Determinants of Willingness-to-Pay for Mpox Vaccination in Indonesia
This cross-sectional study of 1,145 Indonesian respondents reveals that while Mpox awareness is high, willingness to pay for the vaccine is low and primarily driven by education, urban residency, prior STI history, and trust in health authorities rather than income or age, highlighting the need for targeted interventions to improve knowledge and accessibility.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine Indonesia as a giant, bustling archipelago where a new, invisible storm called Mpox is brewing. The government and health experts have a lifeboat ready to save people from this storm: a vaccine. But here's the catch: the lifeboat isn't free. To get on board, people have to pay for their ticket.
This study is like a giant survey asking 1,145 people across the islands: "If you had to buy a ticket to this lifeboat, would you do it? And what makes you say yes or no?"
Here is the story of what they found, broken down into simple, everyday concepts.
1. The "I Know It Exists" vs. "I Know What It Is" Gap
Think of Awareness as hearing a siren in the distance, and Knowledge as actually seeing the fire truck and understanding what fire is.
- The Finding: Almost everyone (94%) heard the siren. They knew Mpox existed.
- The Problem: Only about 74% actually knew what the "fire" looked like (they could identify the rash or lesions).
- The Metaphor: It's like knowing a dangerous animal is in the forest, but not knowing what it looks like, so you don't know if you're in danger. The study found that people who could actually see a picture of the disease were much more likely to want to buy the vaccine ticket.
2. Who Buys the Ticket? (The "Yes" Group)
The researchers found that certain types of people were more likely to say, "Yes, I'll pay for this vaccine."
- The Urbanites: People living in big cities or busy suburbs were more likely to buy a ticket than those in quiet, remote villages.
- Analogy: It's like living in a city where you see billboards and get news on your phone constantly, versus living in a cabin where you might miss the announcement.
- The Educated: People with university degrees were more willing to pay than those with just a high school diploma.
- Analogy: Think of education as a flashlight. The brighter the flashlight (more education), the easier it is to see the value of the vaccine and the path to buying it.
- The "Scared" (Perceived Risk): People who had recently dealt with other "unwanted guests" (Sexually Transmitted Infections) or who had been involved in high-risk situations (like transactional sex or having multiple partners) were very eager to buy the ticket.
- Analogy: If you've already been bitten by a mosquito, you are much more likely to buy expensive bug spray than someone who has never been bitten. They feel the risk personally.
- The Campaign Goers: People who had already attended Mpox events or campaigns were more willing to pay.
- Analogy: If you've already listened to a sales pitch, you're more likely to buy the product than someone who has never heard the pitch.
3. Who Says "No"? (The Barriers)
About 64% of people said, "No, I won't pay." Why?
- The Price Tag: The biggest reason was simply cost. It's too expensive for many.
- The "I'm Fine" Attitude: People who didn't trust official health sources, or who didn't believe the disease was serious, said no.
- The Rural Disconnect: People in rural areas were the least likely to buy a ticket, likely because they felt further from the "action" or had less access to information.
4. The Surprising "No-Effect" Factors
You might think that having a lot of money or being a specific age would decide if you buy the ticket. But the study found something interesting:
- Money: Surprisingly, having a higher monthly income didn't automatically make someone more likely to buy the vaccine.
- Age: Being young or old didn't change the decision much.
- Sexual Orientation: Whether someone was straight or not didn't matter on its own.
- The Takeaway: It wasn't about how much cash was in your pocket or how old you were; it was about how much you understood the risk and how much you trusted the people selling the ticket.
5. How Much Are They Willing to Pay?
For the people who did say "Yes," they had a strict budget.
- Most wanted the ticket to cost between 50,000 and 100,000 Indonesian Rupiah (roughly $3 to $6 USD).
- Very few were willing to pay more than 200,000 Rupiah.
- Analogy: It's like a concert ticket. People are happy to pay for a seat, but if the price jumps too high, they decide to stay home and listen to the music on the radio instead.
The Bottom Line
The study concludes that to get more people on the lifeboat, health officials can't just shout "Buy this!" from a megaphone. They need to:
- Turn on the Flashlight: Teach people exactly what Mpox looks like so they understand the danger.
- Build Trust: Make sure people believe the health authorities are telling the truth.
- Reach the Remote: Specifically target people in villages and schools where information is scarce.
- Keep the Price Low: Since most people are only willing to pay a small amount, the vaccine needs to be affordable, or the government needs to subsidize the cost.
In short: Knowledge and trust are the real keys to the vaccine door, not just money or age.
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