Factors affecting parents’ willingness to pay for dengue vaccination for children in endemic areas, Indonesia: A multicenter crosssectional study

Objective: To predict parents’ willingness to pay for dengue fever vaccination through the perception of dengue vaccine based on the Health Belief Model (HBM). Methods: A multicenter crosssectional study was conducted on parents who had children aged ≤ 5 years and were participating in integrated health service post activities in 3 districts/cities with the highest incidence of dengue fever in Southeast Sulawesi. The instruments used to collect data in this study consisted of a participant characteristics questionnaire, a dengue vaccine perception questionnaire based on the HBM, and a willingness to pay for dengue vaccine questionnaire. Chi -square test and multivariate logistic regression analysis were used to determine the correlation between the perceived HBM subscales and willingness to pay for dengue vaccination. Results: A total of 310 people participated in this study with an average age of (29.9±5.6) years. Most of them were females (284/310, 91.7%), 80.9% (251/310) had a high education status and 87.4% (271/310) had direct experience with DF. The results showed good perceptions including Perceived Susceptibility (adjusted OR 3.7, 95% CI 2.7-6.3, P <0.001), Perceived Severity (adjusted OR 2.8, 95% CI 1.7-5.5, P <0.001), Perceived Benefits (adjusted OR 2.8, 95% CI 1.7-4.5, P <0.001), and Cues to Action (adjusted OR 3.1, 95% CI 1.9-5.1, P <0.001) were positively correlated with willingness to pay for the dengue vaccine comparing with poor perceptions, whereas Perceived Barriers showed no significant effect on willingness to pay for the dengue vaccine. Conclusions: These results suggest that a person’s willingness to pay for dengue vaccine increases with their understanding of the risks and advantages of immunization as well as encouraging outside incentives. As a result, these elements are crucial in raising community involvement in the immunization campaign.