Exploring the impact of reimbursement ratios on willingness to vaccinate: A mixed-effects modeling approach using panel data

This peer-reviewed article examines how reimbursement levels influence parental willingness to vaccinate children with self-paid vaccines in China. Using survey data from 2,212 households in Hangzhou, Zhejiang Province, the study applies mixed-effects modeling, logistic regression, and machine learning clustering techniques to assess willingness to vaccinate for EV71, varicella, influenza, and DTaP-IPV-Hib vaccines under different reimbursement scenarios. 

Key findings

• Vaccination cost was one of the strongest determinants of willingness to vaccinate for self-paid childhood vaccines.
• Higher reimbursement ratios increased willingness to vaccinate across all four vaccines studied.
• The study identified four distinct parental groups with different levels of vaccine willingness and price sensitivity.
• Families with fewer children, younger children, higher parental education, and higher socioeconomic status generally showed higher willingness to vaccinate.
• Doctor recommendation and better vaccine knowledge were strongly associated with increased willingness to vaccinate.
• Satisfaction with vaccination clinic opening hours was positively associated with vaccine willingness.
• Lower socioeconomic status households were more sensitive to vaccine costs and reimbursement levels.
• DTaP-IPV-Hib showed relatively high baseline acceptance compared to the other vaccines studied.

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