1. Introduction
The COVID-19 pandemic first appeared at the end of 2019, broke out in the world until 2021, and is still not completely under control. According to statistics, up to December 22, 2021, there were 275, 233, 892 confirmed cases of COVID-19 and 5, 364, 996 deaths from COVID confirmed by government agencies worldwide (WHO, 2022). In the context of the complicated and dangerous COVID-19 pandemic. The need to protect and care for health is a top concern. Realizing the importance of vaccines to prevent COVID-19, many countries have embarked on research, experimentation, and the commercial production of COVID-19 vaccines. Facing the variety of vaccines, the country of origin of vaccines may be one of the factors that highly affect the consumption intention. Country of origin (COO) serves as a standard by which consumers rely on information, prejudices, and experiences about a product’s country of origin to make inferences about quality, price, performance, and other product functions. Therefore, the COO always dominates the final purchase decisions of customers (Jasrotia & Koul, 2020).
This study focuses on the Covaxin vaccine against the COVID-19 pandemic. India has a population advantage of over 1, 399 billion people, the fastest-growing major economy globally, and India’s pharmaceutical sector has an important position in the world market, with many large companies operating in the pharmaceutical industry. This study aims to measure the perception of Vietnamese people towards India in the production of COVID-19 vaccines, thereby assessing the impact of the country of origin on the intention to consume the COVID-19 vaccine.
2. Literature Review and Hypothesis
2.1. Consumption Intention
Customers willingly pay for products and services (Dodds et al., 1991). Consumption intention is the tendency of consumers to consume goods (Dam, 2020). A customer’s purchase decision is a complex process related to their behavior and perception. Consumption intentions can change under the influence of price, perceived quality, and value. In addition, consumers are affected by motors inside or outside the buying process (Gogoi, 2013). Although consumers can choose a specific product, their final decision to accept or reject it is based on their intentions (Madahi & Sukati, 2012). In addition, many external factors have been acknowledged that can influence consumption intention (Keller, 2001). Besides, favorable behavioral intention is more likely to purchase consumed products instead in case of unfavorable behavioral intention (Truong, 2018).
Previous studies have highlighted the important role of the COO in consumer product evaluation and consumption behavior (Brodowsky, 1998; Chao, 1998; Srinivasan et al., 2004; Manrai et al., 1998). According to Watson and Wright (2000) and Amine (2008) COO is also associated with the concept of “made in” or defined as the positive or negative influence of products from a country that has the potential to affect consumer attitudes and consumption decisions. Other studies, such as Jiménez et al. (2010), Moon and Jain (2002), Apil (2006), Bahaee and Pisani (2009), Edward et al. (2007), and Russell and Russell (2006) argued that COO could be used to conjecture consumer attitudes and purchase intentions towards foreign products. In this study, we expect a positive effect of country of origin on consumption intention for Indian vaccines against COVID-19 among Vietnamese people.
2.2. Country of Origin
Country of origin (COO), which represents where the product is designed, production (manufacturing country), or where the brand is located (brand origin) where an item or product comes from, is a significant recommendation that consumers consider when evaluating products or services (Astuti & Asih, 2016). When it comes to drugs or vaccines, the quality of drugs and vaccines will be evaluated by consumers through the country of manufacture and by the agency or political leader that approved them (Determann et al., 2016; Ledent et al., 2019). The country of origin connects a product with its national identity, leading to a potent emotional attachment to certain brands and products (Fournier, 1998). Consumers often consider the country of manufacture labels as an element of product quality when intrinsic quality (Determann et al., 2016). COO refers to consumer attitudes toward one or more of the following regions: (1) country-specific in general, (2) overall production, or (3) suitable products supplied by a particular country (Lee & Lee, 2011). Based on the literature reviewed, this study proposes a COO that includes perceived country image, perceived brand association, and perceived brand quality (Lee & Lee, 2011).
2.2.1. Country Image
Country image refers to the beliefs, ideas, and impressions people have about a country (Kotler et al., 1993). National historical, traditional, and contextual factors influence national image (Park et al., 2014). On the other hand, a country’s image is the general customer’s perception of particular products of a country based on production and marketing activities (Roth & Romeo, 1992). The results of a study on the influence of country image on consumer purchase intention in China demonstrated that country image has no direct impact on purchase intention (Li et al., 2009). In addition, another study found that country image has a different impact on purchase intention depending on the consumer’s first or subsequent purchase of a product (Wang et al., 2012). Based on the above information, the research criteria used were: creative country (Shaban & Vermeylen, 2015), a rapid development economy (Jalote & Natarajan, 2019), good relationship with other countries (Sibal, 2009; Das, 2016), strong development of information technology (Wang et al., 2012; IBEF, 2021) (5) high level of education (Kingdon, 2007; Stefan, 2018) large pharmaceutical manufacturers (IBEF, 2019; Ali, 2021), and old and diverse culture (Swami & Srivastava, 2020) were used to assess the image of India. Therefore, we propose the following hypothesis:
H1a: Perceived country image has a direct positive influence on perceived brand association.
H1b: Perceived country image has a direct positive influence on perceived brand quality.
H1c: Perceived country image has a direct positive influence on consumption intention.
2.2.2. Brand Association
Brand association is the association of a brand with the customer’s memory, including brand awareness, benefits, and values. Krishnan (1996), Cheng-Hsui Chen (2001) suggested that brand association can be used to express brand association with the customer’s mind. When brand connections are imprinted to purchase consumers’ memories and thoughts, branding ensures that the brand experience has positive connotations to maintain brand loyalty (Westhuizen, 2018). Furthermore, brand associations provide consumers with a reason to buy; therefore, most brand associations are interested in the attributes of the brand, the target consumer market, and the benefits that the brand offers consumers. In addition, Foroudi et al. (2018) find a positive relationship between brand association and purchase intention. The scale of brand association components in this study included good sympathy, appreciation, thinking of good features, and strong beliefs. The following hypothesis was proposed:
H2a: The perceived brand association has a direct positive influence on perceived brand quality.
H2b: The perceived brand association has a direct positive influence on consumption intention.
2.2.3. Brand Quality
Brand quality is the prominence and distinctiveness of a product or brand through the subjective evaluation process of consumers (Akram et al., 2011). Perceived brand quality is an intangible sensation that does not reflect a product or brand (Aaker, 1991; Zeithaml, 1988). This is considered a component of creating brand equity, which is a factor in determining consumer preferences (Yoo et al., 2000; Milberg & Sinn, 2008). Perceived brand quality is considered brand equity (Aaker, 1996). Moslehpour and Huyen (2014) found that perceived brand quality affects customers’ purchase intentions. Therefore, perceived brand quality is an essential element in the formulation and implementation of marketing strategies, contributes to brand image building (Tsiotsou, 2005), and forms the basis for building the long-term success of a product (Mitra & Golder, 2006). Safe immune system boosters, reduce the risk of disease and are highly effective are the criteria used to measure Vietnamese people’s perceptions of the quality of Indian vaccines. Accordingly, the proposed hypothesis:
H3: The perceived brand quality has a direct positive influence on consumption intention.
3. Research Methodology
3.1. Measurement Scales
This study created scales to measure a country’s image, perceived brand association, and perceived brand association from existing literature. First, country image scales were adapted by Shaban and Vermeylen (2015), Jalote and Natarajan (2019), Sibal (2009), Wang et al. (2012), and Swami and Srivastava (2020). It contained seven positive items to investigate consumers’ perceptions of country image. Second, this study opted for a 4-items scale adapted by Kotler et al. (2016) to measure consumers’ perceived brand association. To measure perceived brand quality, this study adopted Jian and Yazdanifard (2014). Finally, the consumption intention scale was based on Lee and Tai (2009).
3.2. Questionnaire Design and Data
This study was designed by using a quantitative research method. The questionnaire was designed to indicate participants’ level of agreement with the proposed items on a 5-level interval scale (1 = fully disagree to 5 = fully agree) to collect primary data for the components in the model. Researchers collected data through the Google platform by submitting the link of the questionnaire to the participants, focusing on the age group of older adults 18, via social networking sites such as Facebook, Instagram, and Zalo. The convenience method was used to select samples because of the willingness of the participants to answer online questionnaires. The survey was conducted from September 15, 2021, to September 30, 2021, and received 305 valid responses. The participants were 18 years of age or older.
3.3. Analytical Methods
The primary data analysis methods used in our study were descriptive statistics to describe the sample structure and vaccination behavior of Vietnamese people, Cronbach’s alpha test to estimate the scales’ reliability, structural equation modeling (SEM) method to evaluate the impact of the country of origin on consumption intention, and binary logistic to analyze and estimate the factors affecting willingness to consume.
4. Results and Discussion
Statistical results from 305 research samples, with females accounting for 51.1% and males accounting for 48.8%. A single status accounted for 34.4% of the patients. The status of being married but having no children accounted for 24.26%. The status of being married and having children under the age of 18 was 26.89%. The status of being married and having children over 18 years of age accounted for 14.43% of the sample.
4.1. Reliability Test
All components in the model were tested using Cronbach’s alpha to assess the reliability of the scales. The results are summarized in Table 1, where the Cronbach’s alpha of the four components is perceived country image (α = 0.92), perceived brand association (α = 0.94), perceived brand quality (α = 0.92), and consumption intention (α = 0.92). All components had a Cronbach’s alpha coefficient greater than 0.90. The corrected item total correlation of all components was greater than 0.50. The Cronbach’s alpha test recognizes that the scales of the components in the model are reliable.
Table 1: Testing Result in Cronbach Alpha
4.2. Measurement and Structural Model
This study used SEM to evaluate the relationships between variables. The results of the analysis are summarized in Table 2, which shows that there is no statistically significant correlation with the 95% confidence level of PCI and PBQ (λ = 0.08, P = 0.17 > 0.05); PCI and CI (λ = −0.10, P = 0.19 > 0.05). Therefore, the following hypotheses are rejected: H1b and H1c. There is no meaningful direct relationship between perceived country image, perceived brand quality, and consumption intention for India’s COVID-19 vaccine.
Table 2: Hypothesis Test Result
***p-value < 0.001; ns: not significant at 95% level.
After removing the two non-significant relationships in the model (PCI and PBA; PCI and CI), the final analysis results obtained using the SEM method are shown in Figure 1. Perceived country image has a statistically significant correlation with a 99% confidence level with perceived brand association (λ = 0.84***), so hypothesis H1b is accepted. Perceived country image has a direct positive impact on the perceived brand association. According to this result, if Vietnamese people have a good impression of India, it will have a positive impact on the positive perception of India’s COVID-19 vaccine, with positive brand associations about COVID-19 vaccine products such as good sympathy, appreciation, and good features and strongly believe. When Vietnamese people feel good about India by one unit, it will contribute to increasing the perception of a good brand association about Indian vaccines by 0.84 units. Build and enhance the brand image to create brand value, thereby affirming the country of origin (PCI). Specifically, it creates a good perception of brand associations, thereby impacting a good perception of product quality and contributing to increasing consumption intention. Thus, India needs to strengthen media campaigns to promote the national image associated with a creative country, develop the economy, and develop information technology, leading the pharmaceutical industry in the world.
Figure 1: The Impact of Country of Origin on Consumption Intention
The results of the analysis of the relationship between recording the direct impact were statistically significant with 99% confidence between PBA and PBQ (λ = 0.96***), PBA and CI (λ = 0.55***); therefore, , H2a and H2b are accepted. When the PQB increased by 1 unit, the CI increased by 0.41 units. Therefore, increased PQB will have a positive impact on India’s consumer vaccine intention. When Vietnamese people feel good about the brand association for Indian vaccines, it will have a positive impact on the perception of product quality and increase the promotion of copper consumption with Indian vaccines. Research results show that when consumers perceive that PBA increases by 1 unit, the impact on PBQ and CI will be increased 0.96 by 0.55 units. Similarly, the results confirm a direct positive correlation between the PBQ and CI (λ = 0.41***), whereby hypothesis H3 is accepted. If Vietnamese people feel good about the quality of India’s COVID vaccine, it will have a positive impact on the intention to use it. If the positive perception of vaccine quality increases by one unit, consumption intention will increase by 0.41 units. In addition, the PBQ accounted for 91% of the variation in PBA and PCI. PBA had a direct positive effect on PBA (0.96), and PCI had an indirect positive effect on PBQ through PBA.
The three components of COO include PCI, PBA, and PBQ, explaining 89% of the variation in CI (Figure 1), which was quite high. The results confirm the importance of the COO in promoting consumption intention for imported products in foreign markets. In addition, this study also recorded a positive correlation between the components of COO, specifically the PCI → PBA → PBQ. The results show the importance of the perceived country image for the country of origin.
4.3. Perception of COO and Intention to Use Covaxin Vaccine
The average statistical results in Table 3 indicate that Vietnamese people’s perception of India is 3.27/5.0, in general, the level of impression and positivity of Vietnamese people towards India in the country. From this result, the impact on the perception of brand association (mean = 3.23/5.0) and the perceived quality of India’s COVID-19 vaccine is also moderate (mean = 3.28/5.0); accordingly, consumption intention to choose India’s COVID-19 vaccine was also recorded on average (mean = 3.17/5.0).
Table 3: Average Statistics of the Perceived Country of Origin and Consumption Intention
Research results show that India is a famous country for pharmaceutical products worldwide, but it has not been well communicated in the Vietnamese market. Communication about India’s national image in Vietnam in recent years has also been limited. Thus, Vietnamese people do not have much information or impressions of India. As a result, the perceived results of India’s brand country of origin for COVID-19 vaccine products and consumption intentions are average.
4.4. Willingness to Consume India’s COVID-19 Vaccine
The results of the binary logistic analysis show that the overall correct guess rate of the whole model was 76.39%, the Nagelkerke R-Square = 40%, and thus, 40% of the variation in the willingness to consume India’s COVID-19 vaccine by PCI, PBA, and PBQ. The binary logistic analysis results in Table 4 show that the variable PBA (B = 0.90, Sig. = 0.00 < 0.05) was significant with 95% confidence, and PBQ (B = 0.56, Sig. = 0.06 < 0.10) is significant, with 90% confidence in India’s COVID-19 vaccine. These results indicate that brand association and brand quality perception have a direct impact on customer consumption. The PCI variable (B = −0.01, Sig. = 0.97 > 0.05) is not significant, with a 95% confidence level on willingness to consume India’s COVID-19 vaccine.
Table 4: The Results of Variables in the Equation in Binary Logistic
The results in Table 4 show that if customers’ perception of brand association increases by one unit, there will be an increase in willingness to consumption by 4.43 units, and if customers’ perception of brand quality increases by one unit, there will be an increase in willingness to consumption by 3.15 units. Research results show that the importance of brand association and brand quality perception of the manufacturing country has a great influence on the intention to choose for COVID-19 vaccine products.
5. Conclusion
Consumers rely on the knowledge, prejudices, and experience of the country of origin to draw conclusions about quality and price and to understand the product performance and impact on consumption intention. Based on research, the impact of country of origin on consumption intention for Indian vaccines shows that country of origin has a direct and positive impact on the perceived brand association, and country of origin indirectly has a positive impact on consumption intention through perceived brand association and perceived brand quality. The results of this study confirm those of previous studies, such as Andéhn and L’Époir Decosta (2016), Roth and Romeo (1992), Li et al. (2009), and Wang et al. (2012). A good perception of a country’s image has a positive impact on perceived brand value. Accordingly, to contribute to improving the perception of brand value for India’s COVID-19 vaccines, it is necessary to promote the implementation of national image communication campaigns in India associated with a creative country, promptly developing economic, strongly developing information technology, and large pharmaceutical manufacturers.
We found that perceived brand association and perceived brand quality are the main factors driving customer consumption intention towards Indian vaccines and that perceived brand association and perceived brand quality has a direct positive effect on the consumption intention of Indian vaccines. The results of this study are similar to those of previous studies: Westhuizen (2018), Foroudi et al. (2018), Moslehpour and Huyen (2014), Yoo et al. (2000), and Milberg and Sinn (2008). The research results show that to increase consumers’ consumption intention, it is necessary to influence the perceived brand association and perceived brand quality through strengthening communication and propaganda campaigns to raise consumers’ awareness of India’s COVID-19 vaccines with safe characteristics, immune system boosters, low risk of disease, and high effectiveness.
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