What is driving unwillingness to receive the COVID-19 vaccine in adult Bangladeshi after one year of vaccine rollout? Analysis of observational data

OBJECTIVE: The present study aimed to (1) assess the prevalence of COVID-19 vaccine unwillingness and (2) identify the factors associated with vaccine unwillingness. METHODS: This cross-sectional study analyzed data of 2633 Bangladeshi adults. Descriptive analysis was performed to compute the prevalence of vaccine unwillingness by the participants’ sociodemographic characteristics. Multiple logistic regression analyses were performed to compute Adjusted Odds Ratios (AORs) with vaccine unwillingness as a dependent variable and sociodemographic characteristics as predictor variables for vaccine unwillingness. RESULTS: Overall, 27.4% respondents showed unwillingness to receive the COVID-19 vaccine. Regression model suggested that groups with significantly higher odds of vaccine unwillingness were found to be participants aged 18-25 years (AOR= 3.41, CI= 1.71-6.80), Muslim (AOR= 1.81, CI= 1.21-2.71), participants with higher secondary education (AOR= 3.12, CI= 1.73-5.63), unemployed (AOR= 8.79, CI= 5.42-14.26), participants with monthly household income < □ 15000 (AOR= 4.03, CI= 2.51-6.47), residents of a semi-urban setting (AOR= 1.43, CI= 1.01-2.03), participants affiliated with opposition parties (AOR= 2.82, CI= 1.89-4.21), and participants who did not report that they or their family members tested positive for COVID-19 (AOR= 4.32, CI= 3.08-6.07). CONCLUSION: The study findings suggested that a certain vaccine literacy campaign targeting semi-urban, low-income, and low-educated Bangladeshi is warranted to ensure the widespread uptake of COVID-19 vaccines in Bangladesh.