Awareness, acceptability, and willingness to pay for the R21/Matrix-M malaria vaccine: a cross-sectional study among pregnant women and nursing mothers in Enugu State, Nigeria.

BACKGROUND

The R21/Matrix-M vaccine has significantly reduced incident malaria in children aged 3–36 months, but awareness, acceptance, and affordability of the vaccine are key to its successful rollout. The objective of this study was to assess the awareness, acceptability, and willingness to pay (WTP) for the R21/Matrix-M malaria vaccine among pregnant women and nursing mothers in Enugu State, Nigeria.

METHODS

A descriptive cross-sectional study was carried out in the selected locations via a 30-item, 4-section questionnaire. Descriptive statistics (frequency, percentage, mean and median) and inferential statistics (chi-square test and binary logistic regression) were used to analyze the data, with the significance level set at p ≤ 0.05.

RESULTS

Of the 310 participants, most were aged 22–33 years, 232 (75.0%) and had at least one child aged 3 years and younger, 180 (58.1%). Additionally, the majority were not aware of the R21/Matrix-M malaria vaccine, 262 (84.5%); agreed to vaccinate their child, 292 (94.2%); and declared a WTP, 247 (79.7%). The mean and median maximum WTP values were US $0.82 ± 1.41 (₦639.27 ± 1097) and US $0.38 (₦300) [Official USD ($) rate; (1 USD = ₦780) as of June–July 2023], respectively. Age (p = 0.005) and health insurance (p = 0.021) were significantly associated with the respondents’ WTP. Health insurance (OR: 0.417, 95% CI: 0.19–0.92) also predicted a lower WTP.

CONCLUSION

Despite limited awareness of the R21/Matrix-M malaria vaccine, participants demonstrated high acceptance and a strong WTP, suggesting that increased awareness could lead to high vaccine coverage.