Predictors of acceptance and willingness to pay for the COVID-19 vaccine in the general public of India: A health belief model approach

Objective: To determine the predictors of acceptance and willingness to pay(WTP) for the COVID-19 vaccine among the Indian public and to provide insights for future demand forecasts and pricing considerations. Methods: A nationwide, web-based, self-administered, crosssectional survey was conducted from 5 to 20 October 2020. The health belief model(HBM) approach was used as a theoretical framework to assess the predictors of acceptance of and WTP for the COVID-19 vaccine. Results: Of 2 480 respondents, 2 451 completed the online survey, yielding a response rate of 98.8%. Participants who participated in the survey had diverse demographics in terms of their location, educational level, occupation type, and family income. Among 2 451 respondents, the majority(89.3%) intended to receive the COVID-19 vaccine. Respondents with high perceived benefits of COVID-19 vaccination, such as reduction in worry(OR 5.87; 95% CI 4.39-7.96) and sickness(OR 4.31; 95% CI 3.31-5.62), showed higher intention to receive the vaccine. However, respondents with a high perception of the side effects and barriers to vaccination(OR 0.36; 95% CI 0.25-0.54) and vaccine shortage(OR 0.58; 95% CI 0.41-0.81) showed lower intention to receive the vaccine. The majority(2 162, 88.21%) of respondents were willing to pay an amount of INR: 500-1 000 or USD: 6.81-13.62 for a dose of COVID-19 vaccine, with a median(Q1, Q3) of INR: 500(500, 1 000) or USD: 6.81(6.81, 13.62). The higher marginal WTP for the COVID-19 vaccine was influenced by advanced age, marital status, female sex, intermediate educational background, high family income, fair or poor perceived health status, and no affordable barriers. Conclusions: The majority of respondents intended to receive the COVID-19 vaccine. Healthcare interventions focusing on HBM constructs and demographic predictors associated with low intention to receive the vaccine can be effective in enhancing the coverage of the COVID-19 vaccine. The findings of this study provide guidance for the future price considerations of the COVID-19 vaccine.