Rural-urban differences in preferences for influenza vaccination among women of childbearing age: Implications for local vaccination service implementation in Vietnam.

OBJECTIVES Pregnant women and new mothers are among the most vulnerable to seasonal influenza; however, little is known about their preferences for flu vaccination. We examined the rural-urban differences in uptake, demand and willingness to pay (WTP) for influenza vaccination among women of childbearing age, to assess the feasibility of implementing locally produced vaccines in Vietnam. METHODS A cross-sectional study was performed in both urban and rural areas of Hanoi in 2018. Sociodemographic characteristics, history of vaccination, demand, and WTP for influenza vaccines were obtained. A multivariate logistic regression model was employed to identify the associated factors. RESULTS Of 750 participants, 29.9% had had flu shots in the current or previous flu season, 64.3% indicated demand for this vaccine. The median of the maximum amount of WTP for influenza vaccination services was US$ 8.5 (IQR: 8.5-17.0). Women living in rural areas had a significantly lower uptake, higher demand, and were willing to pay less than women in urban locations (21.1% vs 36.6%; 69% vs 60.2%; and US $8.5 vs US $11.7, respectively). For urban participants, factors associated with higher demand and WTP for flu shots included having ANC in health facilities and having been vaccinated against influenza in the past; for rural women these factors were having suffered from influenza and hearing about it . CONCLUSIONS This study informs the feasibility of implementing locally produced influenza vaccines in Vietnam. Educational programs, along with counseling services and government subsidies should be implemented to improve the coverage, demand, and WTP for the vaccine.