Using discrete choice modeling to evaluate the preferences and willingness to pay for leptospirosis vaccine.

Leptospirosis is highly endemic in the Philippines and a serious concern to public health. Local research on candidate vaccine is moving through the development pipeline. The availability of vaccines alone does not guarantee acceptance because individuals' vaccination choice decision is influenced by several factors. This study assessed how vaccine attributes and socio-demographic factors affect the acceptability of leptospirosis vaccine; and estimated individuals' willingness to pay for leptospirosis vaccine. A discrete choice experiment was conducted among leptospirosis and non-leptospirosis case respondents (n = 342) living in Metro Manila. Random Parameters Logit model was used to estimate the relative importance of vaccine attributes and socio-demographic variables on respondents' leptospirosis vaccination choice decision. The estimated model coefficients were used to derive implicit prices and willingness to pay for leptospirosis vaccine. Both case respondents preferred leptospirosis vaccine with 70-100% efficacy, mild to moderate risk of side-effects, given in a single shot, and at a lower price. Non-leptospirosis case respondents preferred a vaccine with 7 to 10 y of protection, while leptospirosis case respondents preferred a vaccine with 10 y protection. The probability of leptospirosis vaccination acceptance was affected by respondents' age, education, family size and income, proximity of home to rivers and sewers, and leptospirosis awareness level. Respondents' willingness to pay for leptospirosis vaccine (US$ 31.14-US$ 65.89) was higher than the Japanese retail price (US$ 21.60-US$ 24.00). Our findings indicated significant potential for introducing leptospirosis vaccine in the Philippine vaccine market. Delivery strategies to ensure equitable access to future leptospirosis vaccine are recommended.