King's College London

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Parental preferences for a mandatory vaccination scheme in England: A discrete choice experiment

posted on 2024-02-21, 11:29 authored by Louise SmithLouise Smith, Ben CarterBen Carter

Background: Mandatory vaccination has been mooted to combat falling childhood vaccine uptake rates in England. This study investigated parental preferences for a mandatory vaccination scheme.

Methods: Discrete choice experiment. Six attributes were investigated: vaccine, child age group, incentive, penalty, ability to opt out, and compensation scheme. Mixed effects conditional logit regression models were used to investigate parental preferences and relative importance of attributes.

Findings: Participants were 1,001 parents of children aged 5 years and under in England (53% female; mean age=33·6 years, SD=7·1; 84% white). Parental preferences were mostly based on incentives (30·7% relative importance; 80·9% [95% confidence interval 76·3–85·0%] preference for parent and 74·8% [71·0–78·3%] for child incentive; reference: no incentive) and penalties (25·4% relative importance; 69·5% [65·7–73·1%] preference for schemes where unvaccinated children cannot attend school or day care and 67·6% [63·6–71·4%] for those withholding financial benefits for parents of unvaccinated children; reference: £450 fine). Parents also preferred schemes that: offered a compensation scheme (18·1% relative importance; 66·4% [62·7–69·8%] preference; reference: not offered), mandated vaccination in children aged 2 years (versus 5 years; 11·4% relative importance; 42·6% [39·4–45·9%] preference; reference: 2 years), mandated the 6-in-1 vaccine (10·5% relative importance; 58·2% [54·6–61·7%] preference; reference: MMR), and that offered only medical exemptions (versus medical and religious belief exemptions; 4·0% relative importance; 45·5% [41·1–50·0%] preference; reference: medical exemptions).

Interpretation: These findings can inform policymakers’ decisions about how best to implement a mandatory childhood vaccination scheme in England.

Funding: Data collection was funded by a British Academy/Leverhulme Small Research Grants (SRG1920\101118).

Data will be made available ending 5 years following article publication, until 01/05/2027.


British Academy/Leverhulme Small Research Grants (SRG1920\101118)


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Collection method

Data were collected using an online cross-sectional survey (conducted 20 May to 7 June 2021) conducted by Panelbase, a Market Research Society Company Partner. Participants were recruited from two specialist research panel providers (people who have opted in to take part in online surveys; Panelbase and Lucid). Those aged 18 years or older, living in England, with a child aged 5 years or younger were eligible. Recruitment used non-probability sampling, an approach common in standard opinion polling methods. Quota sampling was based on sex (50% female), ethnicity (86% white) and Government Office Region (nationally representative) using targets from the Office for National Statistics, to ensure the sample was broadly representative of the English general population. Ethical approval for this study was granted by King's College London Psychiatry, Nursing, and Midwifery Research Ethics subcommittee (reference number LRS-20/21-21880).

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