Shahara Sarmin^1,, Enamul Islam Saad², Laxmi Rani Das³

Understanding the determinants of COVID-19 vaccine hesitancy is critical for public health strategy. This study aimed to compare the socio-demographic and perceptual factors influencing vaccine hesitancy between urban and rural populations in Bangladesh. Methods: A comparative study was conducted at Ashiyan Medical College, Dhaka, Bangladesh, from January to December 2021. A purposive sample of 58 individuals (16 urban, 42 rural) was recruited. Data on socio-demographics, vaccination status, trusted information sources, and perceptions were collected. Analysis was performed using SPSS version 23.0, employing descriptive statistics, chi-square, and t-tests. Results: Analysis revealed high overall vaccination uptake (Urban: 100%, Rural: 88.1%, p=0.184) but a significant rural-urban disparity in booster dose coverage (81.3% vs 33.3%, p=0.001). Rural residents had lower education and income (p<0.05). Trusted information sources differed markedly: urban respondents relied on government (81.3%), while rural respondents used community leaders (35.7%) and social media (33.3%) (p<0.001). All unvaccinated individuals (n=5) were rural, citing fear or disbelief. Conclusion: Significant rural-urban disparities in booster coverage persist in Bangladesh, driven by socioeconomic factors and reliance on informal information sources. Targeted, community-led interventions are essential to build vaccine confidence and improve uptake in rural populations.

Booster dose, COVID-19, Health communication, Vaccine hesitancy, Urban-rural differences