Parental perceptions and willingness to pay for childhood vaccination experiences in China: a multi-city...

With China's evolving family policies and rising parental expectations, there is increasing demand for improved childhood vaccination experiences. This study aimed to assess Chinese parents' comprehensive perceptions and willingness to pay (WTP) for childhood vaccination experience improvements, with particular focus on combination vaccine preferences.

A multi-city cross-sectional survey was conducted from January to December 2021 across five cities representing China's eastern, central, and western regions. Face-to-face interviews were conducted with 1845 parents of children aged 1-18 months in 60 community health service centers. The study employed questionnaire surveys, discrete choice experiments (DCE) with four attributes (injection frequency, diseases prevented per dose, vaccination coverage rates, and cost), and contingent valuation methods to assess WTP for specific vaccination benefits including pain reduction, adverse reaction prevention, and convenience improvements.

Participants had a mean age of 30.95 ± 4.34 years, with 79 % being mothers and 66.4 % having bachelor's degrees. Over two-thirds (67.84 %) expressed strong concerns about adverse reactions, 74.40 % reported significant child crying during vaccination, and 65.02 % considered travel time to vaccination sites excessive. DCE analysis revealed strong stated preferences for fewer injections, vaccines preventing more diseases per dose, higher on-time vaccination coverage, and lower costs (all p < 0.001). Parents demonstrated highest WTP for preventing serious adverse reactions (54.53 % willing to pay 200 CNY[approximately 28 USD] per avoided reaction), substantially exceeding WTP for convenience factors. Education level, income, and age were key determinants of WTP, with postgraduate-educated parents showing 32.86-58.13 CNY(approximately 4.6-8.1 USD) higher WTP across different benefits compared to those with high school education or below.

Chinese parents prioritize vaccine safety over convenience factors, with significant concerns about adverse reactions and strong preferences for combination vaccines offering reduced injection frequency. The findings support policy initiatives emphasizing combination vaccine development, government procurement programs, and enhanced safety communication to improve childhood vaccination experiences and coverage rates.