Factors associated with parents’ decision on purchasing optional vaccines: An interview study at Health Promotion Center 6, Khon Kaen

Abstract

Introduction: The national health policy of Thailand assigns that basic vaccines should be provided with free-of-charge for all children aged 0-5 years according to the Expanded Program on Immunization (EPI). The program provides vaccination for diseases including diphtheria, pertussis, tetanus, polio, hepatitis B, Japanese encephalitis (JE), measles, mumps, rubella, and tuberculosis. However, there are other optional vaccines (OVs) not including in the EPI because they are still not cost effective to be provided for all children in the population. The decision of purchasing these OVs is based on the judgement of parents with their own out-of-pocket expenses. This study was aimed to understand factors associated with parents’ decisions on purchasing OVs for their children, information sources and trust in OVs information. Methods: The study sample was thirty parents who decided to purchase OVs at Health Promotion Center 6 during December 2011 to January 2012. The parents of children aged 0-5 years were interviewed for information sources, factors affecting their decision making, and the economic impact of their decision. Results: The in-depth interview results suggested that there were several sources of vaccine information, and healthcare professionals were the most important and reliable sources among these. Additionally, negative economic impacts were not found in parents who purchased high-priced OVs; IPD Rota  Hib  Hep-A and Varicella vaccine. Their decisions were mainly based on risk, incidence and severity of diseases. Some low-income parents purchased OVs that developed from basic vaccines; Combined 5/6 diseases and Live Attenuated JE vaccine. The low-income parents were willing to pay even though they faced nagative economic impacts, because they expected lower side effects to their children. Factors associated with parents’ decision for purchasing OVs were parental factors, properties of the vaccine, occurrence of vaccine side effects, date of diseases, sources of information (healthcare professionals, people around them and the media), price, beliefs and experience. Conclusions: There were several factors associated with parents’ decision on purchasing OVs; parental factors, perception and products). Sufficient, accurate, complete, explicit and clear information were necessary for parents’ decision making on their children’s immunization.