Willingness to vaccinate against COVID-19 among Bangladeshi adults: Understanding the strategies to optimize vaccination coverage

Abstract

Background Although the approved COVID-19 vaccine has been shown to be safe and effective, mass vaccination in Bangladeshi people remains a challenge. As a vaccination effort, the study provided an empirical evidence on willingness to vaccinate by sociodemographic, clinical and regional differences in Bangladeshi adults. Methods This cross-sectional analysis from a household survey of 3646 adults aged 18 years or older was conducted in 8 districts of Bangladesh, from December 12, 2020, to January 7, 2021. Multinomial regression examined the impact of socio-demographic, clinical and healthcare-releated factors on hesitancy and reluctance of vaccination for COVID-19. Results Of the 3646 respondents (2212 men [60.7%]; mean [sd] age, 37.4 [13.9] years), 74.6% reported their willingness to vaccinate against COVID-19 when a safe and effective vaccine is available without a fee, while 8.5% were reluctant to vaccinate. With a minimum fee, 46.5% of the respondents showed intent to vaccinate. Among the respondents, 16.8% reported adequate adherence to health safety regulations, and 35.5% reported high confidence in the country’s healthcare system. The COVID-19 vaccine refusal was significantly high in elderly, rural, semi-urban, and slum communities, farmers, day-laborers, homemakers, low-educated group, and those who had low confidence in the country’s healthcare system. Also, the prevalence of vaccine hesitancy was high in the elderly population, low-educated group, day-laborers, people with chronic diseases, and people with low confidence in the country’s healthcare system. Conclusion A high prevalence of vaccine refusal and hesitancy was observed in rural people and slum dwellers in Bangladesh. The rural community and slum dwellers had a low literacy level, low adherence to health safety regulations and low confidence in healthcare system. The ongoing app-based registration for vaccination increased hesitancy and reluctancy in low-educated group. For rural, semi-urban, and slum people, outreach centers for vaccination can be established to ensure the vaccine’s nearby availability and limit associated travel costs. In rural areas, community health workers, valued community-leaders, and non-governmental organizations can be utilized to motivate and educate people for vaccination against COVID-19. Further, emphasis should be given to the elderly and diseased people with tailored health messages and assurance from healthcare professionals. The media may play a responsible role with the vaccine education program and eliminate the social stigma about the vaccination. Finally, vaccination should be continued without a fee and thus Bangladesh’s COVID vaccination program can become a model for other low and middle-income countries.

Challenges in Preventive Practices and Risk Communication Towards COVID-19: A Cross-sectional Study in Bangladesh

“…However, rural residents, people with low socio-economic and educational backgrounds, and those from disadvantaged communities had di culty adhering to self-quarantine, isolation, and home treatment procedures [18,19], further pointing to a weakness in the COVID-19 information campaigns. Additionally, inadequate vaccine information among respondents is consistent with the ndings of another cross-sectional survey that found vaccine refusal and hesitancy among one-fourth of their participants [24]. About 21% of the respondents in this current study also reported having insu cient information on protective behaviours that potentially contributed to improper use of masks, personal protective equipment (PPE), and faulty hand washing techniques [6,25,26].…”

The Willingness to Receive COVID-19 Vaccine and Its Associated Factors: “Vaccination Refusal Could Prolong the War of This Pandemic” – A Systematic Review

“… 21 Yoda & Katsuyama 60 2021 1100 Residents CS Japan 65.7% Age (≥70 years), residency (rural), having underlying medical conditions, and gender (male). 22 Zigron et al 62 2021 506 Dentists, dental residents, and oral medicine specialists CS Israel 85% Occupation (unemployment) 23 Abedin et al 63 2021 3646 Adults (≥18 years) CS Bangladesh 74.6% NA 24 Alfageeh et al 50 2021 2137 Adults (≥18 years) CS Saudi Arabia 48% Receiving the seasonal influenza vaccination in the past, believed in mandatory COVID-19 vaccination, and reported high levels of concern about contracting COVID-19. 25 Al-Mohaithef et al 51 2021 658 Adults (≥18 years) CS Saudi Arabia 53.3% High-risk perception, and higher trust in the healthcare system.…”

“…From a total of 45 studies, 6 studies have not assessed the factors associated with the willingness of receiving COVID-19 vaccine. They were two studies from the United States, 33 , 38 one study from Bangladesh, 63 one study from Jordan, 64 one study from Italy, 66 and one study from Ethiopia. 67 Generally, the present systematic review has briefly summarized factors associated with the willingness of receiving COVID-19 vaccine.…”

“…The study design of all these studies were cross-sectional. Nine studies were done in the United States, [30][31][32][33][34][35][36][37][38] nine studies were done in China, [39][40][41][42][43][44][45][46][47] one study was done in Australia, 48 four studies were done in Saudi Arabia, [49][50][51][52] one study was done in Kuwait, 53 one study was done in England, 54 one study was done in Congo, 55 one study was done in Greece, 56 two studies were done in UK, 57,58 one study was done in Malaysia, 59 two studies were done in Japan, 60,61 one study was done in Israel, 62 one study was done in Bangladesh, 63 one study was done in Jordan, 64 one study was done in Iran, 65 one study was done in Italy, 66 one study was done in Ethiopia, 67 two studies were done in France, 68,69 one study was done in Vietnam, 70 one study was done in Uganda, 71 one study was done in Pakistan, 72 one study was done in Nigeria, 73 an...…”

“…From a total of 45 studies, 6 studies have not assessed the factors associated with the willingness of receiving COVID-19 vaccine. They were two studies from the United States, 33,38 one study from Bangladesh, 63 one study from Jordan, 64 one study from Italy, 66 and one study from Ethiopia. 67 any vaccine in the past 5 years, perception of disease can be prevented by vaccine, willingness to protect others by getting oneself vaccinated, taking direct care of COVID-19 patients, belief that only people who are at risk of serious illness should be vaccinated, trust in government, complacency, willingness to pay for and travel for a vaccine, themselves or a member of their household belonged to a vulnerable group, trust in public health authorities, believing COVID-19 virus was not developed in laboratories, believing COVID-19 is far more contagious and lethal relative to the H1N1 virus, compliance with community mitigation strategies, being in a private sector, encountering with suspected or confirmed COVID-19 patients, self-reported health outcomes, believing that next waves COVID-19 are coming, knowledge score regarding symptoms, transmission routes and prevention and control measures against COVID-19, and perception that COVID-19 will persist (Table 1).…”