Public preferences for COVID-19 vaccination program in Turkey: Evidence from a discrete choice experiment

Objectives This study aimed to examine public preferences and the trade-offs in vaccine features and policy restrictions towards a COVID-19 vaccination program in Turkey. Methods The study was conducted using a discrete choice experiment (DCE) among 3,086 samples in Turkey. Respondents were provided with hypothetical vaccine options with different attributes and non-pharmaceutical intervention (NPI) scenarios. Multinomial Logit (MNL) and Latent Class Models (LCM) were employed to estimate general-level and heterogenous subgroup-level preferences, respectively. Results Vaccine effectiveness, risk of adverse side-effects, vaccines from Western countries, and duration of protection were highly preferred attributes. The LCM identified two classes, the pro-vaccine (72%) and refuser (28%). Both classes showed a strong preference for highly effective vaccines, longer protection durations, minimal risks of severe side effects, and minimal social restrictions. Approval speed and workplace mandates, however, did not have substantial effect on preferences in both classes. The likelihood of belonging to the pro-vaccine class was shaped by attitudes and sociodemographic factors including trust in institutions, individual vaccine attitudes, and personal responsibilities such as having children or being married. Conclusions Vaccines with high efficacy, low severe side effects, and Western origins were more preferred, while regulatory speed and mandates had little influence on preferences. Policy should focus on developing high-quality vaccines, transparently communicating safety concerns, and aligning ease of restrictions with vaccination milestones. Mandates and accelerated production of vaccines might not be relied on as standalone strategies. Understanding heterogeneity of preferences could guide targeted interventions to improve uptake in future pandemics. Lay summary People in Turkey were interviewed to choose among scenarios of hypothetical vaccination program to understand their preference for vaccinations. The 3086 respondents value vaccine efficacy, less side effects, longer protection and western vaccines. Strict restrictions of lockdowns were unpopular. Speedy vaccine approval process and workers vaccination mandates did not impact their decision. Two distinct group of participants with opposing preference for vaccinations were found; majority favour vaccination and a third of them fall into refusers category. Perception on vaccines, level of trust on public institutions, demographic characteristics and political attitudes determine willingness to vaccinate. Participants stated tolerance for higher risk of side-effects for effective, longer protection vaccines and less social restrictions during a pandemic. Hence, easing social restrictions with vaccination progress, transparent pandemic policies, engaging, trusted and access to credible information imply an increase in future uptake and preparedness to future outbreak of pandemic in Turkey’s healthcare systems and other similar settings.