COVID-19 Vaccination Intent and Willingness to Pay in Bangladesh: A Cross-Sectional Study

Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review

The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.

Predicting the intention to receive the COVID-19 booster vaccine based on the health belief model

COVID-19 vaccine boosters are recommended because the protection provided by previous doses eventually decreases, posing a threat to immunity. Some people, however, remain hesitant or unwilling to get vaccinated. The present study sought to investigate factors associated with the intention to receive the COVID-19 booster vaccine based on (1) the constructs of the Health Belief Model, and (2) trust in healthcare workers and science. A sample of 165 adults with two doses of the COVID-19 vaccine were recruited using convenience sampling. Data was collected using an online survey from November 2021 to January 2022. The survey included questions about participants' socio-demographic details, health beliefs, trust, history of COVID-19 vaccination, and the intention to receive a third dose of the COVID-19 vaccine. Ordinal logistic regression analysis showed that higher perceived benefits, severity, and trust in healthcare workers, and lower perceived barriers predicted higher willingness to get a third dose of the vaccine whereas perceived susceptibility and trust in science did not. Understanding the factors and health beliefs that underlie vaccine hesitancy are vital when developing effective interventions with the aim of increasing uptake of COVID-19 booster vaccines.

Surname order and revaccination intentions during the COVID-19 pandemic

Teachers in Japanese schools employ alphabetical surname lists that call students sooner, with surnames appearing early on these lists. We conducted Internet surveys nearly every month from March 2020 to September 2022 with the same participants, wherein we asked participants where the alphabetical columns of their childhood and adult surnames were located. We aimed to identify how surname order is important for the formation of noncognitive skills. During the data collection period, the COVID-19 vaccines became available; Japanese people could receive their third dose starting in December 2021. The 19th wave of the survey was conducted in January 2022. Therefore, to examine how a surname's alphabetical order could influence intention to revaccinate, we used a subsample of data from December 2021 to September 2022. The major findings were as follows. Women with early surnames had an approximately 4% stronger likelihood of having such intentions than men with early surnames. Early name order was more strongly correlated with revaccination intention among women than among men. The surname effect for women was larger when a mixed-gender list was used compared with when it was not used. This effect was only observed for childhood surnames and not for adult surnames.

Parents' willingness to pay for their children's COVID-19 vaccine in Taiwan, China: A cross-sectional study

Most COVID-19 studies aim to assess factors influencing willingness to pay for vaccines between the public and medical staff. However, few studies focus on parents' willingness to pay for their children's COVID-19 vaccine. The current study aimed to assess parents' willingness to pay for their children's vaccination against COVID-19 and its influencing factors. This population-based cross-sectional study used a self-administered questionnaire. The inclusion criterion was parents with at least one child younger than 18 years. The final analysis included 384 valid data points. A total of 89.1% of the parents indicated that they are willing to pay for their children's vaccination against COVID-19. Among them, both fathers' and mothers' willingness to pay for their children's COVID-19 vaccine was 89.6%. The mean and median willingness to pay were% would pay for their children. Excluding other confounding factors, willingness to pay for the COVID-19 vaccine for themselves and hesitation to vaccinate their children were significantly associated with parents' willingness to pay for their children's COVID-19 vaccine. We found that 89.1% of the parents in Taiwan would pay for their children's COVID-19 vaccine. Parents' willingness to pay for themselves and hesitation to vaccinate their children were associated with willingness to pay. Reducing hesitation about vaccines and developing policies for vaccine payment may have a positive impact on willingness to pay for vaccines and promoting COVID-19 vaccination.

The Effects of the Culturally Tailored Narratives on COVID-19 Vaccine Confidence Among Hispanics: A Randomized Online Experiment

Guided by the health belief model (HBM), cultural sensitivity approach, and the theory of situated cognition, this study compares the effects of culturally tailored narratives and generic narratives on the COVID-19 vaccine confidence among Hispanics. It also examines an array of cognitive responses (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived side effects) associated with the COVID-19 vaccine confidence, and the interaction of these cognitive responses with the two narrative types of messaging. The findings suggest that Hispanics exposed to culturally tailored narratives are more confident in the COVID-19 vaccine compared to Hispanics exposed to generic narratives. The study provides support for the HBM, as the perceived benefit was positively related to vaccine confidence, and the perceived barrier was negatively associated with vaccine confidence. Finally, vaccine confidence was the strongest among Hispanics who had high perceived susceptibility and were exposed to culturally tailored narratives.

Potential factors influencing COVID-19 vaccine acceptance and hesitancy among university students in Bangladesh: a cross-sectional comparative study

This study investigated Coronavirus disease 2019 (COVID-19) vaccine acceptance, and compared the potential factors influencing vaccine acceptance and hesitancy between public university (PuU) and private university (PrU) students in Bangladesh. An anonymous, self-administered questionnaire was sent to 640 PuU and 660 PrU students in Google Form between 25th September and 22nd November 2021, which resulted in the participation of 1034 (461 PuU vs. 573 PrU) respondents (response rate: 72.03% vs. 86.81%). The pooled vaccine acceptance rates among PuU and PrU students were almost similar (88.1%, 95% confidence interval (CI) 85.1-91.1 vs. 87.6%, 95% CI 84.6-90.6). Employing binary logistic regression to assess the association between various potential factors and vaccine acceptance, the study revealed that out of 10 predictors, 'safety' and 'efficacy' had highly significant positive associations with vaccine acceptance in both cohorts (P = 0.000, P = 0.005). 'Political roles' was found to have varied effects- a significant (P = 0.02) negative and a significant positive (P = 0.002) association with vaccine acceptance in PuU and PrU students, respectively. Additionally, 'communication' (P = 0.003) and 'trust' (P = 0.01) were found to have significant positive associations in PrU students while 'rumours' (P = 0.03) had negative association in PuU students. The odds of accepting the COVID-19 vaccine were 1.5 vs. 0.9 in PuU and PrU students. Although chi-square analysis did not show any significant association between gender and vaccine acceptance, discrepancies were found in the factors that potentially affect vaccine uptake decision between PuU and PrU students. COVID-19 vaccine uptake may be improved if vaccine-related information becomes available and is communicated to large numbers of people effectively. The implementation of multidisciplinary interventional educational programmes may also be considered as a preferred approach to improve student's engagement in pandemic awareness and vaccine readiness.

Challenges and difficulties faced in low- and middle-income countries during COVID-19

Objectives

The ongoing COVID-19 pandemic, caused by a novel coronavirus SARS-CoV-2, has created a severe threat to global human health. We are extremely lucky because within the first year of the COVID-19 pandemic, scientists developed a number of vaccines against COVID-19. In this paper, the authors discuss the difficulties and challenges faced in different low-and middle-income countries due to the ongoing pandemic.

Study design and methods

This research is primarily based on secondary data and existing literature reviews. The authors use maps and graphical representations to show information about vaccination coverage.

Results

The lacking vaccination coverage and insufficient supply of oxygen tanks in hospitals of low- and middle-income countries (LMICs) raise the likelihood of death of the critical COVID-19 patients. Developed countries vaccinate their citizens more quickly than LMICs. In comparison to wealthy countries, LMICs usually lack the resources and capacity to obtain the required vaccination doses.

Conclusion

It is frequently observed that hospitals in low- and middle-income nations with a dearth of oxygen tanks result in increased suffering and mortality. To avoid a worldwide disaster, LMICs urgently require COVID-19 vaccinations since viruses have no borders, and no one is safe until every one is protected in our interconnected world. Therefore, more national and international collaborative supports are urgently necessary for LMICs in this regard.

Willingness to pay for booster dose of COVID-19 vaccine among healthcare workers in Taizhou,China

PURPOSE

We explored the willingness to pay for booster dose of COVID-19 vaccine among health-care workers in Taizhou, China.

METHODS

A population-based self-administered online questionnaire evaluating the willingness of health-care workers to pay for booster vaccination of COVID-19 vaccine was conducted in Taizhou, China. Of the 1102 health-care workers received the invitation, 1072 (97.3%) had received twice vaccination of COVID-19 vaccine.

RESULTS

There were 1569 (53.1%) out of 1072 health-care workers not willing to pay for thebooster dose of COVID-19 vaccines, 348 (32.5%) were willing to pay less than 100CHY for the booster dose of COVID-19 vaccines, only 155 (14.5%) were willing to pay more than 100 CHY. The factors related to willingness to pay for booster dose of COVID-19 vaccines were education level (c² = 9.42, P = .01) or whether they had adverse effect to COVID-19 vaccines (c² = 11.87, P < .01) .

CONCLUSION

This study found that about half of health-care workers were willing to pay for booster dose of inactivated SARS-CoV-2 vaccines in Taizhou, China, most of them are willing to pay less than 100 CHY. Health-care workers' willingness to pay for booster dose of COVID-19 vaccines were related to sex, education level, whether they had adverse effect to COVID-19 vaccines.

Myth and Misinformation on COVID-19 Vaccine: The Possible Impact on Vaccination Refusal Among People of Northeast Ethiopia: A Community-Based Research

Background

To prevent the spread of COVID-19 and carry out a successful vaccination program especially in low-income countries, people must have faith on scientists and health experts. The most significant challenge to vaccination programs’ efficacy is now regarded to be a lack of information and trust in immunization due to myths and misinformation spread in the community. Therefore, this study aimed to identify the myth and misconceptions that are propagated about the COVID-19 vaccine, the refusal rate of the vaccine and determine the factors associated with COVID-19 vaccine refusal.

Methods

A community-based cross-sectional study was conducted from December 7 to January 25, 2022. Face-to-face interviews with a standardized questionnaire were used to collect data on the variables. Data were entered into the statistical tool Epi data version 3.1 and then exported to SPSS version 25 for analysis. Binary logistic regression, both bivariable and multivariable, was conducted. In the multivariable binary logistic regression model, the adjusted odds ratio with 95% confidence interval was used to declare statistically significant factors based on a p value less than 0.05.

Results

Out of the total 574 respondents, 60.3% [95% CI (55.5, 64.2)] of them refused to take COVID-19 vaccine. In this study, respondent’s age [AOR = 2.1 at 95% CI: (1.8, 4.9)], perception on COVID-19 vaccine [AOR = 3.0 at 95 CI: (1.9, 4.6)], eHealth literacy [AOR = 2.7 at 95% CI: (1.7, 4.1)], source of information about the vaccine [AOR = 2.9 at 95% CI: (1.9, 4.4)], computer literacy [AOR = 2.8 at 95 CI: (1.8, 4.2)] and frequency of internet use [AOR = 2.2 at 95 CI: (1.8, 5.3)] were identified as determinant factors for COVID-19 vaccine acceptance.

Conclusion

Factors like eHealth literacy, source of information about the vaccine, frequency of internet use, respondent’s perception about the vaccine and computer literacy were found to be determinant factors for COVID-19 vaccine acceptance.

Acceptance towards COVID-19 vaccination in Latin America and the Caribbean: A systematic review and meta-analysis

INTRODUCTION

Vaccination represents an important strategy to mitigate COVID-19 related morbidity and mortality by protecting against severe forms of the disease and reducing hospitalization and death rates. In this sense, the objective of this study is to estimate the prevalence of Vaccination Intention (VI) against COVID-19 in Latin America and Caribbean (LAC).

METHODS

We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention to vaccines against COVID-19 in LAC countries. The Clopper-Pearson method was used to estimate 95% Confidence Intervals. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. A subgroup analysis by study location and a sensitivity analysis were developed.

RESULTS

Nineteen cross-sectional studies were included. Five meta-analyzes were performed according to the target population of the included studies. The VI in the general population of LAC was 78.0% (95%CI: 74.0%-82.0%). The VI for non-pregnant women was 78.0% (95%CI: 58.0%-99.0%), for elderly population was 63.0% (95%CI: 59.0%-69.0%), for pregnant women was 69.0% (95%CI: 61.0%-76.0%) and for health-personnel was 83.0% (95% CI: 71.0%-96.0%). The sensitivity analysis for general population meta-analysis that included only low risk of bias studies showed a 77.0% VI (95%CI: 73.0%-82.0%) and for non-pregnant women, 85.0% VI (95%CI: 79.0%-90.0%).

CONCLUSION

Despite the high prevalence of VI in general population found in our study, VI prevalence from elderly people and pregnant women are lower than other population groups and overall population.

Study of the Side Effects of Pfizer and Oxford COVID-19 Vaccines in the Eastern Province of Saudi Arabia

Background & Objective

The COVID-19 pandemic imposed global concern and became one of the deadliest pandemics of the twenty-first century. Several vaccines were developed against SARS-CoV-2 to counteract the effects of this virus. This study aims to determine the post-vaccination side effects of the most common COVID-19 vaccines used in the Eastern province of Saudi Arabia.

Methods

This is a cross-sectional study using an online questionnaire distributed randomly through social media. Frequencies were calculated to determine participants’ demographic information, vaccination details, and post-vaccination side effects. Univariate and multiple regression analysis were applied to test the association between individuals’ willingness to receive a booster dose and different categorical variables.

Results

A total of 1004 participants were included in the survey, of which 0.6%, 85.3% and 14.1% completed either one, two or three doses of the Pfizer mRNA vaccine and Oxford AstraZeneca vaccines, respectively. The similar common side effects between the first and the second doses were significantly associated with the type of vaccine received; these included fatigue (Pfizer 54.4%, Oxford 73.2%; p < 0.001), headache (Pfizer 33.2%, Oxford 44.7%; p = 0.002), and fever (Pfizer 25.1%, Oxford 57.6%; p < 0.001). Additionally, unusual side effects were also reported (palpitations and menstrual abnormalities). Getting SARS-CoV2 infection after vaccination was significantly associated with the type of vaccine received at the first dose (Chi-Square=5.496, p = 0.019). A statistically significant association was found between the individuals’ willingness to receive a booster dose and their gender (Chi-Square = 39.493, p < 0.001), age (Chi-Square = 11.668, p = 0.02), presence of allergies (Chi-Square = 5.602, p = 0.018), and previous COVID-19 infection (Chi-Square = 9.495, p = 0.002).

Conclusion

Despite the described side effects, further studies should be done to investigate the unusual and rare side effects to assess COVID-19 vaccines effectiveness and safety over longer period of time within a more diverse population.

Factors associated with intention to take COVID-19 vaccine among the university students in Bangladesh

Purpose

This study examined the Bangladeshi university students' intention to take coronavirus disease 2019 (COVID-19) vaccines by assessing the Health Belief Model and Theory of Planned Behavior.

Materials and Methods

University students were queried on their intention to take COVID-19 vaccines. The sample used in this study (n=310) was obtained through an online survey among university students (age, 18-25 years old) from August 7 to September 18, 2021.

Results

Although over 90% of respondents showed their willingness to take the COVID-19 vaccine, around 37.3% of respondents still desired to wait and see to take the vaccine. The most frequently cited reasons for vaccines hesitancy were concerns over side effects (62.4%). There is still an unmet need for adequate information on COVID-19 vaccines (81.4%). Results of the binary logistic regression model showed that students from private universities (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.04-0.97), respondents who concerned about the vaccine safety (OR, 0.07; 95% CI, 0.01-0.44) and side effects of vaccine (OR, 0.21; 95% CI, 0.05-0.89) were less willing to take COVID-19 vaccine. On the other hand, desire to wait to take COVID-19 vaccines was associated with marital status (OR, 7.76; 95% CI, 1.50-40.27); COVID-19 preventive behavior, including use of facemask (OR, 0.25; 95% CI, 0.09-0.70) and maintain social distance (OR,1.75; 95% CI, 1.00-3.07); COVID-19 infection (OR, 0.50; 95% CI, 0.26-0.99); provide more information on vaccines (OR, 2.32; 95% CI, 1.06-5.09); the perceived side effects (OR, 2.82; 95% CI, 1.54-5.17); and effectiveness of COVID-19 vaccines (OR, 2.41; 95% CI, 1.16-5.01).

Conclusion

Public health managers should provide adequate information on COVID-19 vaccines to address the concerns about the safety and side effects of the vaccines.

Beliefs, barriers and hesitancy towards the COVID-19 vaccine among Bangladeshi residents: Findings from a cross-sectional study

Background

COVID‐19 vaccination acceptance is important, and combating hesitancy which is generally based on the individuals’ beliefs and perceptions is essential in the present pandemic. This study assesses COVID‐19 vaccine hesitancy and associated factors, beliefs and barriers associated with COVID-19 vaccination.

Methods

A cross-sectional study was carried out among 492 Bangladeshi residents (76% male; mean age = 24.21 ± 4.91 years; age range = 18–50 years) prior to the nationwide mass COVID-19 vaccination campaign (September 28, 2021). A semi-structured e-questionnaire included three sections (demographic variables, beliefs around the vaccination, and perceived barriers regarding COVID-19 vaccination).

Results

More than a quarter of participants (26.42%) were hesitant, 70.33% reported to accept the vaccine, and 3.25% refused to be vaccinated. While (54%) believed that mass vaccination would be the most effective method to combat the COVID-19 pandemic, concerns regarding the side effects of the vaccine (58%), inadequate vaccine trials before human administration (43%), commercial profiteering (42%), and mistrust of the benefits of the vaccine (20%) were also reported. In addition, other barriers including a short supply of vaccines, unknown future adverse effects (55%), low confidence in the health system (51%), doubts regarding its effectiveness (50%) and safety (45%), and insufficient information regarding potential adverse effects (44.7%) were reported. In bivariate analysis, variables such as current political affiliation, previous vaccination history, and health status were significantly associated with the COVID-19 vaccine uptake variable (acceptance, hesitancy, refusal). Regression analysis showed that participants who identified with the opposing current political parties, and not having been vaccinated since the age of 18 years were significantly more likely to report vaccine hesitancy.

Conclusions

The current findings relating to COVID-19 vaccination demonstrate that government and policy makers need to take all necessary measures to ensure the effectiveness of the vaccination program among the Bangladeshi people.

Vaccination Intention against COVID-19 among the Unvaccinated in Jordan during the Early Phase of the Vaccination Drive: A Cross-Sectional Survey

Objective: This study assessed the intention and predictors of accepting the corona virus disease 2019 (COVID-19) vaccine in Jordan. Method: A national-level online survey was conducted among adults (≥18 years) in Jordan between June and September 2021. Descriptive analyses were performed to report vaccination intent. In addition, bivariate and multivariate logistic regression analyses were done to evaluate the association between vaccination intent and its predictors. Results: A total of 2307 adults participated. Most of them (83.7%) expressed an intention to receive a COVID-19 vaccine. Their vaccination intention was significantly (p < 0.001) associated with male gender (aOR: 2.6), residence in the Amman region (aOR: 51.8), and no history of COVID-19 infection (aOR: 6.0). In contrast, individuals aged 50-64 years (aOR: 0.2, p < 0.001), Jordanians (aOR: 0.7, p = 0.038), and those with an occupation designated as “other” (unemployed, general workers, housewives) (aOR: 0.2, p < 0.001) were less likely to have a positive vaccination intent. Among the health belief model constructs, perceived future (aOR: 2.8) and present (aOR: 5.0) susceptibility to COVID-19 infection; severity of complications (aOR: 9.9); and benefits (aOR: 100.8) were significantly (p < 0.001) associated with a higher likelihood of having a vaccination intent. On the other hand, individuals who are concerned about the efficacy (aOR: 0.2) and side effects (aOR: 0.2) of the vaccine were less likely to have a positive vaccination intent (p < 0.001). Conclusion: Despite having high rates of intention to receive a COVID-19 vaccine, Jordanians, older adults and housewives, general workers and unemployed individuals were less likely to be vaccinated. These findings highlight that need-based public health campaigns are necessary to ensure maximum COVID-19 vaccination uptake in Jordan.

Experience of Bangladeshi Dental Students towards Online Learning during the COVID-19 Pandemic: A Web-Based Cross-Sectional Study

Background: During the COVID-19 pandemic, dental education institutions throughout the world experienced significant challenges, including a quick shift to an online learning paradigm. Since the pandemic has had a considerable impact on dental education, this research evaluated the perspectives and attitudes towards online learning among undergraduate dental students in Bangladesh. Methods: The research was conducted through a cross-sectional method using self-administered online questionnaires. The questionnaire included information on the students’ sociodemographic status, their views, and their attitudes about the changes in the educational system, specifically regarding online learning. The study gathered data from 952 undergraduate students from 14 dental institutions in Bangladesh. Results: The results suggested that 87.5% of all the students were unsatisfied with their online programs. Most of the respondents who expressed dissatisfaction with their online classes were female, did not receive assistance in overcoming barriers to accessing the classes or materials (64.23%), did not have access to the institutional online-learning management system (OLMS) (67.35%), and did not have access to the online course materials (71.43%). The students considered that the shift to online learning failed to provide quality clinical teaching. Conclusions: The lack of an OLMS was found to be linked with dissatisfaction with online learning among Bangladeshi dental students during the COVID-19 outbreak. Additionally, insufficient time allocation and a lack of support through online training were found to be strongly correlated with the students’ discontent. The overall findings highlight the need to develop and implement effective online dentistry educational interventions to promote academic advancement and key practical skills.

Prevalence of COVID-19 vaccine reactogenicity among Bangladeshi physicians

Increased COVID-19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID-19 pandemic. This study was designed to estimate the prevalence of adverse events after the first dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross-sectional study was conducted using an online questionnaire for physicians (n = 916) in Bangladesh. Physicians who received at least one dose of the COVID-19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents (n = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine-related reactogenicities were reported by the younger cohorts (<45 years). The majority of respondents reported severity of reactogenicity as "mild," experienced on the day of vaccination, and lasting for 1-3 days. The most common reactogenicity was pain at the injection site; the second most common was tiredness. Almost half (49.2%) of the physicians took acetaminophen (paracetamol) to minimize the effects of vaccine reactogenicity. Multivariate logistic regression analyses showed that physicians with diabetes and hypertension (OR = 2.729 95% CI: 1.282-5.089) and asthma with other comorbidities (OR = 1.885 95% CI: 1.001-3.551) had a significantly higher risk of vaccine-related reactogenicities than physicians without comorbidities. Further safety studies with larger cohorts are required to monitor vaccine safety and provide assurance to potential vaccine recipients.

Attitudes and Beliefs of the Italian Population towards COVID-19 Vaccinations

Background: Despite the numerous campaigns to encourage vaccination against COVID-19, the public debate and often conflicting information have left many individuals uncertain about the decision to make on whether or not to vaccinate. Methods: This research aims to analyze the attitudes and beliefs of the Italian population towards COVID-19 and other vaccinations through a quantitative methodology. In all, 500 adults (Age M = 39.52) participated in this exploratory study with an online questionnaire conducted in April 2021. Results: most participants believe vaccination is necessary to defeat COVID-19; there is an age-related difference in getting vaccinations, and women were more afraid of unexpected future effects than men; older participants have expressed a greater willingness to pay to be vaccinated against COVID-19 (4). Conclusion: In light of these results, it is necessary to pay greater attention to the perplexity and fears expressed by the population, especially women and youth, in relation to vaccinations; in fact, it would help to achieve a wider adherence to the tools designed to contain the spread of viruses at the base of severe health crises.

COVID-19 Vaccination: Willingness and practice in Bangladesh

Motivation

Mass adult immunization for COVID-19, coupled with the urgency, is a challenge for any lower-middle-income country (LMIC) like Bangladesh. Our analysis focuses on demand-side constraints early in the vaccination campaign to help gauge vaccine acceptability and potential contributing factors. Identifying registration and compliance challenges early on will help ensure a seamless immunization programme.

Purpose

We seek to identify subgroups who may need specific interventions by comparing willingness to be vaccinated and registration behaviour, and to understand how actual registration and take-up decisions compare between rural and urban slum regions.

Approach and Methods

We use data from three surveys conducted between late January and early September 2021. The article includes a nationally representative survey on vaccine acceptability and a study on vaccination rollout behaviour in rural and urban slums.

Findings

Willingness was not an issue in Bangladesh, but the weak link was getting individuals to register. Once they did, compliance was very high. When the information gap regarding registration was addressed by campaigning, registration and take-up increased. Confidence in public service delivery influenced favourable responses to mass immunization efforts. Women were falling behind initially in terms of both registration knowledge and completion. Online registration needed to be complemented with alternatives. Social networking was a vital source of information and encouragement.

Policy implications

Communication strategies are necessary to inform the public at an early stage, which should provide information about registration eligibility and detailed registration instructions. Ensuring and sustaining service quality will also be beneficial. In LMICs like Bangladesh, low-tech intensive registration methods are required. Information campaigns about the registration procedure should specifically target rural communities and women. Community-based mechanisms may reduce transaction costs and increase confidence.

Acceptance of COVID-19 Booster Vaccination Based on the Protection Motivation Theory (PMT): A Cross-Sectional Study in China

The promotion of the booster shots against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is an open issue to be discussed. Little is known about the public intention and the influencing factors regarding the booster vaccine. A cross‐sectional survey in Chinese adults was conducted using an online questionnaire, which designed on the basis of protection motivation theory (PMT) scale and vaccine hesitancy scale (VHS). Hierarchical multiple regression was used to compare the fitness of the PMT scale and VHS for predicting booster vaccination intention. Multivariable logistic regression was used to analyze the factors associated with the acceptance. Six thousand three hundred twenty‐one (76.8%) of participants were willing to take the booster shot. However, the rest of the participants (23.2%) were still hesitant to take the booster vaccine. The PMT scale was more powerful than the VHS in explaining the vaccination intention. Participants with high perceived severity (adjusted odds ratio [aOR] = 0.69) and response cost (aOR = 0.47) were less willing to take the booster shots, but participants with high perceived susceptibility (aOR = 1.19), response efficacy (aOR = 2.13), and self‐efficacy (aOR = 3.33) were more willing to take the booster shots. In summary, interventions based on PMT can provide guidance to ensure the acceptance of the booster vaccine.

Willingness to receive the COVID-19 vaccine and associated factors among residents of Southwestern Ethiopia: A cross-sectional study

Introduction

The COVID-19 vaccine is a key intervention toward containing the pandemic. Vaccines are thought to be a form of defense. One of the major challenges to managing the COVID-19 pandemic is the uncertainty or willingness to accept vaccinations. Our study aimed willingness to get the COVID-19 vaccine and the factors that influence it in Mettu Woreda, Ilu Ababor Zone, Ethiopia.

Methodology

Cross-sectional study design was conducted from August 1, 2021, to September 1, 2021, among rural residents of Mettu woreda's of Ilu Ababor Zone, Oromia, Ethiopia. The semi-structured data collection format was prepared to assess the magnitude of the communities' acceptance of the COVID-19 vaccine. A multivariable logistic regression analysis was used to determine the predictors of communities' acceptance of the COVID-19 vaccine at 95% CI.

Results

Of 350 participants from the study area, 59% of them were males and 41% females. Less than one-third (29.8%) of participants were willing to accept the COVID-19 vaccine. The results multivariable logistic regression revealed that the age group of ≥50 years (OR=0.29; 95% CI: -3.1-0.34) as compare with the 18-29 years, low monthly income (OR=0.85; 95% CI: -0.74-2.33), low perception level (OR=0.35; 95% CI: -2.03-0.24), government unemployed (OR=0.86; 95% CI: -0.72-0.1), low Level of acceptance (OR=0.72; 95% CI: -0.67, 0.08) and unwillingness to test COVID-19 (OR=0.13; 95% CI: -4.47, 0.58) were predictors of willingness to receive COVID-19 vaccine.

Conclusion

Less than one-third of the study, participants were willing to accept the COVID-19 vaccine. The likelihood of Willingness to accept the COVID-19 vaccine was low in the study area. Overall; low education, low vaccination perception, low income, jobless occupation, older age, and unwillingness to test for COVID-19 were associated with greater willingness to take the COVID-19 vaccine and are significantly associated with willingness to get the COVID-19 immunization.

Acceptance of COVID-19 Vaccine among Unvaccinated Filipinos

Background: Access to COVID-19 vaccines was one of the global measures for containing the COVID-19 pandemic. However, it is still not known whether Filipinos accept it.  Methods: Cross-sectional study based on a modified version of the community COVID-19 vaccine acceptance survey, disseminated and collected through Google Forms to Filipinos within the Philippines aged 18-65 years old. Multinomial logistic regression analysis was performed to determine the association between the willingness to be vaccinated and sociodemographic characteristics using odds ratios (OR) with 95% confidence intervals (95%CI).  Results: Among the 1,011 participants, 79.5% were willing to accept the COVID-19 vaccine. Significant determinants (p<0.05) were age, region of residence, sex, profession, income, religion, practice of alternative medicine, and previous contact with COVID-19 positive individuals. Essential healthcare workers (OR=11.0, 95%CI=1.3-93.5), practiced alternative medicine (OR=2.4, 95%CI=1.3-4.4), with previous contact with a COVID-19 positive person (OR=2.9, 95%CI=1.4-6.0), and females>males (OR=0.6, 95%CI=.3-1.0) were also more likely to accept COVID-19 vaccination. 63.7% preferred Pfizer the most, and 54.4% preferred Sinovac the least. In contrast, married individuals, essential non-healthcare workers and private/self-employed sectors were less likely to accept COVID-19 vaccines. Many individuals who refused to be vaccinated were unsure of its safety (59.70%) and had no trust in vaccines (56.50%). Conclusion: Despite a high prevalence of acceptance of the COVID-19 vaccine in our study, there were significant sociodemographic disproportions in vaccine acceptance. Better policies urging Filipinos to get vaccinated and more effective dissemination of unified information regarding vaccines from verified sources are recommended to boost vaccine confidence in the Philippines.

Environmental benefits of blue ecosystem services and residents' willingness to pay in Khulna city, Bangladesh

Nature-based solutions for urban problems gaining popularity globally. The well-functioning ecosystem could offer a nature-based solution to many urban problems including water, drainage and flooding problems. Therefore, conservation and restoration of urban blue ecosystem components such as pond scape are crucial. This research taking Khulna city of Bangladesh as a case has examined the low-income fringe community's willingness to pay (WTP) for conservation and restoration of pond scape/blue ecosystem service (BES) in their locality from where they benefit. The various types of ecosystem services enjoyed by the local community were identified. To assess the community's WTP for conservation and restoration of pond scape, the payment card approach of the Contingent Valuation Method (CVM) was used. Three environmental attributes were considered to assess the existing condition of the blue ecosystem services in the study area. Findings show that 54% of respondents are not satisfied with the existing conditions of the ecosystem services resulting from the pond scape. Respondent's WTP for eleven types of service facilities was calculated. Results show that only 65.20% are eager to pay an amount of 38 Tk to 138 Tk per month for different service facilities. It means about one-third of the community people want to be free riders. The influences of different attributes of the respondents on their WTP were also analyzed. Education, income, and house-ownership appear to have a positive significant influence on WTP for conservation and restoration of pond scape in the study area. In line with the findings if policy measures are taken without further delay it would help conserve the remaining pond scape.

Willingness-to-pay for COVID-19 vaccine in ten low-middle-income countries in Asia, Africa and South America: A cross-sectional study

Vaccine hesitancy is considered as one of the greatest challenges to control the ongoing coronavirus disease 2019 (COVID-19) pandemic. A related challenge is the unwillingness of the general public to pay for vaccination. The objective of this study was to determine willingness-to-pay (WTP) for COVID-19 vaccine among individuals from ten low- middle-income countries (LMICs) in Asia, Africa, and South America. Data were collected using an online questionnaire distributed during February - May 2021 in ten LMICs (Bangladesh, Brazil, Chile, Egypt, India, Iran, Nigeria, Pakistan, Sudan, and Tunisia). The major response variable of in this study was WTP for a COVID-19 vaccine. The assessment of COVID-19 vaccine hesitancy was based on items adopted from the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) vaccine hesitancy scale constructs. In this study, 1337 respondents included in the final analysis where the highest number of respondents was from India, while the lowest number was from Egypt. A total of 88.9% (1188/1337) respondents were willing to pay for the COVID-19 vaccination, and 11.1% (149/1337) were not. The average WTP for COVID-19 vaccination was 87.9 US dollars ($), (range: $5-$200). The multivariate model analysis showed that the country, monthly household income, having a history of respiratory disease, the agreement that routine vaccines recommended by health workers are beneficial and having received the flu vaccination within the previous 12 months were strongly associated with the WTP. Based on the country of origin, the highest mean WTP for COVID-19 vaccine was reported in Chile, while the lowest mean WTP for the vaccine was seen among the respondents from Sudan. The availability of free COVID-19 vaccination services appears as a top priority in the LMICs for successful control of the ongoing pandemic. This is particularly important for individuals of a lower socio- economic status. The effects of complacency regarding COVID-19 extends beyond vaccine hesitancy to involve less willingness to pay for COVID-19 vaccine and a lower value of WTP for the vaccine.

Optimization of COVID-19 vaccination and the role of individuals with a high number of contacts: A model based approach

We report strong evidence of the importance of contact hubs (or superspreaders) in mitigating the current COVID-19 pandemic. Contact hubs have a much larger number of contacts than the average in the population, and play a key role on the effectiveness of vaccination strategies. By using an age-structures compartmental SEIAHRV (Susceptible, Exposed, Infected symptomatic, Asymptomatic, Hospitalized, Recovered, Vaccinated) model, calibrated from available demographic and COVID-19 incidence, and considering separately those individuals with a much greater number of contacts than the average in the population, we show that carefully choosing who will compose the first group to be vaccinated can impact positively the total death toll and the demand for health services. This is even more relevant in countries with a lack of basic resources for proper vaccination and a significant reduction in social isolation. In order to demonstrate our approach we show the effect of hypothetical vaccination scenarios in two countries of very different scales and mitigation policies, Brazil and Portugal.

Progress and Challenges Toward Generation and Maintenance of Long-Lived Memory T Lymphocyte Responses During COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) pandemic is a serious global threat until we identify the effective preventive and therapeutic strategies. SARS-CoV-2 infection is characterized by various immunopathological consequences including lymphocyte activation and dysfunction, lymphopenia, cytokine storm, increased level of neutrophils, and depletion and exhaustion of lymphocytes. Considering the low level of antibody-mediated protection during coronavirus infection, understanding the role of T cell for long-term protection is decisive. Both CD4⁺ and CD8⁺ T cell response is imperative for cell-mediated immune response during COVID-19. However, the level of CD8⁺ T cell response reduced to almost half as compared to CD4⁺ after 6 months of infection. The long-term protection is mediated via generation of immunological memory response during COVID-19. The presence of memory CD4⁺ T cells in all the severely infected and recovered individuals shows that the memory response is predominated by CD4⁺ T cells. Prominently, the antigen-specific CD4⁺ and CD8⁺ T cells are specifically observed during day 0 to day 28 in COVID-19-vaccinated individuals. However, level of antigen-specific T memory cells in COVID-19-vaccinated individuals defines the long-term protection against forthcoming outbreaks of SARS-CoV-2.

Infection and vaccination status of COVID-19 among healthcare professionals in academic platform: Prevision vs. reality of Bangladesh context

COVID-19 posed the healthcare professionals at enormous risk during this pandemic era while vaccination was recommended as one of the effective preventive approaches. It was visualized that almost all health workforces would be under vaccination on a priority basis as they are the frontline fighters during this pandemic. This study was designed to explore the reality regarding infection and vaccination status of COVID-19 among healthcare professionals of Bangladesh. It was a web-based cross-sectional survey and conducted among 300 healthcare professionals available in the academic platform of Bangladesh. A multivariate logistic regression model was used for the analytical exploration. Adjusted and Unadjusted Odds Ratio (OR) with 95% confidence intervals (95% CI) were calculated for the specified setting indicators. A Chi-square test was used to observe the association. Ethical issues were maintained according to the guidance of the declaration of Helsinki. Study revealed that 41% of all respondents identified as COVID-19 positive whereas a significant number (18.3%) found as non-vaccinated due to registration issues as 52.70%, misconception regarding vaccination as 29.10%, and health-related issues as 18.20%. Respondents of more than 50 years of age found more significant on having positive infection rather than the younger age groups. Predictors for the non-vaccination guided that male respondents (COR/p = 3.49/0.01), allied health professionals, and respondents from the public organizations (p = 0.01) who were ≤29 (AOR/p = 4.45/0.01) years of age significantly identified as non-vaccinated. As the older female groups were found more infected and a significant number of health care professionals found as non-vaccinated, implementation of specific strategies and policies are needed to ensure the safety precautions and vaccination among such COVID-19 frontiers.

Interrogating COVID-19 vaccine intent in the Philippines with a nationwide open-access online survey

To mitigate the unprecedented health, social, and economic damage of COVID-19, the Philippines is undertaking a nationwide vaccination program to mitigate the effects of the global pandemic. In this study, we interrogated COVID-19 vaccine intent in the country by deploying a nationwide open-access online survey, two months before the rollout of the national vaccination program. The Health Belief Model (HBM) posits that people are likely to adopt disease prevention behaviors and to accept medical interventions like vaccines if there is sufficient motivation and cues to action. A majority of our 7,193 respondents (62.5%) indicated that they were willing to be vaccinated against COVID-19. Moreover, multivariable analysis revealed that HBM constructs were associated with vaccination intention in the Philippines. Perceptions of high susceptibility, high severity, and significant benefits were all good predictors for vaccination intent. We also found that external cues to action were important. Large majorities of our respondents would only receive the COVID-19 vaccines after many others had received it (72.8%) or after politicians had received it (68.2%). Finally, our study revealed that most (21%) were willing to pay an amount of PHP 1,000 (USD20) for the COVID-19 vaccines with an average willing-to-pay amount of PHP1,892 (USD38).

Factors affecting intention to take COVID-19 vaccine among Pakistani University Students

BACKGROUND

Widespread vaccination coverage is essential for reducing the COVID-19 havoc and regarded as a crucial tool in restoring normal life on university campuses. Therefore, our research aimed to understand the intention to be vaccinated for COVID-19 among Pakistani university students.

METHODS

This cross-sectional study was conducted in five administrative units of Pakistan, i.e., Punjab, Sindh, Balochistan, Azad Jammu and Kashmir, and Khyber Pakhtunkhwa. We obtained data from 2,865 university students between 17th January and 2nd February, 2021, using a semi-structured and self-administered questionnaire. We used Stata (version 16.1, StataCorp LLC) for data management and analysis.

RESULTS

The majority (72.5%) of our respondents were willing to take COVID-19 vaccine. The current level of education had a statistically significant relationship with the intention to be vaccinated (p < 0.05). Respondents answered 11 questions encompassing five different domains of the Health Belief Model (HBM). All the items of HBM were significantly associated with the positive intention towards receiving the vaccine (p < 0.05). We conducted a multivariable logistic regression analysis to assess the relative contribution of different factors towards the intention to receive COVID-19 vaccine. Multiple factors such as belief that vaccination should be mandatory for everyone (AOR: 3.99, 95% CI: 3.20-4.98) and willingness to take vaccine even if it is not free (AOR: 3.91, 95% CI: 3.18-4.81) were observed to be associated with high odds of showing willingness to be vaccinated against COVID-19.

CONCLUSION

Most of our study participants intended to take vaccines based on their belief regarding the high effectiveness of COVID-19 vaccine. But as rumor-mongers are generating and spreading conspiracy theories daily, the health department and policymakers need to undertake evidence-based campaigns through electronic and social media to ensure expected countrywide vaccination coverage. In this case, our study findings can serve as a foundation for them to ensure mass vaccination coverage among university students, which is crucial now to reopen the dormitories and restore everyday life on campuses.

COVID-19 vaccine hesitancy in the UK: a longitudinal household cross-sectional study

BACKGROUND

The approved COVID-19 vaccines have shown great promise in reducing disease transmission and severity of outcomes. However, the success of the COVID-19 vaccine rollout is dependent on public acceptance and willingness to be vaccinated. In this study, we aim to examine how the attitude towards public sector officials and the government impact vaccine willingness. The secondary aim is to understand the impact of ethnicity on vaccine-willingness after we explicitly account for trust in public institutions.

METHODS

This cross-sectional study used data from a UK population based longitudinal household survey (Understanding Society COVID-19 study, Understanding Society: the UK Household Longitudinal Study) between April 2020-January 2021. Data from 22,421 participants in Waves 6 and 7 of the study were included after excluding missing data. Demographic details in addition to previous survey responses relating to public sector/governmental trust were included as covariates in the main analysis. A logit model was produced to describe the association between public sector/governmental mistrust and the willingness for vaccination with interaction terms included to account for ethnicity/socio-economic status.

RESULTS

In support of existing literature, we identified those from BAME groups were more likely to be unwilling to take the COVID-19 vaccine. We found that positive opinions towards public sector officials (OR 2.680: 95% CI 1.888 - 3.805) and the UK government (OR 3.400; 95% CI 2.454-4.712) led to substantive increase in vaccine willingness. Most notably we identified this effect to vary across ethnicity and socio-economic status with those from South Asian background (OR 4.513; 95% CI 1.012-20.123) and possessing a negative attitude towards public officials and the government being the most unwilling to be vaccinated.

CONCLUSIONS

These findings suggests that trust in public sector officials play a key factor in the low vaccination rates particularly seen in at-risk groups. Given the additional morbidity/mortality risk posed by COVID-19 to those from lower socio-economic or ethnic minority backgrounds, there needs to be urgent public health action to review how to tailor health promotion advice given to these groups and examine methods to improve trust in public sector officials and the government.

COVID-19 vaccine acceptance among Bangladeshi adults: Understanding predictors of vaccine intention to inform vaccine policy

OBJECTIVES

The purpose of this study was to identify predictors of COVID-19 vaccine intention among Bangladeshi adults.

METHODS

Secondary data from the COVID-19 Beliefs, Behaviors & Norms Survey conducted by the Massachusetts Institute of Technology (MIT) and Facebook were analyzed. Data were collected from 2,669 adult Facebook users in Bangladesh and was collected between February 15 and February 28, 2021. Binomial logistic regression examined the relationship between COVID-19 vaccination intent and demographic variables, risk perception, preventive behaviors, COVID-19 knowledge, and likelihood of future actions.

RESULTS

Seventy-nine percent of respondents reported intent to get the COVID-19 vaccine when it becomes available. Intent to get vaccinated was highest among females, adults aged 71-80, individuals with college or graduate-level degrees, city dwellers, and individuals who perceived that they were in excellent health. Results of the binomial logistic regression indicated that predictors of vaccination intent include age (OR = 1.39), high risk perception of COVID-19 (OR = 1.47), and intent to practice social distancing (OR = 1.22).

DISCUSSION

Findings suggest that age, perceived COVID-19 risk, and non-pharmaceutical COVID-19 interventions may predict COVID-19 vaccination intent among Bangladeshi adults. Findings can be used to create targeted messaging to increase demand for and uptake of COVID-19 vaccines in Bangladesh.

Sharia (Islamic Law) Perspectives of COVID-19 Vaccines

The Coronavirus disease 2019 (COVID-19) pandemic has caused health, economic, and social challenges globally. Under these circumstances, effective vaccines play a critical role in saving lives, improving population health, and facilitating economic recovery. In Muslim-majority countries, Islamic jurisprudence, which places great importance on sanctity and safety of human life and protection of livelihoods, may influence vaccine uptake. Efforts to protect humans, such as vaccines, are highly encouraged in Islam. However, concerns about vaccine products’ Halal (permissible to consume by Islamic law) status and potential harm can inhibit acceptance. Fatwa councils agree that vaccines are necessary in the context of our current pandemic; receiving a COVID-19 vaccination is actually a form of compliance with Sharia law. Broader use of animal component free reagents during manufacturing may further increase acceptance among Muslims. We herein explain the interplay between Sharia (Islamic law) and scientific considerations in addressing the challenge of COVID-19 vaccine acceptance, particularly in Muslim populations.

COVID-19 vaccine hesitancy among the adult population in Bangladesh: A nationwide cross-sectional survey

INTRODUCTION

Studies related to the COVID-19 vaccine hesitancy are scanty in Bangladesh, despite the growing necessity of understanding the population behavior related to vaccination. 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.

METHODS AND MATERIALS

This study adopted a cross-sectional design to collect data from 1497 respondents using online (Google forms) and face-to-face interviews from eight administrative divisions of Bangladesh between 1-7 February 2021. We employed descriptive statistics and multiple logistic regression analysis.

RESULTS

The prevalence of vaccine hesitancy was 46.2%. The Muslims (aOR = 1.80, p ≤ 0.01) and the respondents living in the city corporation areas (aOR = 2.14, p ≤0.001) had more hesitancy. There was significant variation in vaccine hesitancy by administrative divisions (geographic regions). Compared to the Sylhet division, the participants from Khulna (aOR = 1.31, p ≤0.001) had higher hesitancy. The vaccine hesitancy tended to decrease with increasing knowledge about the vaccine (aOR = 0.88, p≤0.001) and the vaccination process (aOR = 0.91, p ≤ 0.01). On the other hand, hesitancy increased with the increased negative attitudes towards the vaccine (aOR = 1.17, p≤0.001) and conspiracy beliefs towards the COVID-19 vaccine (aOR = 1.04, p≤0.01). The perceived benefits of COVID-19 vaccination (aOR = 0.85, p≤0.001) were negatively associated with hesitancy, while perceived barriers (aOR = 1.16, p ≤0.001) were positively associated. The participants were more hesitant to accept the vaccine from a specific country of origin (India, USA, Europe).

CONCLUSIONS

Our findings warrant that a vigorous behavior change communication campaign should be designed and implemented to demystify negative public attitudes and conspiracy beliefs regarding the COVID-19 Vaccine in Bangladesh. The policymakers should also think about revisiting the policy of the online registration process to receive the COVID-19 vaccine, as online registration is a key structural barrier for many due to the persistent digital divide in the country. Finally, the government should consider the population's preference regarding vaccines' country of manufacture to reduce the COVID-19 vaccine hesitancy.

Impact of second wave of COVID-19 pandemic on the hesitancy and refusal of COVID-19 vaccination in Puducherry, India: a longitudinal study

The second wave of COVID-19 pandemic has spread rampantly throughout India between April and May 2021, leading to high mortality rates. Identifying any change in the rate of vaccine hesitancy or refusal due to such mass casualty events will provide further insights on developing appropriate risk communication strategy. Hence, this study was undertaken to identify the vaccine hesitancy and refusal before and during the second wave of COVID-19 pandemic. We conducted a longitudinal study among 900 adults to know about their vaccine hesitancy and refusal pattern before (March 2021 - round-1) and during the second wave of COVID-19 pandemic (May 2021 - round-2). Telephonic interview was conducted using the pre-tested semi-structured questionnaire. There was an increase in the vaccine hesitancy (27.8% in round-1 to 32.7% in round-2) and refusal (25.6% in round-1 to 35.6% in round-2) during the second wave of pandemic in Puducherry. In adjusted analysis, vaccine hesitancy was found to increase by 1.19 times during the round-2 survey compared to round-1 survey (aIRR = 1.19; 95%CI: 1.03-1.37). We also found that the vaccine refusal increased by 1.40 times during the round-2 survey compared to round-1 survey (aIRR = 1.40; 95%CI: 1.22-1.62) after adjusting for age, place of residence, and occupation. We found that the confidence in COVID-19 vaccine efficacy and safety has declined over time leading to increase in the vaccine hesitancy and refusal in our study cohort, with more than one-third refusing to get themselves vaccinated during the second wave of pandemic.

Determinants of COVID-19 Vaccine Acceptance among the Adult Population of Bangladesh Using the Health Belief Model and the Theory of Planned Behavior Model

Vaccination is undoubtedly one of the most effective strategies to halt the COVID-19 pandemic. The current study aimed to investigate the acceptance of COVID-19 vaccination and its associated factors using two health behavior change frameworks: the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). A total of 639 Bangladeshi adults (mean age: 24 years) participated in a cross-sectional online study between July and August 2021. The questionnaire covered questions regarding vaccine intentions, sociodemographic features, health status, perceived trust in/satisfaction with health authorities, reasons for vaccine hesitancy, and factors related to the health behavior change frameworks. Hierarchical logistic regression was employed to determine associations between these predictors and vaccine acceptance. The intention to get a COVID-19 vaccination was expressed among 85% of the participants. In fully adjusted models, students and respondents with more normal body weights reported higher intentions to get vaccinated. Respondents were also more likely to seek vaccination if they reported greater levels of perceived susceptibility, benefits, and cues to action, as well as lower levels of barriers and self-efficacy. Fear of future vaccine side effects was the most common reason for COVID-19 vaccine hesitancy and was expressed by 94% of the vaccine-hesitant respondents. These factors should be considered by health authorities in Bangladesh and perhaps other countries when addressing the plateauing COVID-19 vaccination rates in many populations.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

BACKGROUND

High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide.

METHODS

A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication.

FINDINGS

Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world.

INTERPRETATION

A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

High COVID-19 Vaccine Hesitancy Among Healthcare Workers: Should Such a Trend Require Closer Attention by Policymakers?

Background The newly developed coronavirus disease 2019 (COVID-19) vaccines are considered to be a powerful tool to contain the devastating pandemic. Healthcare workers (HCWs) are at the highest risk of exposure to COVID-19 and, therefore, they are the priority group for vaccination. Objectives The study aimed to examine the perceptions, attitudes, and acceptability of the COVID-19 vaccination among HCWs in India. Study design A cross-sectional pilot survey was conducted using an online questionnaire between 13 and 25 January 2021. Results Among 264 respondents, 40.2% of HCWs would receive the vaccine against COVID-19 if available and 32.2% were willing to take the vaccine after observing adverse effects in others. Infected members in the immediate social network (OR:2.15; 95%CI:0.426-10.844), COVID-19 knowledge (OR:5.113; 95%CI:0.974-26.853), the safety of vaccines (OR:7.608; 95%CI:2.618-22.11), and those who did not receive a flu vaccine last year (OR:2.612; 95%CI:1.120-6.091) were found to have a statistically significant association with vaccine acceptance. The main reasons to delay/refuse vaccination included: 'quick vaccine development and compromised quality' (43.7%) and 'lack of trusted information regarding COVID-19' (41.3%). Conclusions The finding showed a high rate of vaccine hesitancy among HCWs. Policymakers should take steps to increase public awareness and secure timely and affordable vaccines for the HCWs and general population with effective vaccine promotion campaigns.

Health Belief Model, Theory of Planned Behavior, or Psychological Antecedents: What Predicts COVID-19 Vaccine Hesitancy Better Among the Bangladeshi Adults?

This study aimed to determine the prevalence and investigate the constellations of psychological determinants of the COVID-19 vaccine hesitancy among the Bangladeshi adult population utilizing the health belief model-HBM (perceived susceptibility to and severity of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action), the theory of planned behavior-TPB (attitude toward COVID-19 vaccine, subjective norm, perceived behavioral control, and anticipated regret), and the 5C psychological antecedents (confidence, constraints, complacency, calculation, and collective responsibility). We compared the predictability of these theoretical frameworks to see which framework explains the highest variance in COVID-19 vaccine hesitancy. This study adopted a cross-sectional research design. We collected data from a nationally representative sample of 1,497 respondents through both online and face-to-face interviews. We employed multiple linear regression analysis to assess the predictability of each model of COVID-19 vaccine hesitancy. We found a 41.1% prevalence of COVID-19 vaccine hesitancy among our study respondents. After controlling the effects of socio-economic, demographic, and other COVID-19 related covariates, we found that the TPB has the highest predictive power (adjusted R 2 = 0.43), followed by the 5C psychological antecedents of vaccination (adjusted R 2 = 0.32) and the HBM (adjusted R 2 = 0.31) in terms of explaining total variance in the COVID-19 vaccine hesitancy among the adults of Bangladesh. This study provides evidence that theoretical frameworks like the HBM, the TPB, and the 5C psychological antecedents can be used to explore the psychological determinants of vaccine hesitancy, where the TPB has the highest predictability. Our findings can be used to design targeted interventions to reduce vaccine hesitancy and increase vaccine uptake to prevent COVID-19.

The Health Belief Model Predicts Intention to Receive the COVID-19 Vaccine in Saudi Arabia: Results from a Cross-Sectional Survey

We examined the intention and predictors of accepting the COVID-19 vaccine in Saudi Arabia. We conducted a nation-wide, cross-sectional online survey between February and March 2021. A total of 1387 people (≥18 years) participated. Only 27.3% adults had a definite and 30.2% had a probable vaccination intent; 26.8% and 15.6% had a probable and definite negative vaccination intent. Older people (≥50 years) (p < 0.01), healthcare workers/professionals (p < 0.001), and those who received flu vaccine (p < 0.001) were more likely to have a positive intent. People from Riyadh were less likely to receive the vaccine (p < 0.05). Among the health belief model constructs, perceived susceptibility to and severity of COVID-19 (p < 0.001), and perceived benefit of the vaccine (p < 0.001) were positively associated with vaccination intent, whereas perceived barriers had a negative association (p < 0.001). Individuals were more likely to receive the vaccine after obtaining complete information (p < 0.001) and when the vaccine uptake would be more common amongst the public (p < 0.001).

Prevalence and Factors of the Performed or Scheduled COVID-19 Vaccination in a Chinese Adult General Population in Hong Kong

BACKGROUND

Globally, COVID-19 vaccination programs have been rolled out. To inform health promotion, this study investigated the prevalence and associated factors of performance or being scheduled to perform at least one dose of COVID-19 vaccination (PSCV) in a Chinese adult general population.

METHODS

An anonymous, random telephone survey interviewed 500 adults aged 18-75 in Hong Kong, China from 14-27 May 2021.

RESULTS

The prevalence of PSCV was 21.0%, which was significantly lower among females and those aged ≤30. Positively associated factors of PSCV included perceived protection effect of vaccination, self-perceived physical fitness for vaccination, compulsory COVID-19 testing experience, perceived need to travel, general trust toward the government, and trust toward the governmental vaccination program, while negatively associated factors included perceived low efficacy of vaccination, concerns about side effects, and chronic disease status. Furthermore, the association between sex and PSCV was fully mediated by stronger concern about side effects and lower levels of self-perceived physical fitness for COVID-19 vaccination among females than males.

CONCLUSION

Moderately low prevalence of COVID-19 vaccination was observed in Hong Kong, where there was no shortage of vaccine supply. To achieve herd immunity, health promotion is greatly warranted and may incorporate messages based on the findings of this study.

Disproportionate COVID-19 vaccine acceptance rate among healthcare professionals on the eve of nationwide vaccine distribution in Bangladesh

BACKGROUND

: Acceptance of the COVID-19 vaccine by the target groups would play a crucial role in stemming the pandemic. Healthcare professionals (HCPs) are the priority group for vaccination due to them having the highest risk of exposure to infection. This survey aimed to assess their acceptance of COVID-19 vaccines in Bangladesh.

RESEARCH DESIGN AND METHODS

A cross-sectional survey using an online questionnaire was conducted between January 3 to 25, 2021, among HCPs (n=834) in Bangladesh. The main outcome measures were vaccine acceptance by HCPs if one was available.

RESULTS

Less than 50% of HCPs would receive the vaccine against COVID-19 if available and 54% were willing to take the vaccine at some stage in the future. Female participants (OR:1.64;95%CI:1.172-2.297), respondents between 18-34 years old (OR:2.42; 95% CI:1.314-4.463), HCPs in the public sector (OR:2.09; 95% CI:1.521-2.878), and those who did not receive a flu vaccine in the previous year (OR:3.1; 95% CI:1.552-6.001) were more likely to delay vaccination.

CONCLUSIONS

The study revealed that, if available, less than half of the HCPs would accept a COVID-19 vaccine in Bangladesh. To ensure the broader success of the vaccination drive, tailored strategies and vaccine promotion campaigns targeting HCPs and the general population are needed.

Factors Influencing COVID-19 Vaccination Demand and Intent in Resource-Limited Settings: Based on Health Belief Model

BACKGROUND

Vaccination is, without doubt, one of the most outstanding health interventions in reducing unprecedented damages of coronavirus disease (COVID-19). Globally, several vaccines have been produced to be effective against COVID-19. This survey aimed to assess the demand and intent towards the COVID-19 vaccine among the general population in Ethiopia. Also, factors influencing their demand, intention, and willingness to pay for the COVID-19 vaccine were described, which is poorly understood in resource-limited settings.

METHODS

Subjects were 1160 individuals who completed an online questionnaire from February to March 2021. The study used the health belief model (HBM) to evaluate participants' intention to receive and willingness to pay (WTP) regarding the COVID-19 vaccine. Chi-square and binary logistic regression were conducted to identify the prevalence and associated factors of demand and WTP. Multinomial regression was done to examine the intent to receive a vaccine.

RESULTS

In total 1116 responses were collected. The results indicated a moderate level of demand and WTP among participants (64.7% and 56.0%, respectively). Further, the researchers examined participants' readiness towards COVID-19 vaccination, where 46.6% of participants had a definite intent, and close to half of the participants are unsure (32.8%) or unwilling (20.7%) to get vaccinated. Among other factors, items under perceived susceptibility and perceived benefits constructs in the HBM have been associated with participants' demand, willingness to vaccinate, and WTP.

CONCLUSION

This study demonstrates the usefulness of the HBM model in evaluating the demand, intention, and willingness of participants to pay for COVID-19. Improving public awareness of the vulnerability should be a major point of attention to reduce the barriers, and improve demand and intention for COVID-19. Moreover, public health messages should be tailored to enhance vaccine literacy.

Predictors of Intention to Vaccinate against COVID-19 in the General Public in Hong Kong: Findings from a Population-Based, Cross-Sectional Survey

Vaccination is one of the most effective ways to stop the spread of COVID-19. Understanding factors associated with intention to receive COVID-19 vaccines is the key to a successful vaccination programme. This cross-sectional study explored the rate of vaccination intention and identified its predictors using the health belief model (HBM) in the general population in Hong Kong during the pandemic. Data were collected between December 2020 and January 2021 via telephone surveys. Hierarchical logistic regression analysis was used to identify factors associated with intention to receive COVID-19 vaccines. A total of 1255 adults (>18 years, 53% female) completed the telephone survey. Overall, 42% indicated an intention to vaccinate, 31.5% showed vaccine hesitancy, and 26.5% reported refusal to receive any COVID-19 vaccines. Individuals who were men, older in age, working, with past experiences of other pandemics, less concerned with the vaccine safety, with poorer knowledge about COVID-19, and having greater levels of perceived susceptibility, self-efficacy, cues to action, and acceptance of governmental preventive measures related to COVID-19 were significantly more likely to report an intention to vaccinate. The low intention among the Hong Kong population reflects the importance of developing effective vaccination promotion campaigns with the predictors identified in this study.

Depression among the Non-Native International Undergraduate Students Studying Dentistry in Bangladesh

BACKGROUND

Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh.

METHODS

This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812.

RESULTS

The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p < 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value < 0.01).

CONCLUSION

This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years.