Willingness to Vaccinate (WTV) and Willingness to Pay (WTP) for Vaccination Against Peste des Petits Ruminants (PPR) in Mali

Evaluation of livestock farmers' knowledge, attitudes and practices regarding the use of veterinary vaccines in Southwest Ethiopia

BACKGROUND

The utilization of veterinary vaccines plays a vital role in preventing and managing animal diseases. However, the success of vaccination programmes relies on livestock farmers' understanding, perspectives and behaviours regarding their application. Therefore, this study aims to evaluate the knowledge, attitudes and practices of livestock farmers in Southwest Ethiopia regarding the use of veterinary vaccines.

METHODS

The study followed a cross-sectional design conducted between October 2021 and October 2022. A sample of 476 livestock-owning farmers, including those who raise dairy cattle, beef cattle and poultry, were interviewed from the districts of Shei Bench, Semen Bench, Sheko and Yeki.

RESULTS

The findings revealed that participants from Sheko, who had a poultry farm, were college graduates and resided in an urban area, were more likely to have good knowledge of veterinary vaccines. Similarly, participants who were male, from Semen Bench, had a poultry farm and had a high school education, exhibited a positive attitude towards veterinary vaccines. Furthermore, being male, from Semen Bench, having a poultry farm, and having a high school education were associated with increased veterinary vaccine use.

CONCLUSION

This study highlights the importance of addressing gender differences and tailoring interventions based on geography and farming conditions in the area. These measures are crucial to improve practices related to veterinary vaccines for enhanced animal health and productivity. Prioritizing education, veterinary services and information dissemination is vital. However, further research and targeted interventions are needed to better comprehend underlying factors and implement effective strategies for diverse communities in different areas.

Duration of Immunity Induced after Vaccination of Cattle with a Live Attenuated or Inactivated Lumpy Skin Disease Virus Vaccine

Vaccines have proven themselves as an efficient way to control and eradicate lumpy skin disease (LSD). In addition to the safety and efficacy aspects, it is important to know the duration for which the vaccines confer protective immunity, as this impacts the design of an efficient control and eradication program. We evaluated the duration of immunity induced by a live attenuated vaccine (LSDV LAV) and an inactivated vaccine (LSDV Inac), both based on LSDV. Cattle were vaccinated and challenged after 6, 12 and 18 months for LSDV LAV or after 6 and 12 months for the LSDV Inac. The LSDV LAV elicited a strong immune response and protection for up to 18 months, as no clinical signs or viremia could be observed after a viral LSDV challenge in any of the vaccinated animals. A good immune response and protection were similarly seen for the LSDV Inac after 6 months. However, two animals developed clinical signs and viremia when challenged after 12 months. In conclusion, our data support the annual booster vaccination when using the live attenuated vaccine, as recommended by the manufacturer, which could potentially even be prolonged. In contrast, a bi-annual vaccination seems necessary when using the inactivated vaccine.

Relationship of spirituality, health engagement, health belief and attitudes toward acceptance and willingness to pay for a COVID-19 vaccine

PURPOSE

To explore the wider determinant factor of citizens' spirituality, health engagement, health belief model, and attitudes towards vaccines toward acceptance and willingness to pay for a Coronavirus disease 2019 (COVID-19) vaccination.

METHODS

A community-based cross-sectional online investigation with convenience sampling was utilized to recruit 1423 citizens from 18 districts across Indonesia between December 14, 2020 and January 17, 2021. Descriptive statistics, One-way analysis of variance, Pearson correlation, Independent t-tests, and multiple linear regression were examined.

RESULTS

Spirituality, health engagement and attitude toward vaccines, as well as health beliefs constructs (all scores of perceived benefits and barriers) were significant key factors of acceptance of vaccines. Interestingly, the spirituality, attitude toward vaccine, and health beliefs constructs including perceived susceptibility, and benefits indicated a significantly higher willingness.

CONCLUSIONS

Results demonstrated the utility of spirituality, health engagement, health belief model, and attitudes towards vaccines in understanding acceptance and willingness to pay for a vaccine. Specifically, a key obstacle to the acceptance of and willingness to pay COVID-19 vaccination included a high score of the perceived barrier construct. Moreover, the acceptance of and willingness to pay could be impaired by worries about the side-effects of a COVID-19 vaccination.

Willingness to pay for and willingness to vaccinate with the COVID-19 vaccine booster dose in China

Objective: The present study aims to assess the willingness to pay (WTP) for and willingness to vaccinate (WTV) with the Coronavirus (COVID-19) vaccine booster dose in China when the pandemic is under adequate control and the majority of the population is vaccinated. This study is also to identify significant factors associated with the WTP.

Methods: This was a cross-sectional study on adults with no past or present COVID-19 infection. An online questionnaire was distributed to collect data on vaccination status, quarantine experience, and factors related to health beliefs on vaccination. The WTV was assessed through the vaccination preference. The WTP was examined by payment scale (PS) and iterative bidding game (IBG) administered in random order. Three IBG algorithms with different starting-price were presented randomly. The average WTP of PS and IBG were analyzed as primary outcomes using univariate and multivariate analyses. Multivariate ordered logistic regression was performed to identify significant factors for the WTP.

Results: The survey recruited 543 participants with a mean age of 32 years and 57.80% being female. The WTV rate was 86.74%, while 94.66% of participants completed full-schedule or enhanced vaccination. The mean WTP was CNY 149 (±CNY 197) and the median WTP was CNY 80. Regarding significant factors for the WTP, urban residents were 57% more likely (95% CI: 1.11-2.22) to pay for a high-priced vaccine than rural residents. Respondents who completed full-schedule vaccination were 46% more likely (95% CI: 1.03–2.07) to pay for a high-priced vaccine than those who completed enhanced vaccination. Respondents with a low household income of CNY 40k or lower were 62% less likely (95% CI: 0.21–0.66) to pay for a high-priced vaccine than those with a middle household income of CNY 110k–210k. Other significant factors associated with the WTP included the perceived benefit of vaccination and peer environmental pressure in the health belief model.

Conclusion: The WTV with the COVID-19 vaccine booster dose was high in China. The WTP was influenced by the place of residence, vaccination status, household income, perceived benefit of vaccination, and environmental peer pressure. Study findings can inform policymakers to better design vaccination programs and financial schemes involving out-of-pocket payments.

Beyond the Gender of the Livestock Holder: Learnings from Intersectional Analyses of PPR Vaccine Value Chains in Nepal, Senegal, and Uganda

Simple Summary

The peste des petits ruminants (PPR) is one of the deadliest viral diseases of small ruminants and is endemic in Africa, the Middle East, and Asia. While PPR vaccination programs exist in these contexts, many factors restrict their reach and effectiveness, which go beyond the often cited financial, technological, and logistical constraints. This paper examines these less investigated factors, in particular the role of gender norms and other social and cultural factors, in affecting which livestock keepers are unable to access PPR vaccines and which groups are less reached by the vaccine distribution systems. Across three countries selected for our study, we find that, overall, women derive fewer benefits from the system than men; in addition, belonging to certain ethnic groups, being of low caste, or living in remote regions are additional markers of exclusion and marginalization from accessing livestock vaccines.

Abstract

The peste des petits ruminants (PPR) is a deadly viral disease of small ruminants, which are an important source of livelihood for hundreds of millions of poor smallholders throughout Africa, the Middle East, and Asia. PPR vaccination efforts often focus on overcoming financial, technological, and logistical constraints that limit their reach and effectiveness. This study posits that it is equally important to pay attention to the role of gender and other intersecting social and cultural factors in determining individual and groups’ ability to access PPR vaccines or successfully operate within the vaccine distribution system. We compare three study contexts in Nepal, Senegal, and Uganda. Qualitative data were collected through a total of 99 focus group discussions with men and women livestock keepers and animal health workers, 83 individual interviews, and 74 key informant interviews. Our findings show that there are not only important gender differences, but also interrelated structures of inequalities, which create additional sites of exclusion. However, these intersections are not generalizable across contexts—except for the intersection of gender and geographic remoteness, which is salient across vaccine distribution systems in the three countries—and social markers such as caste, ethnicity, and livelihood are associated with vulnerability only in specific settings. In order to address the distinct needs of livestock keepers in given settings, we argue that an intersectional analysis combined with context-dependent vaccination approaches are critical to achieving higher vaccination rates and, ultimately, PPR disease eradication by 2030.

The Importance of Quality Control of LSDV Live Attenuated Vaccines for Its Safe Application in the Field

Vaccination is an effective approach to prevent, control and eradicate diseases, including lumpy skin disease (LSD). One of the measures to address farmer hesitation to vaccinate is guaranteeing the quality of vaccine batches. The purpose of this study was to demonstrate the importance of a quality procedure via the evaluation of the LSD vaccine, Lumpivax (Kevevapi). The initial PCR screening revealed the presence of wild type LSD virus (LSDV) and goatpox virus (GTPV), in addition to vaccine LSDV. New phylogenetic PCRs were developed to characterize in detail the genomic content and a vaccination/challenge trial was conducted to evaluate the impact on efficacy and diagnostics. The characterization confirmed the presence of LSDV wild-, vaccine- and GTPV-like sequences in the vaccine vial and also in samples taken from the vaccinated animals. The analysis was also suggestive for the presence of GTPV-LSDV (vaccine/wild) recombinants. In addition, the LSDV status of some of the animal samples was greatly influenced by the differentiating real-PCR used and could result in misinterpretation. Although the vaccine was clinically protective, the viral genomic content of the vaccine (being it multiple Capripox viruses and/or recombinants) and the impact on the diagnostics casts serious doubts of its use in the field.

Dairy agripreneurs' preference for production and animal health support services in Kenya-a choice experiment

Utilization of production and animal health services among smallholder dairy agripreneurs is crucial in enhancing their productivity and income levels. However, studies have documented low uptake of these services among smallholder dairy agripreneurs in Kenya. This study utilizes a choice experiment (CE) to determine dairy agripreneurs' preferences and willingness to pay (WTP) for five attributes of production and animal health support services. Multistage sampling procedure was used to collect data from 682 dairy farmers in Murang'a County. Data were analysed using Random Parameter Logit (RPL)/Mixed Logit model. The results of CE reveal significant heterogeneity in preference among dairy agripreneurs. Dairy agripreneurs prefer to have group marketing services offered rather than selling on individual basis. They also prefer curative services rather than preventive services. In addition, dairy agripreneurs prefer use of artificial insemination in improving productivity of cows rather than using improved feeds such as hay and silage. The results further indicate that dairy agripreneurs have less preference for business plan training service. In relation to willingness to pay (WTP), dairy agripreneurs were more willing to pay for group marketing (KES 8797.91/month), artificial insemination (KES 2816.01/month) and curative services (KES 2577.62/month). Lastly, dairy agripreneurs were not willing to forgo KES 2411.29 per month for business plan training service. Service providers should consider the differences in preferences among dairy agripreneurs to increase the uptake of production and animal health services in dairy agrienterprises.

Gender and intersectional analysis of livestock vaccine value chains in Kaffrine, Senegal

Among livestock species, poultry and small ruminants are of particular importance to rural women in low- and middle-income countries, as means to generate income, provide nutritious food for the family, accumulate wealth, and confer social status. Newcastle disease (ND) and Peste des Petits Ruminants (PPR) are widespread livestock diseases of poultry and small ruminants, respectively. While both diseases are vaccine preventable, numerous constraints limit the availability of and access to livestock vaccines, especially among the most vulnerable populations in developing countries. The literature on equity and effectiveness of livestock vaccine distribution systems has emphasized many of these constraints, however a gendered analysis and deeper understanding of the vaccine system remain insufficient. This paper applies a gendered and intersectional transformational approach, or GITA, to highlight how gender and other social factors affect the provision and utilization of vaccines for ND and PPR diseases in the region of Kaffrine, Senegal. We first articulate and describe the vaccine value chains (VVCs) for these diseases in Kaffrine, and then analyze the gendered and intersectional dynamics at different nodes of the VVCs, including actors at the national level, through the regional and district levels, down to providers of animal health at community level and the livestock keepers themselves. Our findings indicate that actors’ various experiences are shaped and defined mainly by rigid gender norms, location and remoteness, and to a lesser degree by other social stratifications of age, ethnicity, and livelihood. Given the significant role that gender norms play in the livestock vaccine value chains, differences according to the livestock species, regulation of vaccine administration, and vaccine distribution systems emerge as highly relevant for understanding barriers that women specifically face within the livestock vaccination system.

Strategies to Upgrade Animal Health Delivery in Village Poultry Systems: Perspectives of Stakeholders From Northern Ghana and Central Zones in Tanzania

Village chicken production holds much potential for the alleviation of malnutrition and poverty in rural communities in Africa. Owing to their subsistence nature, however, such systems are rife with infectious poultry diseases such as Newcastle disease (ND). Strategies common for the management of ND and other poultry diseases in intensive production systems, including vaccination and biosecurity measures, have seen limited success in the village production systems. New approaches are needed that can successfully deliver animal health inputs and services for the effective management of poultry health challenges in low-input systems. Our study utilized focus group discussions with men and women farmers as well as other poultry value chain actors such as input suppliers, live bird traders and processed poultry meat retailers, to investigate potential options for delivery of animal health care to village poultry systems in northern Ghana and central Tanzania. ND was commonly reported as a major disease constraint in the study sites of the two countries, with resulting fatalities particularly impactful on men and women producers and on traders. We therefore also conducted interviews that focused specifically on the gender component of village chicken production. The key health related challenges prioritized by women and men participants included limited access to, and poor quality of, vaccines and veterinary drugs, a shortage of veterinary officers, and insufficient knowledge and training of farmers on flock management practices. Women, more than men, emphasized the difficulties of accessing poultry health services. Our assessments suggest that for poultry health care delivery in the studied communities to be effective, there is need to improve the supply of good quality drugs and vaccines in rural areas, respond to the needs of both men and women, and recognize the different incentives for farmers, traders and other value chain actors. Community-based approaches and increased use of ICT technology such as mobile phones have much to offer in this regard.

Demand for Taenia solium Cysticercosis Vaccine: Lessons and Insights From the Pig Production and Trading Nodes of the Uganda Pig Value Chain

Taenia solium cysticercosis disease remains a key challenge to the pig sector in low- and middle-income countries in sub-Saharan Africa, Latin America and South East Asia, resulting in both economic losses and public health impacts. The World Health Organization has ranked it first on the global scale of foodborne parasites. A One Health approach has been recommended for reduction of infection pressure and eradication in the longer term. A new vaccine TSOL18 (Cysvax™), applied in combination with oxfendazole (Paranthic 10%™), a dewormer drug has been developed and field tested for the control of T. solium cysticercosis, with high potential to break the disease cycle. It is however unclear whether the products can be marketed through a market driven approach, and if smallholder pig farmers would be willing to take up and pay for the vaccine–oxfendazole combination. A choice experiment methodology was used to assess the potential demand and willingness to pay for the vaccine—oxfendazole combination by Ugandan smallholder pig farmers, and demand for vaccinated pigs by pig traders. The results showed that farmers highly valued quality assurance attributes and were not keen on the vaccine if there were no associated returns in the form of premium price for vaccinated pigs during sales. They were willing to pay US$ 2.31 for the vaccine if it resulted in a premium price for vaccinated pigs. Furthermore, they preferred an accompanying vaccine viability detector as part of its quality assurance. The pig traders on the other hand preferred high carcass weight of pigs, potentially achieved by using oxfendazole. The results show that unless the pig market systems pay a premium price for vaccinated pigs, and quality assurance systems guarantee quality vaccine, uptake of the TSOL18 vaccine and oxfendazole by farmers through market mechanisms may be unsuccessful. The current pig marketing system does not reward food safety, the focus is mainly on carcass weight. Alternative delivery mechanisms for the vaccine through a mix of private–public investments needs to be explored, as the benefits of vaccinated pigs are societal and include reduction and elimination of neurocysticercosis in the long run.

Progress towards Eradication of Peste des Petits Ruminants through Vaccination

Peste des petits ruminants (PPR) is a transboundary viral disease that threatens more than 1.74 billion goats and sheep in approximately 70 countries globally. In 2015, the international community set the goal of eradicating PPR by 2030, and, since then, Food and Agriculture Organization of the United Nations (FAO) and World Organization for Animal Health (OIE) have jointly developed and implemented the Global Control and Eradication Strategy for PPR. Here, data from the United Nations Food and Agriculture Organization Statistical Database (FAOSTAT), the OIE World Animal Health Information System (WAHIS), Regional Roadmap Meetings, and countries' responses to PPR Monitoring and Assessment Tool (PMAT) questionnaires were analyzed to inform on current progress towards PPR eradication. OIE recorded the use of over 333 million doses of vaccine in 12 countries from 2015 to 2018, 41.8% of which were used in Asia and 58.2% in Africa. Between 2015 and 2019, a total of 12,757 PPR outbreaks were reported to OIE: 75.1% in Asia, 24.8% in Africa, and 0.1% in Europe. The number of global outbreaks in 2019 fell to 1218, compared with 3688 in 2015. Analysis of vaccine use and PPR outbreaks in countries indicates that disease control strategies, particularly vaccination campaigns and vaccine distribution strategies, still require scientific evaluation. It is imperative that vaccination is undertaken based on the epidemiology of the disease in a region and is coordinated between neighboring countries to restrict transboundary movements. Strengthening surveillance and post-vaccination sero-monitoring at the national level is also essential. The PPR vaccine stock/bank established by FAO, OIE, and other partners have improved the quality assurance and supply of vaccines. However, to achieve PPR eradication, filling the funding gap for vaccination campaigns and other program activities will be critical.

Economic Analysis of Increasing Foot-and-Mouth Disease Vaccination Frequency: The Case of the Biannual Mass Vaccination Strategy

Biannual mass vaccination is a routinely applied foot-and-mouth disease (FMD) control strategy in Turkey. However, because biannual mass vaccination may leave significant immunity gaps, this strategy may cause economic losses because of possible FMD infections. In high-risk areas—such as border cities, it was suggested by the government to increase the vaccination intervals in order to decrease the FMD infection risk. This study analyses and compares the economic effects of a biannual mass vaccination regime and vaccination every 4 months as an alternative strategy in border cities by using partial budgeting approach. Biannual mass vaccination was used as a baseline scenario. Data on the impact of FMD on animal health and production parameters for 2018 were obtained from the OIE-WAHIS system and complemented by literature data and expert opinion. In the partial budgeting model, weight loss was considered as a major loss of income because majority of the farming systems are based on cattle fattening in the border cities of Turkey. Results revealed that the net economic impact, which is the benefit that exceeds the losses and costs of increasing the frequency of vaccination, is 76.4 TL ($15.9) per cattle. The sensitivity analysis showed that average body weight and weight losses when infected had more effect on net impact changes than market prices. The lower and upper FMD incidence variability resulted in 19.2 TL ($4) and 190.8 TL ($39.6) of net impact per cattle, respectively. The new FMD control strategy would make a total net economic impact of 5,274,836 TL ($1,094,250) for a population of 800,970 fattening cattle in border cities. The results of this study indicated that intense FMD control strategies may be more cost effective than the current control strategies, especially in high-risk areas. Future studies with more comprehensive epidemiological and economic data must be conducted to analyze and compare alternative FMD control strategies in Turkey.

Modeling Economic Effects of Vaccination Against Porcine Reproductive and Respiratory Syndrome: Impact of Vaccination Effectiveness, Vaccine Price, and Vaccination Coverage

Porcine reproductive and respiratory syndrome (PRRS) causes substantial financial losses in pig farms and economic losses to societies worldwide. Vaccination against PRRS virus (PRRSV) is a common intervention in affected farms. The aim of this study was to assess the economic impact and profitability of potential new PRRS vaccines with improved efficacy at animal, herd, and national level. Two vaccination strategies were modeled; (i) mass vaccination of sows only (MS) and (ii) mass vaccination of sows and vaccination of piglets (MSP), comprising different scenarios of vaccine effectiveness, vaccine price, and vaccination coverage. A farrow-to-finish farm with 1,000 working sows from a pig-dense region in Germany served as an example farm. Financial benefits were obtained from gross margin analyses and were defined as difference in gross margin between a PRRSV-infected farm without vaccination (baseline) and with vaccination (intervention). Financial benefits were highest if both sows and piglets (MSP) were vaccinated. In these scenarios, median annual net benefits per working sow ranged from €170 to 340. If sows only were vaccinated (MS), estimated benefits attributable to vaccination were between €148 and 270. Decisive variables for the estimation of national level benefits were the number of farmers switching from existing to a better protecting vaccine, the number of previously non-vaccinating herds adopting the new vaccine, and the effectiveness of the new vaccine relative to those already available. Benefits were greatest when the new vaccine was adopted by previously non-vaccinating herds. The analyses showed that vaccination against PRRS was beneficial for all modeled scenarios. The magnitude of benefits derived from vaccination was more susceptible to changes in vaccination effectiveness than to vaccine price changes. This study provides evidence to support future vaccine development. The estimates indicate that the introduction of more efficient vaccines might lead to substantial financial benefits, is of socio-economic importance and that new vaccines might significantly contribute to the reduction of disease burden.

Application of discrete choice experiment to analyze the demand for village chicken paid vaccination service against Newcastle disease in DR Congo

Newcastle disease (ND) is a highly contagious viral disease that can affect a large number of avian species and cause severe economic loss in many countries. This disease is a major constraint for rural chicken production in most developing countries. In this country, ND is known since the 1940s. It exists in enzootic form in almost all provinces of the country. No systematic long-term control measures have been taken against this devastating disease in village poultry. A discrete choice experiment was carried out to analyze the demand for paid vaccination services, by first identifying the preferences of 320 village chicken keepers from eight sites, four of which had benefitted from such a paid chicken vaccination program against ND and four of which did not. The preference was for a vaccination service carried out following imposed calendar. The public veterinarian was the most preferred professional to ensure the paid vaccination of village chickens. The results led to the design of a profile of paid vaccination service tailored to chicken keepers' expectations. The public veterinarian would supervise vaccination activities, which would be implemented by trained community-based health workers, through collective campaigns at fixed periods in the year. The acceptable price (equivalent to 0.10 US dollar per dose) would allow the service to be set in a sustainable way and might be increased if trust in the delivered service may be built further.