Vaccine · 2026
Willingness to pay for influenza vaccination among the elderly in Vietnam: A triple-bounded dichotomous choice analysis of economic and behavioral determinants.
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Le Minh Huu, Tran Nhu Duong, Nguyen Thi Thi Tho, Phan Thi Trung Ngoc, Pham Thi Tam, Tran Nguyen Du
Аннотация
BACKGROUND: Seasonal influenza causes significant morbidity among the elderly, yet vaccination remains an out-of-pocket expense in Vietnam. This study evaluated the willingness to pay (WTP) for influenza vaccination and its determinants among the elderly in Vietnam.
METHODS: A community-based cross-sectional study was conducted in Can Tho City, Vietnam (N = 1486). We employed the Contingent Valuation Method with a Triple-Bounded Dichotomous Choice framework. Data were analyzed using multivariable logistic regression to identify predictors of WTP and interval regression to estimate the mean WTP and its monetary determinants.
RESULTS: Overall, 54.9% of participants expressed a WTP, but only 28.9% were willing to cover the full market cost. The estimated mean WTP was 12.08 USD (95% CI: 11.66-12.50). Logistic regression revealed that vaccine hesitancy was the strongest predictor; non-hesitant individuals were 13.71 times more likely to express WTP (p < 0.001). Other significant predictors included high income (aOR = 2.22), medical recommendations (aOR = 1.80),and diabetes mellitus (aOR = 1.41). Interval regression showed that vaccine hesitancy "devalued" the vaccine by approximately 30%, with highly hesitant individuals willing to pay 4.12 USD less than those with low hesitancy. Conversely, media exposure increased the WTP amount by 1.10 USD. Most respondents (66.1%) identified the state budget as the preferred financial support source.
CONCLUSIONS: A significant affordability gap exists for influenza vaccination among the Vietnamese elderly. While financial subsidies are necessary to support low-income groups, they must be paired with communication strategies to reduce vaccine hesitancy. We recommend a subsidized co-payment model (minimum 4-5 USD subsidy per dose) and leveraging healthcare provider recommendations to enhance vaccine valuation and uptake.
METHODS: A community-based cross-sectional study was conducted in Can Tho City, Vietnam (N = 1486). We employed the Contingent Valuation Method with a Triple-Bounded Dichotomous Choice framework. Data were analyzed using multivariable logistic regression to identify predictors of WTP and interval regression to estimate the mean WTP and its monetary determinants.
RESULTS: Overall, 54.9% of participants expressed a WTP, but only 28.9% were willing to cover the full market cost. The estimated mean WTP was 12.08 USD (95% CI: 11.66-12.50). Logistic regression revealed that vaccine hesitancy was the strongest predictor; non-hesitant individuals were 13.71 times more likely to express WTP (p < 0.001). Other significant predictors included high income (aOR = 2.22), medical recommendations (aOR = 1.80),and diabetes mellitus (aOR = 1.41). Interval regression showed that vaccine hesitancy "devalued" the vaccine by approximately 30%, with highly hesitant individuals willing to pay 4.12 USD less than those with low hesitancy. Conversely, media exposure increased the WTP amount by 1.10 USD. Most respondents (66.1%) identified the state budget as the preferred financial support source.
CONCLUSIONS: A significant affordability gap exists for influenza vaccination among the Vietnamese elderly. While financial subsidies are necessary to support low-income groups, they must be paired with communication strategies to reduce vaccine hesitancy. We recommend a subsidized co-payment model (minimum 4-5 USD subsidy per dose) and leveraging healthcare provider recommendations to enhance vaccine valuation and uptake.