Vaccine Hesitancy: Socio-Demographic and Perceptual Differences between Urban and Rural Individuals in Bangladesh

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

¹Lecturer, Department of Anatomy, Ashiyan Medical College, Dhaka, Bangladesh

²MBBS, Harbin Medical University, Heilongjiang, China

³RN (BNMC), BSN(DU), MPH(IUBAT), Senior Staff Nurse, (NITOR), Dhaka, Bangladesh

Cite this paper:
Shahara Sarmin, Enamul Islam Saad and Laxmi Rani Das. Vaccine Hesitancy: Socio-Demographic and Perceptual Differences between Urban and Rural Individuals in Bangladesh. American Journal of Public Health Research. 2026; 14(4):113-117. doi: 10.12691/ajphr-14-4-5

Abstract

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.

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

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References:

[1]	Chandraker, Dilendra. "REVIEW OF WORLDWIDE PANDEMIC SITUATION OF COVID-19 ACTIVITIES FROM BEGINNING 2019 TO CURRENT SCENARIO–2022." European Journal of Biomedical 9. 12 (2022): 547-553.
[2]	Lurie, Nicole, et al. "Developing Covid-19 vaccines at pandemic speed." New England journal of medicine 382. 21 (2020): 1969-1973.
[3]	Polack, Fernando P., et al. "Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine." New England journal of medicine 383. 27 (2020): 2603-2615.
[4]	Baden, Lindsey R., et al. "Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. " New England journal of medicine 384. 5 (2021): 403-416.
[5]	MacDonald, Noni E. "Vaccine hesitancy: Definition, scope and determinants." Vaccine 33. 34 (2015): 4161-4164.
[6]	Lazarus, Jeffrey V., et al. "A global survey of potential acceptance of a COVID-19 vaccine." Nature medicine 27. 2 (2021): 225-228.
[7]	Sallam, Malik. "COVID-19 vaccine hesitancy worldwide: a concise systematic review of vaccine acceptance rates." Vaccines 9. 2 (2021): 160.
[8]	Joarder, Taufique, Muhammad NB Khaled, and Mohammad AI Joarder. "Urban educated group's perceptions of the COVID-19 pandemic management in Bangladesh: a qualitative exploration." F1000Research 10 (2021): 170.
[9]	Abedin, Minhazul, et al. "Willingness to vaccinate against COVID-19 among Bangladeshi adults: Understanding the strategies to optimize vaccination coverage." PloS one 16. 4 (2021): e0250495.
[10]	Islam, Md Saiful, et al. "COVID-19–related infodemic and its impact on public health: A global social media analysis." The American journal of tropical medicine and hygiene 103. 4 (2020): 1621.
[11]	Zarocostas, John. "How to fight an infodemic." The lancet 395. 10225 (2020): 676.
[12]	Neumann-Böhme, Sebastian, et al. "Once we have it, will we use it? A European survey on willingness to be vaccinated against COVID-19." The European Journal of Health Economics 21. 7 (2020): 977.
[13]	Lin, Cheryl, PikueiTu, and Leslie M. Beitsch. "Confidence and receptivity for COVID-19 vaccines: a rapid systematic review." Vaccines 9. 1 (2020): 16.
[14]	Hossain, Mohammad Bellal, et al. "Health belief model, theory of planned behavior, or psychological antecedents: what predicts COVID-19 vaccine hesitancy better among the Bangladeshi adults?." Frontiers in public health 9 (2021): 711066.
[15]	Kabir, Russell, et al. "COVID-19 vaccination intent and willingness to pay in Bangladesh: a cross-sectional study." Vaccines 9. 5 (2021): 416.
[16]	Tagoe, Eunice Twumwaa, et al. "COVID-19 vaccination in lower-middle income countries: national stakeholder views on challenges, barriers, and potential solutions." Frontiers in Public Health 9 (2021): 709127.
[17]	Khairi, Md. "LNH; Fahrni, ML; Lazzarino, AI The Race for Global Equitable Access to COVID-19 Vaccines. Vaccines 2022, 10, 1306. " 2022,
[18]	Bar-On, Yinon M., et al. "Protection of BNT162b2 vaccine booster against Covid-19 in Israel." New england journal of medicine 385. 15 (2021): 1393-1400.
[19]	Patwary, Muhammad Mainuddin, et al. "COVID-19 vaccine acceptance among low-and lower-middle-income countries: a rapid systematic review and meta-analysis." Vaccines 10. 3 (2022): 427.
[20]	Jefsen, Oskar Hougaard, et al. "COVID-19 vaccine willingness amongst patients with mental illness compared with the general population." ActaNeuropsychiatrica 33. 5 (2021): 273-276.
[21]	Roozenbeek, Jon, et al. "Susceptibility to misinformation about COVID-19 around the world." Royal Society open science 7. 10 (2020): 201199.
[22]	Karlsson, Linda. "Psychological factors associated with vaccine attitudes and vaccination behaviors." (2021).
[23]	Loomba, Sahil, et al. "Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA." Nature human behaviour 5. 3 (2021): 337-348.
[24]	Islam, Md Saiful, et al. "COVID-19 vaccine rumors and conspiracy theories: The need for cognitive inoculation against misinformation to improve vaccine adherence." PloS one 16. 5 (2021): e0251605.
[25]	Moola, Sandeep, et al. "A rapid review of evidence on the determinants of and strategies for COVID-19 vaccine acceptance in low-and middle-income countries." Journal of global health 11 (2021): 05027.