Willingness to pay for COVID-19 vaccine and its correlates: A cross-sectional survey in Bangladesh

The Government of Bangladesh has offered COVID-19 vaccines at no cost; however, sustaining this free vaccination program for a large population poses significant challenges. Assessing willingness to pay (WTP) is essential for understanding potential pricing strategies, subsidy requirements, and vaccine demand. This study aimed to estimate the prevalence of WTP for COVID-19 vaccines and identify its influencing factors to support program sustainability. Using a cross-sectional design, data were collected from 1,497 respondents through online, and face-to-face interviews and multiple logistic regression was employed to analyze the correlates of WTP. Results showed that 50.9% of participants were willing to pay, with an average WTP of 754.55 BDT (US$8.93) and a median of 300 BDT (US$3.55). WTP was significantly higher among individuals with graduate (aOR=2.2, P=0.007) or Masters & MPhil/PhD education (aOR=2, P=0.030), higher family income (aOR=1, P=0.039), and those with more excellent knowledge about the vaccine (aOR=1.1, P=0.003), positive behavioral practices (aOR=1.1, P<0.001), stronger subjective norms (aOR=1.2, P=0.009), higher anticipated regret (aOR=1.2, P=0.005), and perceived benefits (aOR=1.1, P=0.029). Conversely, WTP was lower among participants with negative attitudes toward vaccines (aOR=0.9, P<0.001) and high behavioral control (aOR=0.9, P=0.006). With nearly half of respondents unwilling to pay, the study highlights the need to improve vaccine-related knowledge, promote positive behaviors, reduce vaccine hesitancy, and enhance income-based affordability to increase WTP. Health promotion efforts should focus on disseminating vaccine knowledge and addressing negative perceptions. Additionally, a subsidized program for low-income groups could help mitigate financial barriers and promote equitable vaccine access.