PT  - JOURNAL ARTICLE
AU  - Xuan Thi Thanh Le
AU  - Nguyen Thao Thi Nguyen
AU  - Huong Thi Le
AU  - Toan Thanh Thi Do
AU  - Thang Huu Nguyen
AU  - Huong Lan Thi Nguyen
AU  - Trang Ha Nguyen
AU  - Linh Gia Vu
AU  - Bach Xuan Tran
AU  - Carl A. Latkin
AU  - Cyrus S.H. Ho
AU  - Roger C.M. Ho
TI  - Income Inequalities in Hepatitis B Vaccination and Willingness to Pay Among Women of Reproductive Age in Hanoi, Vietnam
AID  - 10.9745/GHSP-D-20-00480
DP  - 2021 Sep 30
TA  - Global Health: Science and Practice
PG  - 523--531
VI  - 9
IP  - 3
4099  - http://www.ghspjournal.org/content/9/3/523.short
4100  - http://www.ghspjournal.org/content/9/3/523.full
SO  - GLOB HEALTH SCI PRACT2021 Sep 30; 9
AB  - Key FindingsMost women were willing to pay for the hepatitis B virus (HBV) vaccine and there was no difference in willingness to pay for HBV vaccination between income quintiles.The amount willing to pay for the vaccine was different between income levels for prices higher than US$4.50.Key ImplicationsBecause women from the lowest income quintile had the lowest awareness of the HBV vaccine, efforts on education and awareness of HBV and the vaccine should focus on low-income women.Given the high vertical transmission rates of HBV infection, policy makers should prioritize vaccinating women of reproductive age as well as newborns.In light of the finding that higher-income women were willing to pay more for the vaccine, adopting a sliding-scale payment system may mitigate challenges with funding and provide opportunities for equitable vaccine access.Background:Hepatitis B virus (HBV) infection is endemic in Vietnam and can be transmitted from mother to child. Vaccination of women of reproductive age (WRA) can reduce this transmission. Because adult HBV vaccination in Vietnam follows a fee-for-service model, research is needed to determine the effect of household income on willingness to pay (WTP) to ensure equitable access to the vaccine.Methods:A cross-sectional study was performed in Hanoi, Vietnam, in April 2018, among WRA. Questionnaires were administered to assess household income, HBV history, vaccination status, vaccine awareness, and WTP for the vaccine. Multivariable logistic and interval regression were performed to assess the impact of household income on WTP for HBV vaccine.Results:This study found that 62.3% of all participants were willing to pay for the HBV vaccine with no differences in WTP across income quintiles. There were significant differences among household income levels in awareness of HBV vaccination and WTP amount beyond US$4.50 with the lowest awareness and WTP amount among women from the lowest income quintiles.Conclusions:Our data suggest the need to subsidize HBV vaccination for low-income women to ensure more equitable access to HBV vaccination. We propose that a sliding-scale payment method may be an effective strategy in light of limited funding to support vaccination expansion. An education campaign focusing on lower-income households should also be implemented in conjunction with this program. Further research would be required to evaluate consumer acceptance of this payment scheme and to develop an appropriate sliding scale to maximize vaccine uptake.