory Vaccination

Background: Mandatory vaccination has been mooted to combat falling childhood vaccine uptake rates in England. This study investigated parental preferences for a mandatory vaccination scheme. Methods: Discrete choice experiment. Six attributes were investigated: vaccine (MMR, 6-in-1), child age group (2 years and older, 5 years and older), incentive (130 GBP cash incentive for parent, 130 GBP voucher incentive for child, no incentive), penalty (450 GBP fine, parent not able to claim Child Benefits for an unvaccinated child, unvaccinated child not able to attend school or day care), ability to opt out (medical exemption only, medical and religious belief exemption), and compensation scheme (not offered, offered). Mixed effects conditional logit regression models were used to investigate parental preferences and relative importance of attributes. Findings: Participants were 1,001 parents of children aged 5 years and under (53% female, mean age=33.6 years, SD=7.1, 84% white British). Parental preferences were mostly based on incentives (slight preference for cash pay-out for the parent versus a voucher for the child) and penalties (preference for schemes that did not allow unvaccinated children to attend school or day care and those that withheld financial benefits for parents of unvaccinated children). Parents also preferred schemes that: offered a compensation scheme, mandated the 6-in-1 vaccine, mandated vaccination in children aged 2 years and older, and that offered only medical exemptions. Interpretation: Results can inform policymakers' decisions about how best to implement a mandatory childhood vaccination scheme in England. Funding: Data collection was funded by a British Academy/Leverhulme Small Research Grants (SRG1920\101118).

The essential ingredients of research supervision: A discrete-choice experiment.

2019 ◽  
Vol 111 (7) ◽  
pp. 1243-1260 ◽  
Author(s):  
Alex Roach ◽  
Bruce K. Christensen ◽  
Elizabeth Rieger
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Research Supervision

INDIVIDUALS' PREFERENCES FOR ESOPHAGEAL CANCER SCREENING STRATEGIES: A DISCRETE CHOICE EXPERIMENT

2019 ◽  
Author(s):  
Y Peters ◽  
E van Grinsven ◽  
M van de Haterd ◽  
D van Lankveld ◽  
J Verbakel ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Screening ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Screening Strategies

Preferences for antiviral therapy of chronic hepatitis C: a discrete choice experiment

2016 ◽  
Vol 18 (2) ◽  
pp. 155-165 ◽  
Author(s):  
Axel C. Mühlbacher ◽  
John F. P. Bridges ◽  
Susanne Bethge ◽  
Ch.-Markos Dintsios ◽  
Anja Schwalm ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment

Patient preferences for specialist outpatient video consultations: A discrete choice experiment

2021 ◽  
pp. 1357633X2110228
Author(s):  
Centaine L Snoswell ◽  
Anthony C Smith ◽  
Matthew Page ◽  
Liam J Caffery
Keyword(s):  
General Practitioner ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Healthcare Delivery ◽  
General Practitioner Practice ◽  
Specialist Care ◽  
Time Away ◽  
Out Of Pocket Costs

Introduction Telehealth has been shown to improve access to care, reduce personal expenses and reduce the need for travel. Despite these benefits, patients may be less inclined to seek a telehealth service, if they consider it inferior to an in-person encounter. The aims of this study were to identify patient preferences for attributes of a healthcare service and to quantify the value of these attributes. Methods We surveyed patients who had taken an outpatient telehealth consult in the previous year using a survey that included a discrete choice experiment. We investigated patient preferences for attributes of healthcare delivery and their willingness to pay for out-of-pocket costs. Results Patients ( n = 62) preferred to have a consultation, regardless of type, than no consultation at all. Patients preferred healthcare services with lower out-of-pocket costs, higher levels of perceived benefit and less time away from usual activities ( p < 0.008). Most patients preferred specialist care over in-person general practitioner care. Their order of preference to obtain specialist care was a videoconsultation into the patient’s local general practitioner practice or hospital ( p < 0.003), a videoconsultation into the home, and finally travelling for in-person appointment. Patients were willing to pay out-of-pocket costs for attributes they valued: to be seen by a specialist over videoconference ($129) and to reduce time away from usual activities ($160). Conclusion Patients value specialist care, lower out-of-pocket costs and less time away from usual activities. Telehealth is more likely than in-person care to cater to these preferences in many instances.

scholarly journals Understanding what women want: eliciting preference for delivery health facility in a rural subcounty in Kenya, a discrete choice experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038865
Author(s):  
Jackline Oluoch-Aridi ◽  
Mary B Adam ◽  
Francis Wafula ◽  
Gilbert Kokwaro
Keyword(s):  
Quality Of Care ◽  
Health Facility ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Home Delivery ◽  
Process Indicator ◽  
Opt Out ◽  
Women’S Preferences

ObjectiveTo identify what women want in a delivery health facility and how they rank the attributes that influence the choice of a place of delivery.DesignA discrete choice experiment (DCE) was conducted to elicit rural women’s preferences for choice of delivery health facility. Data were analysed using a conditional logit model to evaluate the relative importance of the selected attributes. A mixed multinomial model evaluated how interactions with sociodemographic variables influence the choice of the selected attributes.SettingSix health facilities in a rural subcounty.ParticipantsWomen aged 18–49 years who had delivered within 6 weeks.Primary outcomeThe DCE required women to select from hypothetical health facility A or B or opt-out alternative.ResultsA total of 474 participants were sampled, 466 participants completed the survey (response rate 98%). The attribute with the strongest association with health facility preference was having a kind and supportive healthcare worker (β=1.184, p<0.001), second availability of medical equipment and drug supplies (β=1.073, p<0.001) and third quality of clinical services (β=0.826, p<0.001). Distance, availability of referral services and costs were ranked fourth, fifth and sixth, respectively (β=0.457, p<0.001; β=0.266, p<0.001; and β=0.000018, p<0.001). The opt-out alternative ranked last suggesting a disutility for home delivery (β=−0.849, p<0.001).ConclusionThe most highly valued attribute was a process indicator of quality of care followed by technical indicators. Policymakers need to consider women’s preferences to inform strategies that are person centred and lead to improvements in quality of care during delivery.

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