Willingness to Pay for COVID-19 Vaccines in Indonesia: A Thematic Analysis
[Kesediaan Membayar Untuk Vaksinasi COVID-19 di Indonesia: Studi Analisis Tematik]
DOI:
Abstract Views:
181 times
PDF - Full Text Downloads:
96 times
Abstract
During the pandemic, the Indonesian government has striven to implement steps to prevent and control the impacts of COVID-19, one of which is through a free program of vaccinations, from the first to the third dose (booster), in order to raise herd immunity. Although these were free, the take-up of the booster vaccination has been slow. This study was aimed at exploring individual preparedness to pay for COVID-19 vaccination, if the government was no longer to pay for these vaccines. The study was conducted using a quantitative approach, employing thematic analysis techniques. The participants comprised 27 people, with their ages ranging from 18-83 years. The results of the study found there were two principle themes (or factors) influencing the preparedness to pay for vaccinations, those of: (1) drive; and (2) deterrent. The drive factor comprised the aspects which supported the public in being prepared to receive, and pay for, vaccinations; these being the obligations to adhere to the regulations of government and institutions, to receive social assistance (welfare), and to ensure personal protection. The deterrent factor comprised the aspects which made the public reluctant to pay for the vaccinations, amongst others being the framing of information about the side-effects of the vaccine, the non-halal (religiously acceptable) composition of the vaccine, and the feeling of satisfaction after having received two doses. Amongst all of these factors, the obligatory nature of vaccination was the aspect most influencing the preparedness to pay. This study provides a picture of why the public may be prepared to pay for the vaccine, the factors which may elevate and depress their preparedness to pay, and thoughts about the costs of the vaccine, which may be the benchmarks in planning policies related to health behavior. The plans of the government to make COVID-19 vaccination subject to payment require assessment of the cost of the vaccine, because this will influence the number of members of the public who are prepared to pay to receive vaccination. This may certainly influence the level of public immunity to COVID-19, in the long term.
Selama pandemi, pemerintah Indonesia berupaya melakukan pencegahan dan penanganan dampak COVID-19, salah satunya melalui program vaksinasi gratis dari dosis pertama hingga dosis ketiga (booster) untuk meningkatkan herd immunity. Meskipun gratis, laju vaksinasi booster lambat meningkat. Studi ini bertujuan untuk mengeksplorasi kesediaan individu untuk membayar vaksin COVID-19 jika pemerintah tidak lagi membiayai vaksinasi COVID-19. Studi dilakukan dengan pendekatan kualitatif dengan teknik analisis tematik. Partisipan terdiri dari 27 orang dengan rentang usia antara 18-83 tahun. Hasil studi ini menemukan dua tema utama yang memengaruhi kesediaan membayar vaksin: (1) faktor pendorong (drive); dan (2) faktor penghalang (deterrent). Faktor pendorong (drive) terdiri dari aspek yang mendorong masyarakat untuk bersedia mendapat dan membayar vaksin, yaitu kewajiban untuk mengikuti aturan pemerintah dan institusi, mendapatkan bantuan sosial, dan untuk perlindungan diri. Faktor penghalang (deterrent) merupakan aspek yang membuat masyarakat enggan membayar vaksin, antara lain framing informasi efek samping vaksin, komposisi vaksin yang tidak halal, dan merasa puas dengan dua dosis. Di antara seluruh faktor tersebut, kewajiban vaksinasi adalah aspek yang paling memengaruhi kesediaan membayar. Studi ini memberikan gambaran mengapa masyarakat bersedia membayar untuk vaksin, faktor yang dapat meningkatkan dan menurunkan kesediaan mereka untuk membayar vaksin, dan perkiraan harga vaksin COVID-19 yang dapat menjadi tolok ukur dalam merancang kebijakan terkait perilaku kesehatan. Rencana pemerintah untuk menjadikan vaksinasi COVID-19 sebagai vaksinasi berbayar membutuhkan asesmen mengenai harga vaksin karena akan memengaruhi seberapa banyak masyarakat yang bersedia untuk mengeluarkan biaya sendiri demi mendapatkan vaksinasi. Hal ini tentu dapat memengaruhi tingkat kekebalan masyarakat melawan COVID-19 dalam jangka panjang.
Downloads
References
Adigwe, O. P. (2021). COVID-19 vaccine hesitancy and willingness to pay: Emergent factors from a cross-sectional study in Nigeria. Vaccine: X, 9:100112. https://doi.org/10.1016/J.JVACX.2021.100112
Adonis, L., Paramanund, J., Basu, D., & Luiz, J. (2017). Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: Implications for population-based communication? Journal of Health Psychology, 22(11), 1365-1375. https://doi.org/10.1177/1359105316628735
Aini, M. H., & Widjaja, G. (2021). Mandatory Coronavirus Disease-19 (COVID-19) vaccination in Indonesia: Legal aspect. Journal of Legal, Ethical and Regulatory Issues, 24(Special Issue 1), 1-15. https://www.abacademies.org/articles/mandatory-coronavirus-disease19-covid19-vaccination-in-indonesia-legal-aspect-11702.html
Altay, S., & Mercier, H. (2020). Framing messages for vaccination supporters. Journal of Experimental Psychology: Applied, 26(4), 567-578. https://doi.org/10.1037/xap0000271
Attwell, K., Rizzi, M., McKenzie, L., Carlson, S. J., Roberts, L., Tomkinson, S., & Blyth, C. C. (2022). COVID-19 vaccine mandates: An Australian attitudinal study. Vaccine, 40(51), 7360-7369. https://doi.org/10.1016/j.vaccine.2021.11.056
Bernard, R., Bowsher, G., Sullivan, R., & Gibson-Fall, F. (2021). Disinformation and epidemics: Anticipating the next phase of biowarfare. Health Security, 19(1), 3-12. https://doi.org/10.1089/hs.2020.0038
Betta, S., Castellini, G., Acampora, M., & Barello, S. (2022). The effect of message framing on COVID-19 vaccination intentions among the younger age population groups: Results from an experimental study in the Italian context. Vaccines, 10(4):559. https://doi.org/10.3390/vaccines10040559
Borah, P., Hwang, J., & Hsu, Y. C. (L). (2021). COVID-19 vaccination attitudes and intention: Message framing and the moderating role of perceived vaccine benefits. Journal of Health Communication: International Perspectives, 26(8), 523-533. https://doi.org/10.1080/10810730.2021.1966687
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners (1st ed.). SAGE Publications. https://uk.sagepub.com/en-gb/eur/successful-qualitative-research/book233059
Cable News Network (CNN) Indonesia. (2021, August 25). Sri Mulyani angkat suara soal vaksin berbayar mulai 2022 [Sri Mulyani speaks up regarding paid vaccines starting 2022]. CNN Indonesia. https://www.cnnindonesia.com/ekonomi/20210825185848-532-685381/sri-mulyani-angkat-suara-soal-vaksin-berbayar-mulai-2022
Cable News Network (CNN) Indonesia. (2022, November 2). Kasus COVID RI naik lagi, tren kematian meningkat [Indonesian COVID cases rises again, mortality trend increases]. CNN Indonesia. https://www.cnnindonesia.com/nasional/20221102095527-20-868405/kasus-covid-ri-naik-lagi-tren-kematian-meningkat
Campos-Mercade, P., Meier, A. N., Schneider, F. H., Meier, S., Pope, D., & Wengström, E. (2021). Monetary incentives increase covid-19 vaccinations. Science, 374(6569), 879-882. https://doi.org/10.1126/science.abm0475
Cerda, A. A., & García, L. Y. (2021). Willingness to pay for a COVID-19 vaccine. Applied Health Economics and Health Policy, 19(3), 343-351. https://doi.org/10.1007/S40258-021-00644-6
Cesario, J., Corker, K. S., & Jelinek, S. (2013). A self-regulatory framework for message framing. Journal of Experimental Social Psychology, 49(2), 238-249. https://doi.org/10.1016/j.jesp.2012.10.014
Cheng, F. K. (2022). Debate on mandatory COVID-19 vaccination. Ethics, Medicine and Public Health, 21:100761. https://doi.org/10.1016/j.jemep.2022.100761
Chi, O. H., Denton, G., & Gursoy, D. (2021). Interactive effects of message framing and information content on carbon offsetting behaviors. Tourism Management, 83:104244. https://doi.org/10.1016/j.tourman.2020.104244
Chu, H., & Liu, S. (2021). Integrating health behavior theories to predict American's intention to receive a COVID-19 vaccine. Patient Education and Counseling, 104(8), 1878-1886. https://doi.org/10.1016/j.pec.2021.02.031
Colautti, L., Cancer, A., Magenes, S., Antonietti, A., & Iannello, P. (2022). Risk-perception change associated with COVID-19 vaccine's side effects: The role of individual differences. International Journal of Environmental Research and Public Health, 19(3):1189. https://doi.org/10.3390/ijerph19031189
Cramton, R. C. (1969). Driver behavior and legal sanctions: A study of deterrence. Michigan Law Review, 67(3), 421-454. https://doi.org/10.2307/1287404
Crockett, M. J., Özdemir, Y., & Fehr, E. (2014). The value of vengeance and the demand for deterrence. Journal of Experimental Psychology: General, 143(6), 2279-2286. https://doi.org/10.1037/xge0000018
Delton, A. W., & Krasnow, M. M. (2017). The psychology of deterrence explains why group membership matters for third-party punishment. Evolution and Human Behavior, 38(6), 734-743. https://doi.org/10.1016/j.evolhumbehav.2017.07.003
DiCicco-Bloom, B., & Crabtree, B. F. (2006). The qualitative research interview. Medical Education, 40(4), 314-321. https://doi.org/10.1111/j.1365-2929.2006.02418.x
Drolet, C. E., & Lucas, T. (2022). Justice beliefs buffer against perceived barriers to colorectal cancer screening among African Americans. Psychology & Health, 37(9), 1148-1163. https://doi.org/10.1080/08870446.2021.1928667
Farias, M., Newheiser, A. -K., Kahane, G., & de Toledo, Z. (2013). Scientific faith: Belief in science increases in the face of stress and existential anxiety. Journal of Experimental Social Psychology, 49(6), 1210-1213. https://doi.org/10.1016/j.jesp.2013.05.008
Febryan, A., & Maharani, E. (2022). Capaian vaksinasi booster masih rendah, ini penjelasan Menkes [Booster vaccination still below target, here’s the explanation of the Minister of Health]. Republika. https://www.republika.co.id/berita/reg136335/capaian-vaksinasi-booster-masih-rendah-ini-penjelasan-menkes
Gallagher, K. M., & Updegraff, J. A. (2012). Health message framing effects on attitudes, intentions, and behavior: A meta-analytic review. Annals of Behavioral Medicine, 43(1), 101-116. https://doi.org/10.1007/s12160-011-9308-7
Goruntla, N., Chintamani, S. H., Bhanu, P., Samyuktha, S., Veerabhadrappa, K. V., Bhupalam, P., & Ramaiah, J. D. (2021). Predictors of acceptance and willingness to pay for the COVID-19 vaccine in the general public of India: A health belief model approach. Asian Pacific Journal of Tropical Medicine, 14(4), 165-175. https://doi.org/10.4103/1995-7645.312512 | https://journals.lww.com/aptm/Fulltext/2021/14040/Predictors_of_acceptance_and_willingness_to_pay.4.aspx
Graeber, D., Schmidt-Petri, C., & Schröder, C. (2021). Attitudes on voluntary and mandatory vaccination against COVID-19: Evidence from Germany. PLoS ONE, 16(5):e0248372. https://doi.org/10.1371/journal.pone.0248372
Grinberg, N., Joseph, K., Friedland, L., Swire-Thompson, B., & Lazer, D. (2019). Fake news on Twitter during the 2016 U.S. presidential election. Science, 363(6425), 374-378. https://doi.org/10.1126/science.aau2706
Gursoy, D., Ekinci, Y., Can, A. S., & Murray, J. C. (2022). Effectiveness of message framing in changing COVID-19 vaccination intentions: Moderating role of travel desire. Tourism Management, 90:104468. https://doi.org/10.1016/j.tourman.2021.104468
Hameleers, M. (2021). Prospect Theory in times of a pandemic: The effects of gain versus loss framing on risky choices and emotional responses during the 2020 Coronavirus outbreak - Evidence from the US and the Netherlands. Mass Communication and Society, 24(4), 479-499. https://doi.org/10.1080/15205436.2020.1870144
Hao, F., Wang, B., Tan, W., Husain, S. F., McIntyre, R. S., Tang, X., Zhang, L., Han, X., Jiang, L., Chew, N. W. S., Tan, B. Y. -Q., Tran, B., Zhang, Z., Vu, G. L., Vu, G. T., Ho, R., Ho, C. S., & Sharma, V. K. (2021). Attitudes toward COVID-19 vaccination and willingness to pay: Comparison of people with and without mental disorders in China. The British Journal of Psychiatry (BJPsych) Open, 7(5):E146. https://doi.org/10.1192/bjo.2021.979
Harapan, H., Wagner, A. L., Yufika, A., Winardi, W., Anwar, S., Gan, A. K., Setiawan, A. M., Rajamoorthy, Y., Sofyan, H., Vo, T. Q., Hadisoemarto, P. F., Müller, R., Groneberg, D. A., & Mudatsir, M. (2020). Willingness-to-pay for a COVID-19 vaccine and its associated determinants in Indonesia. Human Vaccines & Immunotherapeutics, 16(12), 3074-3080. https://doi.org/10.1080/21645515.2020.1819741
IDN Financials. (2021, July 16). WHO criticizes paid COVID-19 vaccination in Indonesia. IDN Financials. https://www.idnfinancials.com/news/39818/criticizes-paid-covid-vaccination-indonesia
Kahneman, D., & Tversky, A. (1979). Prospect Theory: An analysis of decision under risk. Econometrica, 47(2), 263-291. https://doi.org/0012-9682(197903)47:2<263:PTAAOD>2.0.CO;2-3 | https://doi.org/10.2307/1914185
Kementerian Kesehatan Republik Indonesia [The Ministry of Health of the Republic of Indonesia]. (2023). Vaksinasi COVID-19 nasional [National COVID-19 vaccination]. Kementerian Kesehatan Republik Indonesia. https://vaksin.kemkes.go.id/#/vaccines
Kim, H. K., Lee, T. K., & Kong, W. Y. (2020). The interplay between framing and regulatory focus in processing narratives about HPV vaccination in Singapore. Health Communication, 35(2), 222-232. https://doi.org/10.1080/10410236.2018.1553022
Kim, H. M., Kim, E. (A)., & Murphy, S. (2022). Testing the effectiveness of message framing and episodic future thinking in promoting HPV vaccination via anticipated regret. Health Communication, 37(5), 525-534. https://doi.org/10.1080/10410236.2020.1855744
Kurniawan, W., Hudiyana, J., & Muluk, H. (2022). Responses of religion and science to the threats of the COVID-19 pandemic in Indonesia [Respon agama dan sains terhadap ancaman pandemi COVID-19 di Indonesia]. ANIMA Indonesian Psychological Journal, 37(2), 181-201. https://doi.org/10.24123/aipj.v37i2.4913
Lipkus, I. M., Johnson, C., Amarasekara, S., Pan, W., & Updegraff, J. A. (2019). Predicting colorectal cancer screening among adults who have never been screened: Testing the interaction between message framing and tailored risk feedback. Journal of Health Communication: International Perspectives, 24(3), 262-270. https://doi.org/10.1080/10810730.2019.1597950
Maragakis, L., & Kelen, G. D. (2022, January 28). Booster shots and additional doses for COVID-19 vaccines - What you need to know. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/booster-shots-and-third-doses-for-covid19-vaccines-what-you-need-to-know
McGinley, L. (2023, January 23). FDA proposes switching to annual coronavirus vaccine, mimicking flu model. The Washington Post. https://www.washingtonpost.com/health/2023/01/23/covid-vaccine-once-a-year/
Merriam, S. B., & Tisdell, E. J. (2015). Qualitative research: A guide to design and implementation (4th ed.). Jossey-Bass. https://www.wiley.com/en-ie/Qualitative+Research:+A+Guide+to+Design+and+Implementation,+4th+Edition-p-9781119003618
Nguyen, L. H., Hoang, M. T., Nguyen, L. D., Ninh, L. T., Nguyen, H. T. T., Nguyen, A. D., Vu, L. G., Vu, G. T., Doan, L. P., Latkin, C. A., Tran, B. X., Ho, C. S. H., & Ho, R. C. M. (2021). Acceptance and willingness to pay for COVID-19 vaccines among pregnant women in Vietnam. Tropical Medicine & International Health (TMIH): A European Journal, 26(10), 1303-1313. https://doi.org/10.1111/tmi.13666
Peng, L., Guo, Y., & Hu, D. (2021). Information framing effect on public’s intention to receive the COVID-19 vaccination in China. Vaccines, 9(9):995. https://doi.org/10.3390/vaccines9090995
Prakash, A., Nathan, R. J., Kini, S., & Victor, V. (2022). Message framing and COVID-19 vaccine acceptance among Millennials in South India. PloS ONE, 17(7):e0269487. https://doi.org/10.1371/journal.pone.0269487
Rahma, A. (2021, July 12). 3 negara ini sediakan vaksinasi COVID-19 berbayar [These three countries provide paid COVID-19 vaccination]. Merdeka. https://www.merdeka.com/uang/3-negara-ini-sediakan-vaksinasi-covid-19-berbayar.html
Rakhmadhani, I., Yulida, E., Fahrina, & Jaelani, A. K. (2021). COVID-19 vaccine hesitancy on society and related legal regulations. Proceedings of the International Conference on Environmental and Energy Policy (ICEEP 2021), 583(ICEEP), 281-285. https://doi.org/10.2991/assehr.k.211014.061
Romadhon, Y. A., Lestari, N., Firdausi, N. F., & Kurniati, Y. P. (2022). Analyzing the determinants of the willingness to receive and pay for COVID-19 vaccines prior to the commencement of vaccination in Indonesia using a mixed-method study. Magna Medika: Berkala Ilmiah Kedokteran dan Kesehatan, 9(2), 155-174. https://doi.org/10.26714/magnamed.9.2.2022.155-174
Sagita, N. S. (2023, January 25). Yuk booster mumpung masih gratis! Ini wacana Kemenkes soal vaksin COVID berbayar [Let’s get the booster vaccine while it’s still free! The discourse of the Ministry of Health regarding paid COVID vaccine]. detikHealth. https://health.detik.com/berita-detikhealth/d-6532442/yuk-booster-mumpung-masih-gratis-ini-wacana-kemenkes-soal-vaksin-covid-berbayar
Savulescu, J., Pugh, J., & Wilkinson, D. (2021). Balancing incentives and disincentives for vaccination in a pandemic. Nature Medicine, 27(9), 1500-1503. https://doi.org/10.1038/s41591-021-01466-8
Shitu, K., Wolde, M., Handebo, S., & Kassie, A. (2021). Correction to: Acceptance and willingness to pay for COVID-19 vaccine among school teachers in Gondar City, Northwest Ethiopia. Tropical Medicine and Health, 49:65. https://doi.org/10.1186/s41182-021-00354-8
Smith, L. E., Hodson, A., & Rubin, G. J. (2021). Parental attitudes towards mandatory vaccination: A systematic review. Vaccine, 39(30), 4046-4053. https://doi.org/10.1016/j.vaccine.2021.06.018
University of Nevada. (n.d.). Vaccines: Invaluable public health tool or commercial product? University of Nevada, Reno. https://onlinedegrees.unr.edu/blog/vaccines-invaluable-public-health-tool-or-commercial-product/
Vorpahl, M. M., & Yang, J. Z. (2018). Who is to blame? Framing HPV to influence vaccination intentions among college students. Health Communication, 33(5), 620-627. https://doi.org/10.1080/10410236.2017.1289436
Wang, D. W. L., Moribe, G., & Arruda, A. L. G. D. M. (2021). Is mandatory vaccination for COVID-19 constitutional under Brazilian Law? Health and Human Rights Journal, 23(1), 163-174. https://www.hhrjournal.org/2021/06/is-mandatory-vaccination-for-covid-19-constitutional-under-brazilian-law/
Ward, J. K., Gauna, F., Gagneux-Brunon, A., Botelho-Nevers, E., Cracowski, J. -L., Khouri, C., Launay, O., Verger, P., & Peretti-Watel, P. (2022). The French health pass holds lessons for mandatory COVID-19 vaccination. Nature Medicine, 28(2), 232-235. https://doi.org/10.1038/s41591-021-01661-7
Wong, L. P., Alias, H., Wong, P. -F., Lee, H. Y., & AbuBakar, S. (2020). The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Human Vaccines & Immunotherapeutics, 16(9), 2204-2214. https://doi.org/10.1080/21645515.2020.1790279
World Health Organization (WHO). (2021a). COVID-19 and mandatory vaccination: Ethical considerations and caveats. World Health Organization. https://apps.who.int/iris/rest/bitstreams/1342697/retrieve
World Health Organization (WHO). (2021b). Interim statement on booster doses for COVID-19 vaccination. World Health Organization. https://www.who.int/news/item/04-10-2021-interim-statement-on-booster-doses-for-covid-19-vaccination
World Health Organization (WHO). (2023). Coronavirus disease (COVID-19): Vaccines and vaccine safety. World Health Organization. https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-vaccines
Zhang, Y., Luo, X., & Ma, Z. F. (2021). Willingness of the general population to accept and pay for COVID-19 vaccination during the early stages of COVID-19 pandemic: A nationally representative survey in mainland China. Human Vaccines & Immunotherapeutics, 17(6), 1622-1627. https://doi.org/10.1080/21645515.2020.1847585
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Articles published in ANIMA are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license. You are free to copy, transform, or redistribute articles for any lawful, non-commercial purpose in any medium, provided you give appropriate credit to ANIMA and the original Author(s), link to the license, indicate if changes were made, and redistribute any derivative work under the same license.
Copyright on articles is retained by the respective Author(s), without restrictions. A non-exclusive license is granted to ANIMA to publish the article and identify itself as its original publisher, along with the commercial right to include the article in a hardcopy issue for sale to libraries and individuals.
By publishing in ANIMA, Author(s) grant any third party the right to use their article to the extent provided by the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license.
