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      Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review

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          ABSTRACT

          The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.

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          Most cited references67

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          Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment

          The COVID-19 pandemic is unlikely to end until there is global roll-out of vaccines that protect against severe disease and preferably drive herd immunity. Regulators in numerous countries have authorised or approved COVID-19 vaccines for human use, with more expected to be licensed in 2021. Yet having licensed vaccines is not enough to achieve global control of COVID-19: they also need to be produced at scale, priced affordably, allocated globally so that they are available where needed, and widely deployed in local communities. In this Health Policy paper, we review potential challenges to success in each of these dimensions and discuss policy implications. To guide our review, we developed a dashboard to highlight key characteristics of 26 leading vaccine candidates, including efficacy levels, dosing regimens, storage requirements, prices, production capacities in 2021, and stocks reserved for low-income and middle-income countries. We use a traffic-light system to signal the potential contributions of each candidate to achieving global vaccine immunity, highlighting important trade-offs that policy makers need to consider when developing and implementing vaccination programmes. Although specific datapoints are subject to change as the pandemic response progresses, the dashboard will continue to provide a useful lens through which to analyse the key issues affecting the use of COVID-19 vaccines. We also present original data from a 32-country survey (n=26 758) on potential acceptance of COVID-19 vaccines, conducted from October to December, 2020. Vaccine acceptance was highest in Vietnam (98%), India (91%), China (91%), Denmark (87%), and South Korea (87%), and lowest in Serbia (38%), Croatia (41%), France (44%), Lebanon (44%), and Paraguay (51%).
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            COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

            Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs. Survey data collected across ten low-income and middle-income countries (LMICs) in Asia, Africa and South America compared with surveys from Russia and the United States reveal heterogeneity in vaccine confidence in LMICs, with healthcare providers being trusted sources of information, as well as greater levels of vaccine acceptance in these countries than in Russia and the United States.
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              The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay

              The development of a vaccine against SARS-CoV-2 infection is on the way. To prepare for public availability, the acceptability of a hypothetical COVID-19 vaccine and willingness to pay (WTP) were assessed to provide insights into future demand forecasts and pricing considerations.
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                Author and article information

                Journal
                Hum Vaccin Immunother
                Hum Vaccin Immunother
                Human Vaccines & Immunotherapeutics
                Taylor & Francis
                2164-5515
                2164-554X
                15 February 2024
                2024
                15 February 2024
                : 20
                : 1
                : 2313860
                Affiliations
                [a ]Department of Epidemiology and Health Statistics, Fujian Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University; , Fuzhou, Fujian, China
                [b ]Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine; , Universiti Malaya, Kuala Lumpur, Malaysia
                [c ]Tropical Infectious Diseases Research & Education Centre (TIDREC), Universiti Malaya; , Kuala Lumpur, Malaysia
                [d ]Department of Pediatrics, Indiana University School of Medicine; , Indianapolis, IN, USA
                [e ]Department of Gynecology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University; , Fuzhou, Fujian, China
                Author notes
                CONTACT Li Ping Wong wonglp@ 123456ummc.edu.my Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University; , Fuzhou, Fujian 350122, China.
                Hai Yen Lee leehaiyen@ 123456um.edu.my Tropical Infectious Diseases Research & Education Centre (TIDREC), Universiti Malaya; , Kuala Lumpur 50603 Malaysia.
                Author information
                https://orcid.org/0000-0002-0107-0532
                Article
                2313860
                10.1080/21645515.2024.2313860
                10877984
                38359815
                625a8847-0fe2-4873-962b-0a9426a9f457
                © 2024 The Author(s). Published with license by Taylor & Francis Group, LLC.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

                History
                Page count
                Figures: 0, References: 76, Pages: 1
                Categories
                Review Article
                Coronavirus

                Molecular medicine
                cost-based vaccination,covid-19,willingness to pay
                Molecular medicine
                cost-based vaccination, covid-19, willingness to pay

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