Physicians' Intentions to Recommend Influenza Vaccine: A Multi-Centered Hospital-Based Study Using the Theory of Planned Behavior in Bangladesh.

BACKGROUND

Influenza remains a significant public health challenge in low- and middle-income countries (LMICs) like Bangladesh, where vaccine uptake remains low despite the substantial disease burden. Physicians play a vital role in promoting vaccination, yet their intentions and influencing factors are not well understood.

METHODS

We conducted a cross-sectional study from June to October 2022 across four tertiary-level hospitals in Bangladesh using a questionnaire grounded in the Theory of Planned Behavior (TPB). Hierarchical logistic regression was employed to identify factors associated with vaccine recommendation intentions.

RESULTS

Among 972 physicians with an average age of 32.1 years, 40.1% intended to recommend and administer the influenza vaccine. Most (85.3%) agreed vaccination reduces risk, 65.5% desired vaccination for self-protection, 63.5% would vaccinate if available at work, and 85.3% anticipated Ministry of Health support. Male (OR = 1.9, 95% CI: 1.5-2.3) and married (OR = 1.5, 95% CI: 1.1-1.9) physicians were more likely to recommend vaccination. Each unit increase in attitude score doubled the likelihood of recommending the vaccine (OR = 2.0, 95% CI: 1.4-3.0).

CONCLUSIONS

Physicians' influenza vaccine recommendations in Bangladesh are suboptimal, influenced by gender, marital status, and attitudes. Targeted educational interventions addressing attitudinal barriers and leveraging institutional support could improve recommendation practices.