COVID-19 Vaccine Hesitancy among the Adult Population in Bangladesh: A Nationally Representative Cross-sectional Survey

Hossain, M. B.; Alam, M. Z.; Islam, M. S.; Sultan, S.; Faysal, M. M.; Rima, S.; Hossain, M. A.; Mamun, A. A.

Introduction: The study related to the COVID-19 vaccine hesitancy is scanty in the context of Bangladesh, despite the growing necessity of understanding the mass people's vaccination-related behavior. Thus, the present study was conducted to assess the prevalence of the COVID-19 vaccine hesitancy and its associated factors in Bangladesh to fill the knowledge gap. Methodology: This study adopted a cross-sectional study design to collect data from 1497 respondents using online (Google forms) and face-to-face interviews. We employed descriptive statistics and multiple hierarchical linear regression analysis. Findings: The prevalence of vaccine hesitancy was 41.1%. Men had less hesitancy ({beta} = -0.046, p = 0.030) than women. The Muslims ({beta} = 0.057, p = 0.009) and the respondents living in the city corporation areas ({beta} = 0.132, p <0.001) had more hesitancy. There was significant variation in vaccine hesitancy by administrative divisions (geographic regions). The vaccine hesitancy tended to decrease with increasing knowledge about the vaccine ({beta} = -0.072, p=0.001) and vaccination process ({beta}= -0.058, p = 0.018). On the other hand, hesitancy increased with the increased negative attitudes towards vaccine ({beta} = 0.291, p <0.001) and conspiracy beliefs towards the COVID-19 vaccine ({beta} = 0.105, p=0.004). The perceived severity ({beta} = -0.079, p=0.002) and benefits ({beta} = -0.180, p=0.001) were negatively associated with hesitancy, while perceived barriers ({beta} = 0.180, p <0.001) were positively associated. The participants were more hesitant to accept the vaccine from a specific manufacturer. Conclusion: This study emphasizes that negative attitudes and conspiracies towards the COVID-19 vaccine should be reduced through effective communications and contracting with additional vaccine manufacturers should be prioritized. The barriers like online registration for receiving the COVID-19 vaccination need to be removed, and initiatives like text message service using the mobile phone operator can be introduced.