Publication
Title
Individual decisions to vaccinate one's child or oneself : a discrete choice experiment rejecting free-riding motives
Author
Abstract
It is essential for public health to understand what drives people's hesitance towards vaccination. Theoretical models of vaccination decisions are ubiquitous, often incorporating herd immunity, perceptions of vaccine related side-effects (VRSE) and of vaccine-preventable burden of disease, but with little to no empirical exploration. Herd immunity is a (usually) positive externality where vaccinated individuals influence others' risks by their reduced capability to transmit an infectious disease to them. It is often assumed that (rational) individuals incorporate this externality in their strategic vaccination decision, from which free-riding behavior arises. We performed a Bayesian D-efficient discrete choice experiment in February March 2017 to study vaccination behavior in 1919 Belgian respondents. Choice sets with vaccine profiles were constructed using six attributes: vaccine effectiveness, VRSE, accessibility (in terms of convenience and reimbursement), vaccine preventable burden of disease, local (respondents' network of contacts) vaccination coverage, and population (the population at large) vaccination coverage. VRSE and accessibility are the most influential attributes, followed by vaccine effectiveness and burden of disease. Both population and local coverage are less important than the other attributes, but show a significant direct linear relationship with vaccine utility. This supports the existence of peer influence (more incentivized as more and more vaccinate), rather than free-riding on herd immunity. These findings were independent of whether respondents made vaccine choices for themselves or for their child. Around 40% of the respondents indicated accepting vaccination with little or no questioning. These `acceptors' were less sensitive to changes in the vaccine-preventable burden of disease for their child's vaccination choices (but not for themselves). Public health institutions are critical in stimulating vaccine uptake by making vaccines conveniently available at an affordable price and by communicating pro-actively on perceived VRSEs. The free-riding assumption as a driver of individual vaccine decisions, seems inappropriate, but this observation needs confirming in other populations.
Language
English
Source (journal)
Social science and medicine (1982). - Oxford
Publication
Oxford : 2018
ISSN
0277-9536
Volume/pages
207(2018), p. 106-116
ISI
000435050600013
Pubmed ID
29738898
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Project info
Individual behaviour and extra-utilitarian ethics in health economic evaluation: an individual-based modelling approach for measles elimination.
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 10.07.2018
Last edited 02.08.2021
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