title: Parental preferences for rotavirus vaccination in young children: a discrete choice experiment.
abstract: OBJECTIVE
  This study aimed to identify characteristics that affect parental decisions about rotavirus vaccination, to determine the relative importance of those characteristics and subsequently to estimate vaccination coverage for different implementation strategies.
  
  
  METHODS
  A Discrete choice experiment (DCE) questionnaire was sent to the parents of 1250 newborns aged 6 weeks (response rate 37.3%). Mixed-logit models were used to estimate the relative importance of the five included rotavirus vaccine and implementation characteristics; vaccine effectiveness, frequency of severe side effects, protection duration, the healthcare facility that administrates vaccination and out-of-pocket costs. Based on the utility functions of the mixed-logit model, the potential vaccination coverage was estimated for different vaccine scenarios and implementation strategies.
  
  
  RESULTS
  All characteristics, except for healthcare facility that administrates vaccination, influenced parental willingness to vaccinate their newborn against rotavirus. Parents were willing to trade 20.2 percentage points vaccine effectiveness for the lowest frequency of severe side effects (i.e., 1 in 1,000,000) or 20.8 percentage points for a higher protection duration. Potential vaccination coverage ranged between 22.7 and 86.2%, depending on vaccine scenario (i.e., vaccine effectiveness and protection duration) and implementation strategy (i.e., out-of-pocket costs and healthcare facility that administrates vaccination).
  
  
  CONCLUSIONS
  When deciding about vaccination against rotavirus, parents are mostly driven by the out-of-pocket costs, vaccine effectiveness, protection duration, and frequency of severe side effects. The highest vaccination coverage is expected for a vaccine with high effectiveness and protection duration that is implemented within the current National Immunization Program context. Implementation of the same rotavirus vaccine in the free market will result in lowest coverage.
authors.affiliation: National Institute for Public Health and the Environment, Center for Prevention and Health Services Research, Bilthoven, The Netherlands; University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands. Electronic address: Jorien.Veldwijk@rivm.nl.
authors.forename: Jorien
authors.initials: J
authors.lastname: Veldwijk
authors.affiliation: National Institute for Public Health and the Environment, Center for Prevention and Health Services Research, Bilthoven, The Netherlands.
authors.forename: Mattijs S
authors.initials: MS
authors.lastname: Lambooij
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands; National Institute for Public Health and the Environment, Center for infectious disease control, Bilthoven, The Netherlands.
authors.forename: Patricia C J
authors.initials: PC
authors.lastname: Bruijning-Verhagen
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Smit
authors.affiliation: National Institute for Public Health and the Environment, Center for Prevention and Health Services Research, Bilthoven, The Netherlands; University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
authors.forename: G Ardine
authors.initials: GA
authors.lastname: de Wit
mesh_terms: D000328:Adult; D002755:Choice Behavior; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015233:Models, Statistical; D009426:Netherlands; D010290:Parents; D057240:Patient Preference; D012400:Rotavirus Infections / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000191:economics*
chemical_list: D022243:Rotavirus Vaccines
keywords: Discrete choice experiments; Preferences; Rotavirus; Vaccination; Vaccination coverage; Vaccine