Adult and maternal pertussis vaccination in China: intention, preferences, and pricing implications from a discrete choice experiment

IF 3.4 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2026-03-07 Epub Date: 2026-01-19 DOI:10.1016/j.vaccine.2026.128243

Bo Wu , Tao Cheng , Yanyang Zhang , Kezhong A , Zhiyuan Hou , Xiaohua Ying , Chaowei Fu

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引用次数: 0

Abstract

Objectives

To assess pertussis vaccination intentions and identify key vaccine attribute preferences among Chinese adolescents, adults and pregnant women to inform future pertussis immunisation strategies.

Methods

We conducted a cross-sectional survey using multistage stratified cluster random sampling across five provinces selected to capture geographic and socioeconomic diversity in China. Participants included adolescents aged 15–17 years, adults, and pregnant women. Prior to the DCE component, all respondents received a brief, standardised description of pertussis and pertussis vaccination to ensure a minimum level of understanding. Correlates of intention were examined using multivariable logistic regression and causal mediation analysis. A discrete choice experiment (DCE) varied efficacy, adverse events following immunisation (AEFI), duration, origin and cost, with willingness-to-pay (WTP) estimated via mixed logit models. Subgroup heterogeneity was assessed by demographic and cognitive characteristics.

Results

Respondents expressed generally high vaccination intention. Among adolescents and adults, larger household size was associated with higher intention; among pregnant women, primiparity was associated with lower intention. Pertussis knowledge partially mediated the education–intention association. In the DCE, all attributes except duration influenced choices, with efficacy the dominant driver; lower AEFI risk, domestically produced vaccines, and lower cost increased preference. Pregnant women showed higher WTP than adults. Preferences varied across demographic and cognitive subgroups.

Conclusions

Respondents showed sizeable intention and consistent preferences for efficacy, safety and affordability, especially for domestically produced vaccines, informing programme design through targeted risk communication, willingness-to-pay–aligned pricing and integration within antenatal services to support real-world uptake.

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中国成人和母亲百日咳疫苗接种：意向、偏好和离散选择实验的定价含义。

目的：评估中国青少年、成年人和孕妇的百日咳疫苗接种意向，并确定关键疫苗属性偏好，为未来的百日咳免疫策略提供信息。方法：采用多阶段分层整群随机抽样的方法，在中国5个省份进行横断面调查，以捕捉中国的地理和社会经济多样性。参与者包括15-17岁的青少年、成年人和孕妇。在DCE组成部分之前，所有应答者都收到了关于百日咳和百日咳疫苗接种的简短、标准化描述，以确保最低程度的了解。使用多变量逻辑回归和因果中介分析来检验意向的相关关系。一项离散选择实验（DCE）研究了不同的疗效、免疫后不良事件（AEFI）、持续时间、来源和成本，并通过混合logit模型估计了支付意愿（WTP）。通过人口统计学和认知特征评估亚组异质性。结果：受访者普遍表示较高的疫苗接种意愿。在青少年和成年人中，家庭规模越大，倾向越高；在孕妇中，初产与低意愿相关。百日咳知识对教育意向有部分中介作用。在DCE中，除持续时间外，所有属性都影响选择，其中效能是主要驱动因素；较低的急性呼吸道感染风险、国产疫苗和较低的成本增加了偏好。孕妇WTP高于成年人。不同人口统计学和认知亚群的偏好不同。结论：受访者对有效性、安全性和可负担性表现出相当大的意愿和一贯的偏好，特别是对国内生产的疫苗，通过有针对性的风险沟通、与支付相一致的定价意愿和产前服务整合来为规划设计提供信息，以支持实际应用。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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