Parental preferences for a mandatory vaccination scheme in England: A discrete choice experiment

ABSTRACT

Summary Background Mandatory vaccination has been mooted to combat falling childhood vaccine uptake rates in England. This study investigated parental preferences for a mandatory vaccination scheme. Methods Discrete choice experiment. Six attributes were investigated vaccine, child age group, incentive, penalty, ability to opt out, and compensation scheme. Mixed effects conditional logit regression models were used to investigate parental preferences and relative importance of attributes. Findings Participants were 1,001 parents of children aged 5 years and under in England (53% female;mean age=33·6 years, SD=7·1;84% white). Parental preferences were mostly based on incentives (30·7% relative importance;80·9% [95% confidence interval 76·3–85·0%] preference for parent and 74·8% [71·0–78·3%] for child incentive;reference no incentive) and penalties (25·4% relative importance;69·5% [65·7–73·1%] preference for schemes where unvaccinated children cannot attend school or day care and 67·6% [63·6–71·4%] for those withholding financial benefits for parents of unvaccinated children;reference £450 fine). Parents also preferred schemes that offered a compensation scheme (18·1% relative importance;66·4% [62·7–69·8%] preference;reference not offered), mandated vaccination in children aged 2 years (versus 5 years;11·4% relative importance;42·6% [39·4–45·9%] preference;reference 2 years), mandated the 6-in-1 vaccine (10·5% relative importance;58·2% [54·6–61·7%] preference;reference MMR), and that offered only medical exemptions (versus medical and religious belief exemptions;4·0% relative importance;45·5% [41·1–50·0%] preference;reference medical exemptions). Interpretation These findings can inform policymakers’ decisions about how best to implement a mandatory childhood vaccination scheme in England. Funding Data collection was funded by a British Academy/Leverhulme Small Research Grants (SRG1920\101118).