Individual Preferences for COVID-19 Vaccination in China

Background: Vaccinations are an effective choice to stop disease outbreaks, including COVID-19. There is little research on individuals’ COVID-19 vaccination decision-making. In this study, we aimed to determine individual preferences for COVID-19 vaccinations in China, and to assess the factors influencing vaccination decision-making to facilitate vaccination coverage.Methods: A D-efficient discrete choice experiment was conducted across 6 Chinese provinces selected by the stratified random sampling method. Vaccine choice sets were constructed using seven attributes: vaccine effectiveness, side-effects, accessibility, number of doses, vaccination sites, duration of vaccine protection, and proportion of acquaintances vaccinated. Conditional logit and latent class models were used to identify preferences.Findings: Although all seven attributes were proved to significantly influence respondents’ vaccination decision, vaccine effectiveness, side-effects and proportion of acquaintances vaccinated were the most important. We also found a higher probability of vaccinating when the vaccine was more effective; risks of serious side effects were small; vaccinations were free and voluntary; the fewer the number of doses; the longer the protection duration; and the higher the proportion of acquaintances vaccinated. Higher local vaccine coverage created altruistic herd incentives to vaccinate rather than free-rider problems.The predicted vaccination uptake of the optimal vaccination scenario in our study was 84.77%. Preference heterogeneity was substantial. Individuals who were older, had a lower education level, lower income, higher trust in the vaccine and higher perceived risk of infection, displaing a higher probability to vaccinate.Interpretation: Preference heterogeneity among individuals should lead health authorities to address the diversity of expectations about COVID-19 vaccinations.To maximize COVID-19 vaccine uptake, health authorities should promote vaccine effectiveness; pro-actively communicate the absence or presence of vaccine side effects; and ensure rapid and wide media communication about local vaccine coverage.Funding Statement: This work was supported by China Postdoctoral Science Foundation (grant number 2019M662392) and Qingdao Postdoctoral FoundationDeclaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The study was approved by Nanjing Medical University Ethics Committee (No.2020565) and the face-to-face survey conducted by trained researchers.