Community acceptance and willingness-to-pay for a hypothetical Zika vaccine: a cross-sectional study in Indonesia

Harapan Harapan, Mudatsir Mudatsir, Amanda Yufika, Yusuf Nawawi, Nur Wahyuniati, Samsul Anwar, Fitria Yusri, Novi Haryanti, Nanda Putri Wijayanti, Rizal Rizal, Devi Fitriani, Nurul Fadhliati Maulida, Muhammad Syahriza, Ikram Ikram, Try Purwo Fandoko, Muniati Syahadah, Febrivan Wahyu Asrizal, Alma Aletta, Kurnia Fitri Jamil, Yogambigai RajamoorthyPanji Fortuna Hadisoemarto, Abram Luther Wagner, David Alexander Groneberg, Ulrich Kuch, R Tedjo Sasmono, Ruth Müller, Allison Imrie

Research output: Contribution to journalA1: Web of Science-articlepeer-review


Background: Understanding people's perceptions of the economic benefits of a potential Zika vaccine (ZV) is critical to accelerating its introduction into either public sector programs or private market. The aim of this study was to assess the acceptance and willingness-to-pay (WTP) for a hypothetical ZV and the associated explanatory variables in Indonesia.

Methods: We conducted a health facility-based cross-sectional study in Aceh and West Sumatra province from 1 February to 13 June 2018. Patients who visited outpatient departments, have had children or were expecting their first child, were approached and interviewed to collect information on acceptance, WTP, demographic and socio-economic variables and attitudes towards childhood vaccines. Associations of explanatory variables influencing acceptance and WTP were assessed using logistic regression and linear regression analysis, respectively.

Results: In total, 956 respondents were included in the final analysis of acceptance, of whom 338 (35.3%) expressed their WTP. We found that 757 (79.1%) of the respondents were likely to be vaccinated and to recommend their partner to be vaccinated. Higher educational attainment, having a job, having heard about Zika and a good attitude towards childhood vaccination were associated with ZV acceptance in the univariate analyses. In the multivariate analysis, attitude towards childhood vaccination was the strongest predictor for ZV vaccination. We found the geometric mean and median of WTP was US$ 13.1 (95% CI: 11.37-15.09) and US$ 7.0 (95% CI: 4.47-10.98), respectively. In the final model, having heard about Zika, having a job, and higher income were associated with a higher WTP.

Conclusion: Although the acceptance rate of the ZV is relatively high in Indonesia, less than 40% of respondents are willing to pay, underscoring the need for a low-cost, high-quality vaccine and public sector subsidies for Zika vaccinations in the country.

Original languageEnglish
Issue number11
Pages (from-to)1398-1406
Number of pages9
Publication statusPublished - 2019


  • Adult
  • Attitude to Health
  • Community Health Services/economics
  • Cross-Sectional Studies
  • Educational Status
  • Fees, Pharmaceutical
  • Female
  • Humans
  • Income/statistics & numerical data
  • Indonesia
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care
  • Surveys and Questionnaires
  • Vaccination/economics
  • Viral Vaccines/economics
  • Young Adult
  • Zika Virus
  • Zika Virus Infection/prevention & control


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