COVID-19 vaccine acceptability among public university students in Bangladesh: Highlighting knowledge, perceptions, and attitude

Figures & data

Table 1. Characteristics of selected respondents (N = 900)

Personal and clinical characteristics	Level	No. of participants (%)
Age (years)	Mean ± Standard deviation	23.95 ± 3.38
Participants category	Postgraduate	372 (41.3)
	Undergraduate	528 (58.7)
Sex	Male	502 (55.8)
	Female	398 (44.2)
Total family income (monthly)*	Low income	34 (4.0)
	Lower-middle income	530 (58.9)
	Upper-middle income	294 (32.7)
	High income	40 (4.4)
Residence area	Urban	486 (54.0)
	Rural	236 (26.2)
	Semi-urban	178 (19.8)
Covid-19 infected (either respondent or any of their family member)	Yes	84 (9.3)
	No	572 (63.6)
	Did not test	244 (27.1)
Have you heard about the COVID-19 vaccine	Yes	900 (100)
	No	0
Sources from where you first heard about the COVID-19 vaccine	Print newspaper	160 (17.8)
	Television/radio	234 (26.0)
	Social media	290 (41.1)
	Medical personnel	96 (10.7)
	Friends and family	40 (4.4)

*Total household income categorized into: Low income (≤$85), Lower middle income ($86 to $336), Upper middle income ($337 to $1040), and High income (≥$1040) according to World Bank income group.

Table 2. Responses to knowledge questions related to COVID-19 vaccine (N = 900)

Question	No. of participants (%)
	Correct	Incorrect
What app/website does it require for registration to get a vaccine?	526 (58.4)	374 (41.6)
Do you know about mandatory vaccination for all public university students prior to open up the institutions?	522 (58.0)	378 (42.0)
How many vaccines get approval for emergency use?	620 (68.9)	280 (31.1)
What number of vaccine doses are required for each person?	766 (85.1)	134 (14.9)
When from Bangladesh Government began mass vaccination?	562 (62.4)	338 (37.6)
From where Bangladesh received the first vaccine consignment?	802 (89.1)	98 (10.9)
How many countries/institutes are producing vaccines now?	500 (55.6)	400 (44.4)
For how many vaccine doses has Bangladesh secured priority contracts with the Serum Institute of India?	358 (39.8)	542 (60.2)
Which pharmaceutical company has partnered with the government on the vaccination campaign?	838 (93.1)	62 (6.9)
Overall knowledge score (mean ± SD)	3.21 ± 4.13

Table 3. Perceptions about the COVID-19 vaccine among participants (N = 900)

Statements	No. of participants (%)
	Yes	Not sure	No
COVID-19 vaccine is effectual	306 (34.0)	506 (56.2)	88 (9.8)
I am worried about how vaccine react into my body	632 (70.2)	158 (17.6)	110 (12.2)
COVID-19 disease is naturally curable without any vaccine	68 (7.6)	276 (30.7)	556 (61.8)
Without any vaccine, antibiotics can cure the disease	76 (8.4)	262 (29.1)	562 (62.4)
COVID-19 vaccine can only be applicable for people infected with coronavirus	96 (10.7)	320 (35.6)	484 (53.8)
Eating nutritious foods to boost one’s immune function outperforms the vaccine	68 (7.6)	304 (33.8)	528 (58.7)
I think vaccine is more applicable for patients with chronic diseases	286 (31.8)	362 (40.2)	252 (28.0)
I am confident that vaccine can obliterate COVID-19 from Bangladesh	450 (50.0)	374 (41.6)	76 (8.4)
Overall perception score (mean ± SD)	7.89 ± 2.81

Table 4. Attitudes toward COVID-9 vaccine (N = 900)

Statements	No. of participants (%)
	Strongly agree	Agree	Not sure	Disagree		Strongly disagree
My family will allow me to get vaccinated	222 (24.7)	248 (27.6)	314 (34.9)	80 (8.9)	36 (4)
COVID-19 vaccine will bring us back to normal education system	258 (28.7)	264 (29.3)	288 (32.0)	66 (7.3)	24 (2.7)
I might be infected with COVID-19 if I do not get vaccinated	170 (18.9)	142 (15.8)	340 (37.8)	216 (24.0)	32 (3.6)
COVID-19 vaccine must be mandatory for all students before the opening up the university	144 (16.0)	396 (44.0)	258 (28.7)	70 (7.8)	32 (3.6)
I can easily have the COVID-19 vaccine	50 (5.6)	112 (12.4)	204 (22.7)	254 (28.2)	280 (31.1)
If university inaugurate without providing vaccine, I might get infected	122 (13.6)	152 (16.9)	474 (52.7)	96 (10.7)	56 (6.2)
I would regret If I become infected with coronavirus even after getting the vaccine	240 (26.7)	388 (43.1)	170 (18.9)	80 (8.9)	22 (2.4)
Since a coronavirus vaccine is too new, I might be worried	348 (38.7)	246 (27.3)	168 (18.7)	98 (10.9)	40 (4.4)
Overall attitude score (mean ± SD)	27.39 ± 3.82

Figure 1. Percentage of respondents having adequate knowledge, positive perceptions, and attitude.

Figure 2. COVID-19 vaccine acceptability among the respondents (N = 900).

Figure 3. Reasons for refusing to receive COVID-19 vaccine in percentage. The reasons were asked only if the respondents were not interested in receiving the vaccine or not sure (N = 246).

Table 5. Logistic regression showing factors significantly affect the respondent’s knowledge, perception, and attitude toward the COVID-19 vaccine (N = 900)

		Knowledge			Perception			Attitude
Variable	Categories	Coef.	AOR	P-value	Coef.	AOR	P-value	Coef.	AOR	P-value
Age		0.05	1.05	.14	0.12	1.51	.19	0.12	1.20	.00***
Sex	Male (Ref.)
	Female	0.20	1.23	.41	0.05	1.05	.76	0.10	1.11	.54
Residence area	Rural (Ref.)
	Urban	1.27	3.58	.00***	1.04	2.85	.00***	0.21	1.23	.18
	Semi-urban	0.35	1.42	.04**	0.65	1.91	.00***	0.17	1.19	.42
Economic class	Low income (Ref.)
	Lower-middle income	0.73	2.01	.12	1.89	3.25	.33	0.56	1.93	.29
	Upper-middle income	0.43	1.87	.17	1.45	2.88	.46	0.51	1.76	.22
	High income	0. 23	1.01	.28	1.34	2.09	.57	0.04	1.55	.37
Participants category	Undergraduate (Ref.)
	Postgraduate	1.01	2.44	.00***	0.59	1.84	.00***	0.19	1.21	.00***
COVID-19 infected	No (Ref.)
	Yes	0.15	1.31	.04**	0.14	1.14	.82	0.36	1.25	.03**
	Did not test	0.39	1.37	.00***	0.16	1.18	.50	0.86	1.42	.00***

***, and ** indicates significance at 1%, and 5% level, respectively. In logistic regression, dependent variables are knowledge (1 if having adequate knowledge, 0 for otherwise), perception (1 if having positive perception, 0 for otherwise), and attitude (1 if having positive attitude, 0 for otherwise). AOR = Adjusted Odds Ratio, Ref. = Reference category, Coef. = Coefficient.

Table 6. Multinomial logistic regression showing the factors influencing the vaccine acceptability (N = 900)

Characteristics of participants	Vaccine acceptance (yes) = Reference
	Vaccine resistant (no)		Vaccine hesitant (not sure)
	AOR (95% CI)	P-value	AOR (95% CI)	P-value
Age (Years)
18 to 24	1.08 (0.71 to 2.15)	.28	1.13 (1.02 to 2.12)	.14
More than 24	0.92 (0.60 to 1.94)	.17	1.62 (1.11 to 3.24)	.22
Sex
Male	0.72 (0.23 to 1.78)	.62	0.94 (0.64 to 1.38)	.75
Female	1.87 (1.23 to 3.26)	.02**	1.94 (1.43 to 2.89)	.00***
Economic class
Low income	1.67 (1.17 to 5.30)	.09	1.67 (0.56 to 3.88)	.00***
Lower-middle income	1.39 (0.17 to 2.92)	.13	1.44 (0.79 to 3.65)	.22
Upper-middle income	3.58 (0.13 to 5.23)	.17	1.21 (0.78 to 1.83)	.54
High income	3.43 (0.11 to 4.34)	.25	1.39 (0.79 to 1.89)	.56
Living area
Urban	0.77 (0.52 to 1.49)	.48	1.22 (0.81 to 1.89)	.21
Rural	1.92 (1.03 to 3.82)	.15	2.34 (1.28 to 4.56)	.10
Semi-urban	1.25 (0.81 to 1.95)	.11	1.09 (0.65 to 2.23)	.17
Participants category
Undergraduate	0.72 (0.51 to 1.00)	.67	0.89 (0.61 to 1.22)	.59
Postgraduate	0.60 (0.36 to 1.02)	.72	0.55 (0.28 to 0.99)	.82
COVID-19 affected
No	2.18 (1.11 to 5.54)	.04**	2.23 (1.11 to 4.94)	.05**
Yes	0.35 (0.16 to 1.09)	.06	0.63 (0.20 to 1.98)	.44
Did not test	1.44 (0.89 to 2.37)	.12	0.83 (0.54 to 1.27)	.29
Knowledge about the COVID-19 vaccine
Inadequate	1.46 (0.82 to 2.59)	.00***	2.36 (1.03 to 4.40)	.00***
Adequate	1.26 (0.59 to 2.17)	.16	1.17 (0.67 to 2.04)	.18
Perception of the COVID-19 vaccine
Positive	1.05 (0.53 to 1.65)		1.23 (0.77 to 1.88)
Negative	4.09 (1.19 to 10.48)	.04**	5.31 (3.09 to 11.92)	.05**
Attitude toward COVID-19 vaccine
Positive	1.18 (0.62 to 2.17)		1.77 (0.49 to 6.39)
Negative	2.23 (1.14 to 8.09)	.00***	2.82 (1.04 to 7.78)	.02**

***, and ** indicates significance at 1%, and 5% level, respectively. Multinomial logistic regression was employed to determine the significant factor influencing the vaccine-taking decision (dependent variable). The respondents who were not sure to take vaccine were termed as vaccine-hesitant, while those who refused were denoted as vaccine-resistant. The reference category was vaccine acceptance (respondents who are willing to be vaccinated). All predictors in the model are adjusted for all other covariates. AOR: adjusted odds ratios, 95% CI: 95% confidence intervals for the adjusted odds ratios.

Data availability statement

Data may be available from the corresponding author upon request.