Predictors of acceptance and willingness to pay for the COVID-19 vaccine in the general public of India: A health belief model approach

ABSTRACT

Objective: To determine the predictors of acceptance and willingness to pay (WTP) for the COVID-19 vaccine among the Indian public and to provide insights for future demand forecasts and pricing considerations. Methods: A nationwide, web-based, self-administered, cross-sectional survey was conducted from 5 to 20 October 2020. The health belief model (HBM) approach was used as a theoretical framework to assess the predictors of acceptance of and WTP for the COVID-19 vaccine. Results: Of 2 480 respondents, 2 451 completed the online survey, yielding a response rate of 98.8%. Participants who participated in the survey had diverse demographics in terms of their location, educational level, occupation type, and family income. Among 2 451 respondents, the majority (89.3%) intended to receive the COVID-19 vaccine. Respondents with high perceived benefits of COVID-19 vaccination, such as reduction in worry (OR 5.87; 95% CI 4.39-7.96) and sickness (OR 4.31; 95% CI 3.31-5.62), showed higher intention to receive the vaccine. However, respondents with a high perception of the side effects and barriers to vaccination (OR 0.36; 95% CI 0.25-0.54) and vaccine shortage (OR 0.58; 95% CI 0.41-0.81) showed lower intention to receive the vaccine. The majority (2 162, 88.21%) of respondents were willing to pay an amount of INR 500-1 000 or USD 6.81-13.62 for a dose of COVID-19 vaccine, with a median (Q1, Q3) of INR 500 (500, 1 000) or USD 6.81 (6.81, 13.62). The higher marginal WTP for the COVID-19 vaccine was influenced by advanced age, marital status, female sex, intermediate educational background, high family income, fair or poor perceived health status, and no affordable barriers. Conclusions: The majority of respondents intended to receive the COVID-19 vaccine. Healthcare interventions focusing on HBM constructs and demographic predictors associated with low intention to receive the vaccine can be effective in enhancing the coverage of the COVID-19 vaccine. The findings of this study provide guidance for the future price considerations of the COVID-19 vaccine.