Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study

doi:10.3390/v10110648

. 2018 Nov 18;10(11):648.

doi: 10.3390/v10110648.

Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study

Harapan Harapan^{1

2

3

4}, Mudatsir Mudatsir^{5

6

7}, Amanda Yufika⁸, Yusuf Nawawi⁹, Nur Wahyuniati¹⁰, Samsul Anwar¹¹, Fitria Yusri¹², Novi Haryanti¹³, Nanda Putri Wijayanti¹⁴, Rizal Rizal¹⁵, Devi Fitriani¹⁶, Nurul Fadhliati Maulida¹⁷, Muhammad Syahriza¹⁸, Ikram Ikram¹⁹, Try Purwo Fandoko²⁰, Muniati Syahadah²¹, Febrivan Wahyu Asrizal²², Kurnia F Jamil^{23

24}, Yogambigai Rajamoorthy²⁵, Abram Luther Wagner²⁶, David Alexander Groneberg²⁷, Ulrich Kuch²⁸, Ruth Müller^{29

30}, R Tedjo Sasmono³¹, Allison Imrie³²

Affiliations

¹ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. harapan@unsyiah.ac.id.
² Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. harapan@unsyiah.ac.id.
³ Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. harapan@unsyiah.ac.id.
⁴ School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia. harapan@unsyiah.ac.id.
⁵ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. mudatsir@unsyiah.ac.id.
⁶ Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. mudatsir@unsyiah.ac.id.
⁷ Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. mudatsir@unsyiah.ac.id.
⁸ Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. amandayufika@gmail.com.
⁹ Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. yusufnawawi@unsyiah.ac.id.
¹⁰ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. nur.wahyuniati@unsyiah.ac.id.
¹¹ Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. samsul.anwar@unsyiah.ac.id.
¹² School of Medicine, Malikussaleh University, Lhokseumawe, Aceh 24352, Indonesia. fitriayusri1006@gmail.com.
¹³ Community Health Centre of Meurah Mulia, North Aceh, Aceh 24372, Indonesia. novi.haryanti1985@gmail.com.
¹⁴ Community Health Centre of Tapaktuan, South Aceh, Aceh 23711, Indonesia. puput_sbg@yahoo.com.
¹⁵ Bunda Hospital, Lhokseumawe, Aceh 24351, Indonesia. dr_rizalmz@yahoo.com.
¹⁶ Community Health Centre of Teunom, Aceh Jaya, Aceh 23653, Indonesia. devifitriani.y@gmail.com.
¹⁷ Meuraxa Hospital, Banda Aceh, Aceh 23231, Indonesia. nfmaulidaz@gmail.com.
¹⁸ Department of Public Health and Community Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. syahriza60@gmail.com.
¹⁹ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. ikramkeren@yahoo.co.id.
²⁰ Community Health Centre of Gunung, Padang Panjang, West Sumatera 27122, Indonesia. okoex123@gmail.com.
²¹ Community Health Centre of Lima Kaum, Tanah Datar, West Sumatera 27211, Indonesia. muniatisyahadah94@gmail.com.
²² Community Health Centre of Tanjung Paku, Solok, West Sumatera 27317, Indonesia. febrivanwahyu.asrizal@gmail.com.
²³ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. kurnia_jamil@unsyiah.ac.id.
²⁴ Department of Internal Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. kurnia_jamil@unsyiah.ac.id.
²⁵ Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Selangor 43000, Malaysia. yogambigai@utar.edu.my.
²⁶ Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA. awag@umich.edu.
²⁷ Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany. groneberg@med.uni-frankfurt.de.
²⁸ Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany. kuch@med.uni-frankfurt.de.
²⁹ Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany. ruth.mueller@med.uni-frankfurt.de.
³⁰ Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp 2000, Belgium. ruth.mueller@med.uni-frankfurt.de.
³¹ Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia. sasmono@eijkman.go.id.
³² School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia. allison.imrie@uwa.edu.au.

PMID: 30453663
PMCID: PMC6266114
DOI: 10.3390/v10110648

Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study

Harapan Harapan et al. Viruses. 2018.

. 2018 Nov 18;10(11):648.

doi: 10.3390/v10110648.

Authors

Affiliations

¹ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. harapan@unsyiah.ac.id.
² Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. harapan@unsyiah.ac.id.
³ Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. harapan@unsyiah.ac.id.
⁴ School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia. harapan@unsyiah.ac.id.
⁵ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. mudatsir@unsyiah.ac.id.
⁶ Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. mudatsir@unsyiah.ac.id.
⁷ Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. mudatsir@unsyiah.ac.id.
⁸ Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. amandayufika@gmail.com.
⁹ Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. yusufnawawi@unsyiah.ac.id.
¹⁰ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. nur.wahyuniati@unsyiah.ac.id.
¹¹ Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. samsul.anwar@unsyiah.ac.id.
¹² School of Medicine, Malikussaleh University, Lhokseumawe, Aceh 24352, Indonesia. fitriayusri1006@gmail.com.
¹³ Community Health Centre of Meurah Mulia, North Aceh, Aceh 24372, Indonesia. novi.haryanti1985@gmail.com.
¹⁴ Community Health Centre of Tapaktuan, South Aceh, Aceh 23711, Indonesia. puput_sbg@yahoo.com.
¹⁵ Bunda Hospital, Lhokseumawe, Aceh 24351, Indonesia. dr_rizalmz@yahoo.com.
¹⁶ Community Health Centre of Teunom, Aceh Jaya, Aceh 23653, Indonesia. devifitriani.y@gmail.com.
¹⁷ Meuraxa Hospital, Banda Aceh, Aceh 23231, Indonesia. nfmaulidaz@gmail.com.
¹⁸ Department of Public Health and Community Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. syahriza60@gmail.com.
¹⁹ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. ikramkeren@yahoo.co.id.
²⁰ Community Health Centre of Gunung, Padang Panjang, West Sumatera 27122, Indonesia. okoex123@gmail.com.
²¹ Community Health Centre of Lima Kaum, Tanah Datar, West Sumatera 27211, Indonesia. muniatisyahadah94@gmail.com.
²² Community Health Centre of Tanjung Paku, Solok, West Sumatera 27317, Indonesia. febrivanwahyu.asrizal@gmail.com.
²³ Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. kurnia_jamil@unsyiah.ac.id.
²⁴ Department of Internal Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia. kurnia_jamil@unsyiah.ac.id.
²⁵ Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Selangor 43000, Malaysia. yogambigai@utar.edu.my.
²⁶ Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA. awag@umich.edu.
²⁷ Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany. groneberg@med.uni-frankfurt.de.
²⁸ Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany. kuch@med.uni-frankfurt.de.
²⁹ Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany. ruth.mueller@med.uni-frankfurt.de.
³⁰ Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp 2000, Belgium. ruth.mueller@med.uni-frankfurt.de.
³¹ Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia. sasmono@eijkman.go.id.
³² School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia. allison.imrie@uwa.edu.au.

PMID: 30453663
PMCID: PMC6266114
DOI: 10.3390/v10110648

Abstract

One of the crucial steps during trials for Zika and other vaccines is to recruit participants and to understand how participants' attitudes and sociodemographic characteristics affect willingness to participate (WTP). This study was conducted to assess WTP, its explanatory variables, and the impact of financial compensation on WTP in Indonesia. A health facility-based cross-sectional study was conducted in eleven regencies in the Aceh and West Sumatra provinces of Indonesia. Participants were recruited via a convenience sampling method and were interviewed. The associations between explanatory variables and WTP were assessed using a two-step logistic regression analysis. A total of 1,102 parents were approached, and of these 956 (86.8%) completed the interview and were included in analysis. Of those, 144 (15.1%) were willing to participate in a Zika vaccine trial without a financial compensation. In the multivariate analysis, WTP was tied to an age of more than 50 years old, compared to 20⁻29 years (odds ratio (OR): 5.0; 95% confidence interval (CI): 2.37⁻10.53), to being female (OR: 2.20; 95% CI: 1.11⁻4.37), and to having heard about Zika (OR: 2.41; 95% CI: 1.59⁻3.65). Participants' WTP increased gradually with higher financial compensation. The rate of WTP increased to 62.3% at the highest offer (US$ 350.4), and those who were still unwilling to participate (37.7%) had a poorer attitude towards childhood vaccination. This study highlights that pre-existing knowledge about Zika and attitudes towards childhood vaccination are important in determining community members being willing to participate in a vaccine trial. Financial incentives are still an important factor to enhance participant recruitment during a vaccine trial.

Keywords: Zika; Zika vaccine; vaccine acceptance; vaccine trial; willingness to participate.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Relationship between financial compensation and the proportion of participants who are willing to participate in a Zika vaccine trial in Aceh and West Sumatra, Indonesia. Purple dotted line indicates the maximum percentage of participants who are willing to participate at the highest financial compensation.

See this image and copyright information in PMC

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References

1. Macnamara F.N. Zika virus: A report on three cases of human infection during an epidemic of jaundice in Nigeria. Trans. R. Soc. Trop. Med. Hygiene. 1954;48:139–145. doi: 10.1016/0035-9203(54)90006-1. - DOI - PubMed
1. Duffy M.R., Chen T.H., Hancock W.T., Powers A.M., Kool J.L., Lanciotti R.S., Pretrick M., Marfel M., Holzbauer S., Dubray C., et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N. Engl. J. Med. 2009;360:2536–2543. doi: 10.1056/NEJMoa0805715. - DOI - PubMed
1. World Health Organization (WHO) Zika Situation Report. [(accessed on 1 January 2018)]; Available online: http://www.who.int/emergencies/zika-virus/situation-report/10-march-2017...
1. Cauchemez S., Besnard M., Bompard P., Dub T., Guillemette-Artur P., Eyrolle-Guignot D., Salje H., Van Kerkhove M.D., Abadie V., Garel C., et al. Association between Zika virus and microcephaly in French Polynesia, 2013–2015: A retrospective study. Lancet. 2016;387:2125–2132. doi: 10.1016/S0140-6736(16)00651-6. - DOI - PMC - PubMed
1. De Araujo T.V.B., Rodrigues L.C., Ximenes R.A.D.A., Miranda-Filho D.D.B., Montarroyos U.R., de Melo A.P.L., Valongueiro S., de Albuquerque M.D.F.P.M., Souza W.V., Braga C., et al. Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: Preliminary report of a case-control study. Lancet Infect. Dis. 2016;16:1356–1363. doi: 10.1016/S1473-3099(16)30318-8. - DOI - PMC - PubMed

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[1] Macnamara F.N. Zika virus: A report on three cases of human infection during an epidemic of jaundice in Nigeria. Trans. R. Soc. Trop. Med. Hygiene. 1954;48:139–145. doi: 10.1016/0035-9203(54)90006-1. - DOI - PubMed

[2] Macnamara F.N. Zika virus: A report on three cases of human infection during an epidemic of jaundice in Nigeria. Trans. R. Soc. Trop. Med. Hygiene. 1954;48:139–145. doi: 10.1016/0035-9203(54)90006-1. - DOI - PubMed

[3] Duffy M.R., Chen T.H., Hancock W.T., Powers A.M., Kool J.L., Lanciotti R.S., Pretrick M., Marfel M., Holzbauer S., Dubray C., et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N. Engl. J. Med. 2009;360:2536–2543. doi: 10.1056/NEJMoa0805715. - DOI - PubMed

[4] Duffy M.R., Chen T.H., Hancock W.T., Powers A.M., Kool J.L., Lanciotti R.S., Pretrick M., Marfel M., Holzbauer S., Dubray C., et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N. Engl. J. Med. 2009;360:2536–2543. doi: 10.1056/NEJMoa0805715. - DOI - PubMed

[5] World Health Organization (WHO) Zika Situation Report. [(accessed on 1 January 2018)]; Available online: http://www.who.int/emergencies/zika-virus/situation-report/10-march-2017...

[6] World Health Organization (WHO) Zika Situation Report. [(accessed on 1 January 2018)]; Available online: http://www.who.int/emergencies/zika-virus/situation-report/10-march-2017...

[7] Cauchemez S., Besnard M., Bompard P., Dub T., Guillemette-Artur P., Eyrolle-Guignot D., Salje H., Van Kerkhove M.D., Abadie V., Garel C., et al. Association between Zika virus and microcephaly in French Polynesia, 2013–2015: A retrospective study. Lancet. 2016;387:2125–2132. doi: 10.1016/S0140-6736(16)00651-6. - DOI - PMC - PubMed

[8] Cauchemez S., Besnard M., Bompard P., Dub T., Guillemette-Artur P., Eyrolle-Guignot D., Salje H., Van Kerkhove M.D., Abadie V., Garel C., et al. Association between Zika virus and microcephaly in French Polynesia, 2013–2015: A retrospective study. Lancet. 2016;387:2125–2132. doi: 10.1016/S0140-6736(16)00651-6. - DOI - PMC - PubMed

[9] De Araujo T.V.B., Rodrigues L.C., Ximenes R.A.D.A., Miranda-Filho D.D.B., Montarroyos U.R., de Melo A.P.L., Valongueiro S., de Albuquerque M.D.F.P.M., Souza W.V., Braga C., et al. Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: Preliminary report of a case-control study. Lancet Infect. Dis. 2016;16:1356–1363. doi: 10.1016/S1473-3099(16)30318-8. - DOI - PMC - PubMed

[10] De Araujo T.V.B., Rodrigues L.C., Ximenes R.A.D.A., Miranda-Filho D.D.B., Montarroyos U.R., de Melo A.P.L., Valongueiro S., de Albuquerque M.D.F.P.M., Souza W.V., Braga C., et al. Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: Preliminary report of a case-control study. Lancet Infect. Dis. 2016;16:1356–1363. doi: 10.1016/S1473-3099(16)30318-8. - DOI - PMC - PubMed

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Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study

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Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study

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