Enhancing vaccine acceptance: a mixed methods approach to health promotion and willingness to pay among low-income Vietnamese communities

Abstract

Background: This inquiry assesses the willingness to pay (WTP) for a COVID-19 vaccination in Vietnam, and uses a mixed-method approach to investigate how economic, social, and health factors influence acceptance of a vaccine and payment preferences. Methods: The research agenda was implemented via a Discrete Choice Experiment (DCE) with 685 Vietnamese respondents aged 18 years and older from June to September 2024, to measure preferences based on vaccine attributes such as cost, safety, side effects, and duration of protection. WTP was estimated using Binary Logistic Regression. In addition, semi-structured interviews were carried out with 26 community members to explore perceptions, beliefs, and trust in government health messages. Results: Quantitative findings indicated that increased WTP was significantly associated with income, education, and perceived vaccine safety. The qualitative findings also raised concerns regarding vaccine side effects and trust in public health communications. Citizens who are higher in socioeconomic status are more likely to accept and pay for the vaccine. Conclusions: The study shows that there are behavioral as well as economic factors influencing vaccinations. The findings may inform targeted strategies to increase vaccine acceptance among poor communities. Limitations include a cross-sectional design and self-reported attitudes, which may be subject to recall bias.