Public Acceptance and Willingness-to-Pay for a Future Dengue Vaccine: A Community-Based Survey in Bandung, Indonesia

Abstract

BackgroundAll four serotypes of dengue virus are endemic in Indonesia, where the population at risk for infection exceeds 200 million people. Despite continuous control efforts that were initiated more than four decades ago, Indonesia still suffers from multi-annual cycles of dengue outbreak and dengue remains as a major public health problem. Dengue vaccines have been viewed as a promising solution for controlling dengue in Indonesia, but thus far its potential acceptability has not been assessed.Methodology/Principal FindingsWe conducted a household survey in the city of Bandung, Indonesia by administering a questionnaire to examine (i) acceptance of a hypothetical pediatric dengue vaccine; (ii) participant's willingness-to-pay (WTP) for the vaccine, had it not been provided for free; and (iii) whether people think vector control would be unnecessary if the vaccine was available. A proportional odds model and an interval regression model were employed to identify determinants of acceptance and WTP, respectively. We demonstrated that out of 500 heads of household being interviewed, 94.2% would agree to vaccinate their children with the vaccine. Of all participants, 94.6% were willing to pay for the vaccine with a median WTP of US$1.94. In addition, 7.2% stated that vector control would not be necessary had there been a dengue vaccination program.Conclusions/SignificanceOur results suggest that future dengue vaccines can have a very high uptake even when delivered through the private market. This, however, can be influenced by vaccine characteristics and price. In addition, reduction in community vector control efforts may be observed following vaccine introduction but its potential impact in the transmission of dengue and other vector-borne diseases requires further study.

Socioeconomic and Attitudinal Variables Associated with Acceptance and Willingness to Pay Towards Dengue Vaccine: A Systematic Review

“…After reading the full texts, five additional papers regarding vaccine acceptance were excluded because they did not provide sufficient data for calculation of OR95%CI. Therefore, two studies regarding dengue vaccine acceptance were included in the meta-analysis (12,13). While, all papers (eight papers) regarding WTP for dengue vaccine were excluded because they were not qualified to calculate OR95%CI.…”

“…In total, 1151 participants from two studies regarding dengue vaccine acceptance were identified (12,13) Evidence for heterogeneity between studies was found in the attitude towards dengue variable (P = 0.051); therefore, the data were assessed using random effect model. Evidence for heterogeneity was not found regarding other variables including attitude towards vaccination (P = 2…”

“…In four studies (12,(14)(15)(16), there were 12 factors that were assessed related to WTP towards dengue vaccine. They were attitude towards vaccination, preventive measures against dengue, attitude towards dengue, knowledge on dengue fever, knowledge on dengue viruses, socioeconomic levels, dengue experience, knowing someone who had dengue, vaccine price, having family member(s) suffering from dengue, and previous vaccine purchase.…”

“…They were attitude towards vaccination, preventive measures against dengue, attitude towards dengue, knowledge on dengue fever, knowledge on dengue viruses, socioeconomic levels, dengue experience, knowing someone who had dengue, vaccine price, having family member(s) suffering from dengue, and previous vaccine purchase. Of those, preventive measures against dengue (P = 0.029; P < 0.05; P = 0.036) (14-16), attitude towards dengue (P = 0.005) (14), knowledge on dengue fever (P = 0.050; P = 0.024) (12,16), knowledge on dengue viruses (P = 0.028) (14), socioeconomic levels (P < 0.01) (12,15), dengue experience (P = 0.041), and vaccine price (P < 0.01) (15) were associated with WTP. Other factors had no significant association with WTP towards dengue vaccine (Table 2).…”

“…We reviewed several factors associated with dengue vaccine acceptance. Until now (updated-January 2, 2017), only two studies (11,12) evaluated factors associated with dengue vaccine acceptance. Although there were several factors associated with vaccine acceptance from individual study (attitude towards vaccination, preventive measures against dengue, attitude towards dengue, knowledge on dengue fever, socioeconomic level, and dengue experience), our meta-analysis revealed that only attitude towards vaccination and socioeconomic level had significant associations with dengue vaccine acceptance.…”