Parents’ preference for the inclusion of pediatric vaccines in the Chinese National Immunization Program: A discrete choice experiment

The National Immunization Program (NIP) has significantly improved public health in China. However, current NIP coverage does not fully meet China's disease prevention needs. Some pediatric vaccines recommended by the World Health Organization (WHO) and widely used in other countries are not included. Currently, public participation can provide valuable insights for prioritizing vaccine inclusion in the NIP. This study aims to construct a prioritization model for evaluating pediatric vaccines that could be incorporated into the NIP based on Discrete Choice Experiment (DCE) and Swing Weighting (SW) method. It further seeks to rank candidate vaccines. The DCE and SW methods were employed to identify key attributes and levels for vaccine prioritization. A questionnaire was designed and distributed nationwide to parents of children aged 0-14 y. To estimate the coefficient of attribute preferences and predict the selection probability, mixed logit models were employed. Of 1,533 invited individuals, 1,406 responded, and 926 valid responses were included in the analysis. Parents prioritized vaccine effectiveness and vaccine cost, followed by the morbidity of the vaccine-preventable disease when considering whether to include pediatric vaccines in the NIP. The Haemophilus influenzae type b (Hib) vaccine ranked highest for NIP inclusion, followed by the ACYW135 meningococcal polysaccharide conjugate vaccine, varicella vaccine, and bivalent HPV vaccine. The results highlight the importance of vaccine effectiveness and cost in public preferences. The Hib vaccine is strongly recommended for inclusion in the NIP. Parental preferences play a crucial role in the inclusion of pediatric vaccines in NIP.