COVID-19 Vaccine Uptake in Individuals with Functional Difficulty, Disability, and Comorbid Conditions: Insights from a National Survey in Bangladesh

Abstract

Background: COVID-19 vaccine coverage among individuals with disabilities is crucial for safeguarding their health and well-being. However, the extent of vaccine coverage among this group remains largely unknown in low- and middle-income countries. This study aims to explore the COVID-19 vaccine coverage among persons with functional difficulty, disability and/or morbidity in Bangladesh. Methods: Data from 9,370 respondents extracted from the 2021 National Household Survey on Persons with Disability were analysed. The outcome variable was the receipt of at least one dose of the COVID-19 vaccine (yes, no). Key explanatory variables included the presence of disability (yes, no), morbidity (yes, no), and both morbidity and disability (yes, no) among persons with functional difficulty. The relationship between the outcome and explanatory variables was determined using multilevel logistic regressions adjusted for covariates. Results: The overall acceptance rate for at least one dose of the COVID-19 vaccine among persons with functional difficulty was 57.37%, among persons with functional difficulty and disability was 48.63% and among persons with functional difficulty and single (57.85%) or multi-morbidity (60.37%). Compared to the respondents with functional difficulty only, the adjusted odds ratio (aOR) of acceptance of at least one dose of the COVID-19 vaccine for individuals with both functional difficulty and disability was 0.73 (95% CI, 0.65-0.82) and 0.77 (95% CI, 0.70-0.87) for individuals with functional difficulty, disability and one or more comorbid conditions. The aOR for individuals with functional difficulty and one or more morbid conditions was significantly higher than that for persons with functional difficulty only. Conclusion: In Bangladesh, COVID-19 vaccine coverage was relatively low among individuals with disabilities. The existing COVID-19 vaccine rollout programs and similar future programs should prioritise individuals with disabilities and include targeted strategies to reach them.