Young Adult and Parent Willingness to Pay for Meningococcal Serogroup B Vaccination

Abstract

Introduction. Serogroup B (MenB) is the leading cause of invasive meningococcal disease among adolescents and young adults in the United States. The US Advisory Committee on Immunization Practices (ACIP) recommends MenB vaccination based on shared clinical decision making between patients and providers. However, suboptimal understanding of these recommendations could contribute to low vaccination awareness and coverage. Understanding young adult and parent expectations of their health care providers (HCPs) and the value they place on vaccine information could help inform a consistent approach to HCP MenB vaccination discussions and recommendations. Methods. Data collected via a discrete-choice experiment online survey were used to evaluate preferences and willingness to pay regarding MenB vaccination among US parents and young adults in 2019. Results. Of 2,388 respondents with valid data, 1,185 were parents of children aged 12 to 25 y, and 1,203 were young adults aged 18 to 25 y. Approximately 70% of parents and young adults indicated that they would react negatively if their HCP chose not to initiate a discussion with them about MenB vaccines. Neither parents nor young adults were willing to pay for additional time for MenB vaccine discussions with their HCP but were willing to pay an average of $416 and $282, respectively, for the vaccine. For parents and young adults, greater willingness to pay was associated with a provaccination attitude and the opinion that the HCP has a moral obligation to discuss the MenB vaccine with them. Conclusion. Both parents and young adults felt their HCP is responsible for initiating a discussion about MenB vaccination and disease risk and were willing to pay for the vaccine. These findings should help inform ACIP recommendations for meningococcal vaccination.

Highlights: ACIP recommends shared clinical decision making for MenB vaccination.Data were collected from young adults and parents of adolescents by online survey.We measured values and consultation preferences on MenB disease and vaccination.Young adults/parents strongly preferred doctor-initiated MenB vaccine discussion.Respondents were willing to pay for a MenB vaccine.

Keywords: contingent valuation method; meningococcal disease; serogroup B; shared clinical decision making; vaccines; willingness to pay.

Figure 1

Reaction to doctor choosing not to discuss MenB vaccine. *Average for the combined groups. Participants were asked on the survey, “Suppose your doctor did not discuss the vaccine with you, so you never knew it was an option. You found out later when a friend asked whether you got the vaccine. How would you feel about this situation?” Responses were then categorized by the interviewer as either “unconcerned,” “calm,” “understanding,” “concerned,” “disappointed,” “anxious or afraid,” “upset,” or “angry or disgusted.” MenB, meningococcal serogroup B.

Figure 2

Multinomial-logit log-odds estimates of “upset” or “concerned” versus “unconcerned.” Shown are the multinomial-logit estimates for a response of “upset” or “concerned” versus “unconcerned.” Values on the x-axis indicate the strength of the association between each demographic variable or characteristic and the likelihood that a respondent would indicate that they would be “upset” or “concerned” rather than “unconcerned” if their doctor neglected to discuss MenB vaccination. The responses of “disappointed,” “anxious or afraid,” “upset,” and “angry or disgusted” were grouped into a single “more concerned” category, and responses of “unconcerned,” “calm,” and “understanding” were grouped into a single “less concerned” omitted category. Error bars indicate 95% confidence intervals. CV, contingent valuation; MenB, meningococcal serogroup B; vax, vaccine; WTP, willingness to pay.

Figure 3

Factors associated with WTP for MenB vaccination. Statistically significant participant characteristics associated with WTP are shown. The change from the average WTP estimate for each statistically significant covariate is shown. The vertical line indicates the mean WTP. Error bars indicate 95% confidence intervals. MenB, meningococcal serogroup B; vax, vaccine; WTP, willingness to pay.