Abstract
PurposeVaccine hesitancy among the population raises concern for health policymakers because it threatens the attainment of herd immunity, which is necessary to keep the society healthy and manage public health spending. However, a problem arises when there is hesitancy by economic agents and their dependents, even when the resource is freely available. This policy problem is analyzed in the context of Ghana's major urban area, Accra, where a cross-section of urban parents are surveyed regarding vaccine hesitancy and whether it extends to their children, with special reference to the COVID-19 vaccine.MethodologyData on preferences of residents regarding the choice for their dependents to receive the vaccine gathered in 2022. The data was obtained through a cross-sectional online survey of 2000 urban parents in Accra, Ghana. The paper estimates logit and probit regression models and their associated marginal effects to examine the willingness of respondents to allow their children to take the vaccine and the extent of influence of attitudinal and demographic characteristics of respondents.FindingsThe results first show that urban respondents who had tested for COVID-19, taken the vaccine and were willing to pay for the COVID-19 vaccine are more likely to allow their children to take the vaccine. More so, urban respondents concerned about age group vulnerability of their children, not suffering permanently health conditions, and being infected by others are also more likely to allow their children to take the COVID-19 vaccine.Practical implicationsBased on the findings, this paper recommends to policymakers to strengthen education efforts, with special encouragement for parents to get their children vaccinated. Vaccines are meant to provide immunity to the populace and its hesitancy among the population sets back the public health objective of achieving herd immunity and building a robust pharmaceutical industry while increasing the risk of poor public services and higher public health spending.Originality/valueThis paper offers a novel lens on the sustainability of public health expenditure by examining vaccine hesitancy during a pandemic that caught populations unprepared and distrustful. Using evidence from urban Ghana, it shows how reluctance to accept free vaccines reveals the hidden social costs and governance gaps in public health delivery-an overlooked dimension in discussions of health financing in developing countries.