Acceptability and Willingness-to-Pay for a Hypothetical Ebola Virus Vaccine in Nigeria

Abstract

BackgroundEbola virus disease is a highly virulent and transmissible disease. The largest recorded fatality from Ebola virus disease epidemic is ongoing in a few countries in West Africa, and this poses a health risk to the entire population of the world because arresting the transmission has been challenging. Vaccination is considered a key intervention that is capable of arresting further spread of the disease and preventing future outbreak. However, no vaccine has yet been approved for public use, although various recombinant vaccines are undergoing trials and approval for public use is imminent. Therefore, this study aimed to determine the acceptability of and willingness-to-pay for Ebola virus vaccine by the public.MethodsThe study was a community-based cross-sectional qualitative and quantitative interventional study conducted in two communities, each in two states in Nigeria. An interviewer-administered questionnaire was used to collect information on respondents’ knowledge of the Ebola virus, the ways to prevent the disease, and their preventive practices, as well as their acceptability of and willingness-to-pay for a hypothetical vaccine against Ebola virus disease. The association between acceptability of the vaccine and other independent variables were evaluated using multivariate regression analysis.ResultsEbola virus disease was considered to be a very serious disease by 38.5% of the 582 respondents (224/582), prior to receiving health education on Ebola virus and its vaccine. Eighty percent (80%) accepted to be vaccinated with Ebola vaccine. However, among those that accepted to be vaccinated, most would only accept after observing the outcome on others who have received the vaccine. More than 87.5% was willing to pay for the vaccine, although 55.2% was of the opinion that the vaccine should be provided free of charge.ConclusionThe level of acceptability of Ebola virus vaccine among respondents was impressive (though conditional), as well as their willingness to pay for it if the vaccine is not publicly funded. In order to achieve a high uptake of the vaccine, information and education on the vaccine should be extensively shared with the public prior to the introduction of the vaccine, and the vaccine should be provided free of charge by government.

Values and Hopes of Ebola Vaccines Mass Immunization Programs and Treatments Adoption and Implementation Benefits in Africa

“…At this time, there are no vaccines to protect against EVD licensed for use in humans. Clinical trials for several candidate vaccines are in various phases and a safe and effective vaccine is hoped for by the end of 2015 and there are no proven Ebola vaccines to prevent individuals becoming infected [4][5][6][7][8][9] (Table 1). Currently, into human experimental clinical trials of multivalent DNA vaccine against EVD is ongoing in West Africa and in regions neighbouring EVD-endemic areas including vaccine candidates cAd3-EBOV (cAd3), from GlaxoSmithKline (GSK) and the U.…”

“…and 2x1010PU and 2x1011PU) respectively have demonstrated 100% efficacy in studies in nonhuman primates, but how that will translate to human subjects remains unknown as the minimum antibody titre needed to confer protection and common adverse events in humans is unknown. These studies will assess safety, side effects, and immunogenicity, including antibody responses as measured by enzyme-linked immunosorbent assay (ELISA) and neutralization assays and T-cell immune responses as measured by intracellular cytokine [5,12,14]. Other potential therapies under identification, verification, safety and efficacy exploration include Favipiravir Brincidofovir, Interferons, ZMapp, Amodiaquine, Atorvostatin plus Irbesartan / Clomiphene and amiodarone [1].…”

“…Recent temporal and spatial epidemics events around the world have taught us that Ebola outbreaks and public health concerns is increasingly risky with the intensification of globalization of travel and trade, environmental and climate changes and growing inequalities. Also migration into mega-cities has led to new possibilities of cross-transmission of diseases and outbreaks associated consequences and problems, including higher rates of poverty and unemployment, and environmental degradation [2,5].…”

“…relief supplies. In addition, active surveillance systems including effective community engagement and empowerment, prompt detection case investigation, tracing and mandatory quarantine/ isolation measures for at least for 21-42 days of high-risk suspected or probable individuals that had contact with Ebolainfected patients at home or in Ebola Treatment Centres [1,4,5]. These are necessary steps in improving and guiding evidencebased decision making policies, humanitarian response, priority in quality care interventions and efficient service delivery.…”

“…The innovative supportive measures and recommendations should be applied in improving and fostering significant change in vulnerable countries health systems programming, policies and economic enhancements, which may contribute to compliance to international health regulations and global health initiatives in diseases prevention and control [4,6]. Nevertheless, robust and sustainable innovative approaches should be developed and implemented for effective Ebola community-based immunization programs and treatments in prevention and control of regional and global outbreak threat and public health burden [4,5]. The need to understand the potential benefits of intensive surveillance and screening programs of vulnerable population and travellers in an integrated approach require more research and development (R&D) investments efforts of all stakeholders.…”