A new study examines awareness, acceptability, and willingness to pay (WTP) for the new R21/Matrix-M malaria vaccine among 310 pregnant women and nursing mothers attending health facilities in Enugu State, Nigeria. Despite Nigeria’s recent rollout of malaria vaccination, awareness remains low: 68% of respondents either believed there is no effective malaria vaccine or were unaware of one, and 84.5% had never heard of R21/Matrix-M specifically. Yet, once informed, acceptability was very high—94.2% agreed their child should receive the vaccine and over 92% supported its inclusion in the routine childhood immunization schedule. These findings highlight a critical communication gap: low baseline awareness co-exists with strong latent demand among key decision-makers for child health.
From an economics perspective, the study provides early market signals for R21/Matrix-M in a Nigerian setting. Nearly 80% of respondents were willing to pay for their child to be vaccinated, with most stating a maximum WTP between ₦300 and ₦600; the median WTP was ₦300 (around US$0.38 at the June–July 2023 official rate). Age, occupation and health insurance status substantially shaped WTP: younger women and government employees were more likely to pay, while those with health insurance had lower odds of being willing to pay, suggesting expectations that such vaccines should be publicly funded. The authors argue for a hybrid financing approach—free provision for low-income groups alongside paid options for better-off households—combined with sustained communication campaigns to raise awareness and address concerns about safety and effectiveness.
How can these findings be used?
To increase awareness, acceptability, and willingness to pay for the R21/Matrix-M malaria vaccine, authors recommend a comprehensive strategy involving the government, society, and nursing mothers. First, government is encouraged to allocate funds to subsidize the vaccine’s cost, making it more accessible to all socioeconomic groups, investing in public health campaigns and integrate vaccination into existing healthcare policies. Community engagement is vital; involving local leaders and healthcare workers can address cultural beliefs and misconceptions. Tailoring vaccination campaigns to respect cultural norms and practices and promoting health literacy can break down barriers. By incorporating local languages and adjusting vaccination schedules, cultural sensitivity is ensured. Education and counseling should be offered, addressing concerns related to vaccine safety, efficacy, and side effects. Leveraging local celebrities and influencers such as ‘Vaccine_pharmacist’ can amplify vaccination campaigns.
Thumbnail image credit: Gavi / 2024 / Milequem Diarassouba
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