Willingness-to-pay for COVID-19 vaccine in ten low-middle-income countries in Asia, Africa and South America: A cross-sectional study

Malik  Sallam; Samsul  Anwar; Amanda  Yufika; Marhami  Fahriani; Milda  Husnah; Hendrix I.  Kusuma; Rawan  Raad; Namareg ME.  Khiri; Rashed YA.  Abdalla; Rashed Y.  Adam; Mohajer IH.  Ismaeil; Asma Y.  Ismail; Wajdi  Kacem; Zeineb  Teyeb; Khaoula  Aloui; Montacer  Hafsi; Nesrine Ben Hadj Dahman; Manel  Ferjani; Dalia  Deeb; Dina  Emad; Farah S. Sami; Kirellos Said Abbas; Fatma A.  Monib; Subramaniam  R; Suhrud  Panchawagh; Khan  Sharun; Sunil  Anandu; Mahir  Gachabayov; Md A.  Haque; Talha B.  Emran; Guilherme W. Wendt; Lirane ED. Ferreto; María F. Castillo-Briones; Rocío B. Inostroza-Morales; Sebastián A. Lazcano-Díaz; José T. Ordóñez-Aburto; Jorge E. Troncoso-Rojas; Emmanuel O. Balogun; Akele R. Yomi; Abiodun  Durosinmi; Esther N. Adejumo; Eyiuche D.  Ezigbo; Morteza  Arab-Zozani; Elham  Babadi; Edris  Kakemam; Irfan  Ullah; Najma I. Malik; Deema  Dababseh; Francesco  Rosiello; Seyi S. Enitan

doi:10.52225/narra.v2i1.74

Authors

Malik Sallam Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan; Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan; Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
Samsul Anwar Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia https://orcid.org/0000-0003-3165-2151
Amanda Yufika Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia https://orcid.org/0000-0001-8408-9396
Marhami Fahriani Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
Milda Husnah Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia; Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Darussalam Banda Aceh, Indonesia https://orcid.org/0000-0003-2923-4313
Hendrix I. Kusuma Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia; Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Darussalam Banda Aceh, Indonesia; Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Ar-Raniry, Banda Aceh, Indonesia https://orcid.org/0000-0003-3555-0136
Rawan Raad Faculty of Medicine and General Surgery, Sudan University of Science and Technology, Khartoum,Sudan https://orcid.org/0000-0003-4060-3378
Namareg ME. Khiri Faculty of Medicine, University of Khartoum, Omdurman, Sudan https://orcid.org/0000-0003-4032-4205
Rashed YA. Abdalla Faculty of Medicine, University of Bahri, Khartoum, Sudan https://orcid.org/0000-0002-7841-4807
Rashed Y. Adam Omdurman Teaching Hospital, Omdurman, Sudan
Mohajer IH. Ismaeil Faculty of Medicine, Alzaeim Alazhari University, Khartoum, Sudan
Asma Y. Ismail Department of Internal Medicine, Faculty of Medicine, Sudan International University, Khartoum, Sudan https://orcid.org/0000-0001-6890-8611
Wajdi Kacem Department of Emergency Medicine, Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia https://orcid.org/0000-0003-0088-2974
Zeineb Teyeb Department Of Internal Medicine, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia https://orcid.org/0000-0003-2871-9773
Khaoula Aloui Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia https://orcid.org/0000-0002-1594-3429
Montacer Hafsi Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia https://orcid.org/0000-0001-8826-7073
Nesrine Ben Hadj Dahman Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Manel Ferjani Faculty of Dental Medicine Monastir, University of Monastir, Monastir, Tunisia.
Dalia Deeb Faculty of Medicine, Zagazig University, El-sharkia, Egypt https://orcid.org/0000-0002-4434-947X
Dina Emad Faculty of Medicine, Ain Shams university Nasr City, Cairo, Egypt
Farah S. Sami Faculty of Medicine, Ain Shams University, Nasr City, Cairo, Egypt
Kirellos Said Abbas Faculty of Medicine, Alexandria University, Alexandria, Egypt
Fatma A. Monib Faculty of Medicine, Assiut University, Assiut, Egypt
Subramaniam R Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, Kothamangalam, India https://orcid.org/0000-0003-2863-6708
Suhrud Panchawagh Department of General Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, India
Khan Sharun Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India https://orcid.org/0000-0003-1040-3746
Sunil Anandu Division of Veterinary Parasitology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
Mahir Gachabayov Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia https://orcid.org/0000-0002-9200-1304
Md A. Haque Department of Orthopedic Surgery, Yan an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China https://orcid.org/0000-0003-4632-5153
Talha B. Emran Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh https://orcid.org/0000-0003-3188-2272
Guilherme W. Wendt Department of Life Sciences, Faculty of Medicine, Western Paraná State University, Brazil https://orcid.org/0000-0002-9014-6120
Lirane ED. Ferreto Department of Public Health and Postgraduate Program in Applied Health Sciences, Faculty of Medicine, Western Paraná State University, Brazil https://orcid.org/0000-0002-0757-3659
María F. Castillo-Briones Faculty of Medicine, University of La Frontera, Temuco, Chile
Rocío B. Inostroza-Morales Faculty of Medicine, University of La Frontera, Temuco, Chile https://orcid.org/0000-0003-3473-4654
Sebastián A. Lazcano-Díaz Faculty of Medicine, University of La Frontera, Temuco, Chile
José T. Ordóñez-Aburto Faculty of Medicine, University of La Frontera, Temuco, Chile https://orcid.org/0000-0001-8705-4041
Jorge E. Troncoso-Rojas Faculty of Medicine, University of La Frontera, Temuco, Chile https://orcid.org/0000-0001-7399-3654
Emmanuel O. Balogun Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria.
Akele R. Yomi Medical Laboratory Science Department, College of Medicine and Health Science, Afe Babalola University, Ado Ekiti, Nigeria
Abiodun Durosinmi State Hospital, Ijebu Ode, Ogun, Nigeria
Esther N. Adejumo Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria https://orcid.org/0000-0001-5825-4247
Eyiuche D. Ezigbo Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria https://orcid.org/0000-0001-9397-3706
Morteza Arab-Zozani Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran https://orcid.org/0000-0001-7223-6707
Elham Babadi Mayo Clinic, Rochester, USA.
Edris Kakemam Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran https://orcid.org/0000-0001-7721-6924
Irfan Ullah Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan https://orcid.org/0000-0003-1100-101X
Najma I. Malik Department of Psychology, University of Sargodha, Sargodha, Pakistan https://orcid.org/0000-0002-3521-1014
Deema Dababseh School of Dentistry, The University of Jordan, Amman, Jordan
Francesco Rosiello Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy https://orcid.org/0000-0002-6532-1185
Seyi S. Enitan Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Ogun State, Nigeria https://orcid.org/0000-0001-5993-7920

DOI:

https://doi.org/10.52225/narra.v2i1.74

Keywords:

COVID-19, SARS-CoV-2, acceptance, hesitancy, value, WHO SAGE

Abstract

Vaccine hesitancy is considered as one of the greatest challenges to control the ongoing coronavirus disease 2019 (COVID-19) pandemic. A related challenge is the unwillingness of the general public to pay for vaccination. The objective of this study was to determine willingness-to-pay (WTP) for COVID-19 vaccine among individuals from ten low-middle-income countries (LMICs) in Asia, Africa, and South America. Data were collected using an online questionnaire distributed during February - May 2021 in ten LMICs (Bangladesh, Brazil, Chile, Egypt, India, Iran, Nigeria, Pakistan, Sudan, and Tunisia). The major response variable of in this study was WTP for a COVID-19 vaccine. The assessment of COVID-19 vaccine hesitancy was based on items adopted from the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) vaccine hesitancy scale constructs. In this study, 1337 respondents included in the final analysis where the highest number of respondents was from India, while the lowest number was from Egypt. A total of 88.9% (1188/1337) respondents were willing to pay for the COVID-19 vaccination, and 11.1% (149/1337) were not. The average WTP for COVID-19 vaccination was 87.9 US dollars ($), (range: $5-$200). The multivariate model analysis showed that the country, monthly household income, having a history of respiratory disease, the agreement that routine vaccines recommended by health workers are beneficial and having received the flu vaccination within the previous 12 months were strongly associated with the WTP. Based on the country of origin, the highest mean WTP for COVID-19 vaccine was reported in Chile, while the lowest mean WTP for the vaccine was seen among the respondents from Sudan. The availability of free COVID-19 vaccination services appears as a top priority in the LMICs for successful control of the ongoing pandemic. This is particularly important for individuals of a lower socio-economic status. The effects of complacency regarding COVID-19 extends beyond vaccine hesitancy to involve less willingness to pay for COVID-19 vaccine and a lower value of WTP for the vaccine.