Willingness to pay for COVID-19 vaccine and its associated factors: A cross-sectional survey in Bangladesh

Background: The Government of Bangladesh is currently providing COVID-19 vaccines free of cost, but for a massive population, the free vaccination program’s sustainability is challenging. In this regard, assessing willingness to pay can help to explore vaccine pricing, subsidizing strategy, and vaccine demand. The study aimed to evaluate the prevalence of willingness to pay (WTP) for the COVID-19 vaccine and its associated factors to ensure the sustainability of the vaccination program.

Methods: A cross-sectional research design was adopted to collect data from 1497 respondents through online and face-to-face interviews. Data were analyzed using the chi-square test and point-biserial correlation for descriptive statistical analysis, and multiple logistic regression analysis was also used to identify the factors associated with the dependent variable in the study.
Results: The prevalence of WTP towards a COVID-19 vaccine was 50.9 %, and mean and median WTP were respectively 754.55 BDT (US$ 8.93), 300 BDT (US$ 3.55). WTP of other religions was significantly higher than Muslims (aOR=1.5, P=0.037). WTP was also higher among Graduate (aOR=2.2, P=0.007), Masters & MPhil/PhD (aOR=2, P=0.030), higher family income group (aOR=1, P=0.039) and respondents with higher knowledge about the vaccine (aOR=1.1, P=0.003), behavioral practice (aOR=1.1, P< 0.001), higher subjective norms (aOR=1.2, P=0.009), higher anticipated regret (aOR=1.2, P=0.005) and higher perceived benefits from the vaccine (aOR=1.1, P=0.029). On the contrary, WTP is lower among respondents who had a higher negative attitude toward vaccines (aOR= 0.9, P<0.001) and higher behavioral control (aOR=0.9, P=0.006). The participants who had experienced severe morbidity and who belonged to a higher income group, they have highly tended to WTP's highest amount of money for the COVID-19 vaccine.
Conclusion: The study found that nearly half of the respondents were not interested in paying for the COVID-19 vaccine. It emphasizes higher education, proper knowledge dissemination about the COVID-19 vaccine, positive behavioral practice, reducing negative attitudes towards it, and higher household income to increase WTP for the COVID-19 vaccine. Health promotion materials should be developed to improve COVID-19 vaccine knowledge and reduce negative attitudes regarding vaccines. A subsidized scheme for lower-income groups should be initiated to minimize the catastrophic income challenge regarding WTP for the COVID-19 vaccine.

背景：孟加拉国政府目前正在免费提供COVID-19疫苗，但对于庞大的人口基数而言，免费疫苗接种项目的可持续性面临着挑战。鉴于此，评估支付意愿有助于探讨疫苗定价策略、补贴政策和疫苗需求。本研究旨在评估对COVID-19疫苗的支付意愿（WTP）及其相关因素，以确保疫苗接种项目的可持续性。研究方法：本研究采用横断面研究设计，通过在线和面对面访谈收集了1497名受访者的数据。数据采用卡方检验和点二列相关分析进行描述性统计分析，并运用多因素逻辑回归分析以识别与研究依赖变量相关的因素。结果：对COVID-19疫苗的支付意愿普及率为50.9%，平均支付意愿和中位数支付意愿分别为754.55孟加拉塔卡（约合8.93美元）和300孟加拉塔卡（约合3.55美元）。其他宗教群体的支付意愿显著高于穆斯林（调整优势比aOR=1.5，P=0.037）。在教育程度方面，研究生（aOR=2.2，P=0.007）、硕士及MPhil/PhD（aOR=2，P=0.030）、高收入家庭群体（aOR=1，P=0.039）以及对于疫苗知识了解较多的受访者（aOR=1.1，P=0.003）、具有良好的行为习惯（aOR=1.1，P<0.001）、较高的主观规范（aOR=1.2，P=0.009）、较高的预期遗憾（aOR=1.2，P=0.005）以及较高的疫苗认知益处（aOR=1.1，P=0.029）的支付意愿较高。反之，对疫苗持负面态度（aOR=0.9，P<0.001）和行为控制能力较强（aOR=0.9，P=0.006）的受访者的支付意愿较低。经历过严重疾病且属于高收入群体的受访者，倾向于为COVID-19疫苗支付最高金额。结论：研究发现，近一半的受访者对支付COVID-19疫苗费用不感兴趣。研究强调，提高教育水平、正确传播COVID-19疫苗知识、培养积极的行为习惯、减少对疫苗的负面态度以及提高家庭收入是提高对COVID-19疫苗支付意愿的关键。应开发健康教育材料，以提高对COVID-19疫苗的认知并减少对疫苗的负面态度。应启动针对低收入群体的补贴方案，以降低支付COVID-19疫苗时的收入冲击。