Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh.
Department of Media Studies and Journalism, University of Liberal Arts Bangladesh, Dhaka, Bangladesh.
PLoS One. 2021 Apr 27;16(4):e0250495. doi: 10.1371/journal.pone.0250495. eCollection 2021.
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.
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.
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.
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.
尽管已批准的 COVID-19 疫苗已被证明是安全有效的，但在孟加拉国人中进行大规模疫苗接种仍然是一个挑战。作为一项疫苗接种工作，本研究通过在孟加拉国成年人中按社会人口统计学、临床和地区差异来提供对疫苗接种意愿的实证证据。
这项横断面分析来自于 2020 年 12 月 12 日至 2021 年 1 月 7 日在孟加拉国 8 个地区进行的一项针对 3646 名 18 岁或以上成年人的家庭调查。多项回归分析考察了社会人口统计学、临床和与医疗保健相关因素对 COVID-19 疫苗接种犹豫和抵触的影响。
在 3646 名受访者（2212 名男性[60.7%]；平均[标准差]年龄为 37.4[13.9]岁）中，74.6%的受访者表示，如果有安全有效的疫苗且无需付费，他们愿意接种 COVID-19 疫苗，而 8.5%的受访者表示不愿意接种。如果需要最低费用，46.5%的受访者表示有意愿接种疫苗。在受访者中，16.8%的人表示充分遵守了健康安全法规，35.5%的人对本国的医疗保健系统有高度信心。在老年人、农村、半城市和贫民窟社区、农民、临时工、家庭主妇、低教育程度群体以及对本国医疗保健系统缺乏信心的人群中，COVID-19 疫苗的拒绝率明显较高。此外，在老年人、低教育程度群体、临时工、患有慢性病的人群以及对本国医疗保健系统缺乏信心的人群中，疫苗犹豫的发生率也很高。
在孟加拉国，农村地区和贫民窟居民中存在较高的疫苗拒绝和犹豫率。农村社区和贫民窟居民文化程度低，对健康安全法规的遵守程度低，对医疗保健系统的信心低。正在进行的基于应用程序的疫苗接种登记增加了低教育程度群体对疫苗的犹豫和抵触情绪。对于农村、半城市和贫民窟地区的人，可以设立疫苗接种外展中心，以确保疫苗就近供应，并限制相关旅行费用。在农村地区，可以利用社区卫生工作者、有价值的社区领导人和非政府组织来激励和教育人们接种 COVID-19 疫苗。此外，应重点关注老年人和患病者，为他们提供量身定制的健康信息，并由医疗保健专业人员提供保证。媒体可以通过疫苗教育计划发挥负责任的作用，消除对疫苗接种的社会污名。最后，应继续免费接种疫苗，从而使孟加拉国的 COVID 疫苗接种计划成为其他低收入和中等收入国家的典范。
