Vaccine In Bangladesh Research Articles

Cost-effectiveness of seasonal influenza vaccination in WHO-defined high-risk populations in Bangladesh.

Bangladesh carries a substantial health and economic burden of seasonal influenza, particularly among the World Health Organization (WHO)-defined high-risk populations. We implemented a modelling study to determine the cost-effectiveness of influenza vaccination in each of five high-risk groups (pregnant women, children under five years of age, adults with underlying health conditions, older adults (≥60 years), and healthcare personnel) to inform policy decisions on risk group prioritisation for influenza vaccination in Bangladesh. We implemented a Markov decision-analytic model to estimate the impact of influenza vaccination for each target risk group. We obtained model inputs from hospital-based influenza surveillance data, unpublished surveys, and published literature (preferentially from studies in Bangladesh, followed by regional and global ones). We used quality-adjusted life years (QALY) as the health outcome of interest. We also estimated incremental cost-effectiveness ratios (ICERs) for each risk group by comparing the costs and QALY of vaccinating compared to not vaccinating each group, where the ICER represents the additional cost needed to achieve one year of additional QALY from a given intervention. We considered a willingness-to-pay threshold (ICER) of less than one gross domestic product (GDP) per capita as highly cost-effective and of one to three times GDP per capita as cost-effective (per WHO standard). For Bangladesh, this threshold ranges between USD 2462 and USD 7386. The estimated ICERs were USD -99, USD -87, USD -4, USD 792, and USD 229 per QALY gained for healthcare personnel, older adults (≥60), children aged less than five years, adults with comorbid conditions, and pregnant women, respectively. For all risk groups, ICERs were below the WHO willingness-to-pay threshold for Bangladesh. Vaccinating pregnant women and adults with comorbid conditions was highly cost-effective per additional life year gained, while vaccinating healthcare personnel, older adults (≥60), and children under five years were cost-saving per additional life year gained. Influenza vaccination to all target risk groups in Bangladesh would be either cost-saving or cost-effective, per WHO guidelines of GDP-based thresholds.

Antibody Response after Homologous and Heterologous Prime-Boost COVID-19 Vaccination in a Bangladeshi Residential University Cohort.

COVID-19 vaccination strategies, including heterologous prime-boost regimens and additional booster doses, aim to optimize immune responses. However, seroepidemiological studies on immune responses to different COVID-19 vaccine types and schedules remain limited. This study investigated antibody levels following homologous and heterologous prime-and-boost COVID-19 vaccination in Bangladesh. In a cohort of 606 participants who received first/second/booster doses of vaccines (AstraZeneca, Moderna, Pfizer-BioNTech, and Sinopharm), anti-spike IgG and anti-nucleocapsid IgG levels were measured. Antibody titer variations with respect to age, gender, intervals between doses, and prior infection status were analyzed. mRNA vaccines elicited the highest antibody levels after homologous and heterologous boosting. The AstraZeneca booster resulted in a sharp titer decline rate of ~0.04 units per day. Second or booster vaccine doses significantly increased antibody levels, especially in males (p < 0.05). Older age correlated with higher titers, likely reflecting previous infection, which was further confirmed by the elevation of anti-nucleocapsid IgG levels. About 95.5% of non-Sinopharm recipients were anti-nucleocapsid IgG positive, suggesting prior exposure exceeding self-reported infections (12.5%). mRNA and heterologous COVID-19 boosting enhances humoral immunity over homologous prime-boost vector/inactivated vaccination. However, waning immunity merits further investigation across vaccine platforms.

Mathematical analysis and simulation of COVID-19 model with booster dose vaccination strategy in Bangladesh

The control of COVID-19 transmission remains a crucial issue despite the administration of multiple doses of vaccines, given the ongoing emergence of new variants. This study proposes a mathematical model of COVID-19 with multiple doses of vaccinations. We find disease-free equilibrium (DFE) and disease-endemic equilibrium (DEE) and perform their stability analysis to explore in which parameters space the disease will be fade-out or persists in the population. This study derives mathematical expressions for the basic reproductive numbers (R0) using the Next-Generation Matrix method. Using surface and contour plots, we brought to light the exciting consequences of disease transmission rate and other parameter values on the basic reproduction number (R0). It demonstrates that the disease-free equilibrium point is locally stable when R0 < 1, whereas the disease-endemic equilibrium point is locally stable for R0 > 1. We also perform bifurcation analysis to demonstrate in which conditions the disease will be stable or unstable when R0 = 1. Numerical simulations show that increasing first dose vaccination rate is more effective than second and booster doses vaccination rate for reducing the number of asymptomatic and symptomatic cases in Bangladesh. We use COVID-19 incidence data from WHO between January and December 2022 and estimate parameters using the least-squares technique. We perform the sensitivity index of symptomatic and asymptomatic cases to identify the most significant parameter for disease outbreaks and found that transmission rate had the highest impact on disease prevalence. This research provides insight to prevent and control of COVID-19 transmission with booster-dose vaccination in Bangladesh.

Perception and Attitudes towards COVID‑19 Vaccination in Bangladesh: A Cross-sectional Analysis

Background: Vaccination is now considered the most effective measure to prevent the harm resulting from the SARS-CoV-2. Mass vaccination has been started in different regions of the world, including Bangladesh. Objective: The present work has been done to discover the Bangladeshi people’s attitude, perception towards COVID-19 vaccines, and their willingness to be vaccinated. Methodology: This cross-sectional analysis was performed from the online survey data collected from 01 August 2021 to 17 august 2021 from Bangladeshi people over 21 years old at the Department of Pharmacy, Northern University Bangladesh. Results: Among the total participants (517), the majority (60.74%) gave a positive response for being vaccinated. The reasons for unwillingness to be vaccinated were listed as adverse effects of the vaccine (46.04%), complex procedures of vaccination (18.32%), doubtfulness about the vaccine’s efficacy (15.35%), reduced risk perception about COVID-19 (15.35%) and needle phobia (4.95%). Conclusion: It is revealed from the current study that education and media can motivate a person's attitude towards vaccination. To bring mass people under the vaccination program, it is necessary to broadcast proper and authentic information about vaccines. Besides, the procedure of getting vaccines should be simpler. Bangladesh Journal of Infectious Diseases, December 2023;10(2):65-70

Prevalence and genetic diversity of rotavirus in Bangladesh during pre-vaccination period, 1973-2023: a meta-analysis.

Rotavirus infection is a major cause of mortality among children under 5 years in Bangladesh. There is lack of integrated studies on rotavirus prevalence and genetic diversity during 1973 to 2023 in Bangladesh. This meta-analysis was conducted to determine the prevalence, genotypic diversity and seasonal distribution of rotavirus during pre-vaccination period in Bangladesh. This study included published articles on rotavirus A, rotavirus B and rotavirus C. We used Medline, Scopus and Google Scholar for published articles. Selected literatures were published between 1973 to 2023. This study detected 12431 research articles published on rotavirus. Based on the inclusion criteria, 29 of 75 (30.2%) studies were selected. Molecular epidemiological data was taken from 29 articles, prevalence data from 29 articles, and clinical symptoms from 19 articles. The pooled prevalence of rotavirus was 30.1% (95% CI: 22%-45%, p = 0.005). Rotavirus G1 (27.1%, 2228 of 8219) was the most prevalent followed by G2 (21.09%, 1733 of 8219), G4 (11.58%, 952 of 8219), G9 (9.37%, 770 of 8219), G12 (8.48%, 697 of 8219), and G3 (2.79%, 229 of 8219), respectively. Genotype P[8] (40.6%, 2548 of 6274) was the most prevalent followed by P[4] (12.4%, 777 of 6274) and P[6] (6.4%, 400 of 6274), respectively. Rotavirus G1P[8] (19%) was the most frequent followed by G2P [4] (9.4%), G12P[8] (7.2%), and G9P[8], respectively. Rotavirus infection had higher odds of occurrence during December and February (aOR: 2.86, 95% CI: 2.43-3.6, p = 0.001). This is the first meta-analysis including all the studies on prevalence, molecular epidemiology, and genetic diversity of rotavirus from 1973 to 2023, pre-vaccination period in Bangladesh. This study will provide overall scenario of rotavirus genetic diversity and seasonality during pre-vaccination period and aids in policy making for rotavirus vaccination program in Bangladesh. This work will add valuable knowledge for vaccination against rotavirus and compare the data after starting vaccination in Bangladesh.

The role of vaccination and environmental factors on outbreaks of high pathogenicity avian influenza H5N1 in Bangladesh

High Pathogenicity Avian Influenza (HPAI) H5N1 outbreaks continue to wreak havoc on the global poultry industry and threaten the health of wild bird populations, with sporadic spillover in humans and other mammals, resulting in widespread calls to vaccinate poultry. Bangladesh has been vaccinating poultry since 2012, presenting a prime opportunity to study the effects of vaccination on HPAI H5N1circulation in both poultry and wild birds. We investigated the efficacy of vaccinating commercial poultry against HPAI H5N1 along with climatic and socio-economic factors considered potential drivers of HPAI H5N1 outbreak risk in Bangladesh. Using a multivariate modeling approach, we estimated that the rate of outbreaks was 18 times higher before compared to after vaccination, with winter months having a three times higher chance of outbreaks than summer months. Variables resulting in small but significant increases in outbreak rate were relatively low ambient temperatures for the time of year, literacy rate, chicken and duck density, crop density, and presence of highways; this may be attributable to low temperatures supporting viral survival outside the host, higher literacy driving reporting rate, density of the host reservoir, and spread of the virus through increased connectivity. Despite the substantial impact of vaccination on outbreaks, we note that HPAI H5N1 is still enzootic in Bangladesh; vaccinated poultry flocks have high rates of H5N1 prevalence, and spillover to wild birds has increased. Vaccination in Bangladesh thus bears the risk of supporting “silent spread,” where the vaccine only provides protection against disease and not also infection. Our findings underscore that poultry vaccination can be part of holistic HPAI mitigation strategies when accompanied by monitoring to avoid silent spread.

The Dengue-in-Dhaka Initiative: results from a phase 2 trial evaluating the TV005 tetravalent dengue vaccine in Bangladesh

The Dengue-in-Dhaka Initiative: results from a phase 2 trial evaluating the TV005 tetravalent dengue vaccine in Bangladesh

Comparison of O-specific polysaccharide responses in patients following infection with Vibrio cholerae O139 versus vaccination with a bivalent (O1/O139) oral killed cholera vaccine in Bangladesh.

Cholera caused by Vibrio cholerae O139 emerged in the early 1990s and spread rapidly to 11 Asian countries before receding for unclear reasons. Protection against cholera is serogroup-specific, which is defined by the O-specific polysaccharide (OSP) component of lipopolysaccharide (LPS). V. cholerae O139 also expresses the OSP-capsule. We, therefore, assessed antibody responses targeting V. cholerae O139 OSP, LPS, capsule, and vibriocidal responses in patients in Bangladesh with cholera caused by V. cholerae O139. We compared these responses to those of age-gender-blood group-matched recipients of the bivalent oral cholera vaccine (OCV O1/O139). We found prominent OSP, LPS, and vibriocidal responses in patients, with a high correlation between these responses. OSP responses primarily targeted the terminal tetrasaccharide of OSP. Vaccinees developed OSP, LPS, and vibriocidal antibody responses, but of significantly lower magnitude and responder frequency (RF) than matched patients. We separately analyzed responses in pediatric vaccinees born after V. cholerae O139 had receded in Bangladesh. We found that OSP responses were boosted in children who had previously received a single dose of bivalent OCV 3 yr previously but not in vaccinated immunologically naïve children. Our results suggest that OSP-specific responses occur during cholera caused by V. cholerae O139 despite the presence of capsules, that vaccination with bivalent OCV is poorly immunogenic in the short term in immunologically naïve individuals, but that OSP-specific immune responses can be primed by previous exposure, although whether such responses can protect against O139 cholera is uncertain. IMPORTANCE Cholera is a severe dehydrating illness in humans caused by Vibrio cholerae serogroups O1 or O139. Protection against cholera is serogroup-specific, which is defined by the O-specific polysaccharide (OSP) of V. cholerae LPS. Yet, little is known about immunity to O139 OSP. In this study, we assessed immune responses targeting OSP in patients from an endemic region with cholera caused by V. cholerae O139. We compared these responses to those of the age-gender-blood group-matched recipients of the bivalent oral cholera vaccine. Our results suggest that OSP-specific responses occur during cholera caused by V. cholerae O139 and that the OSP responses primarily target the terminal tetrasaccharide of OSP. Our results further suggest that vaccination with the bivalent vaccine is poorly immunogenic in the short term for inducing O139-specific OSP responses in immunologically naïve individuals, but OSP-specific immune responses can be primed by previous exposure or vaccination.

Economic assessment of childhood rotavirus vaccination in Bangladesh

Rotavirus is one of the most highly prevalent communicable diseases in Bangladesh. The objective of this study is to evaluate the benefit-cost ratio of childhood rotavirus vaccination program in Bangladesh. A spreadsheet-based model was used to estimate the benefit and cost of a nationwide universal rotavirus vaccination program against rotavirus infections among under-five children in Bangladesh. A benefit-cost analysis was performed to evaluate a universal vaccination program compared with a status quo. Data from various published vaccination-related studies and public reports were used. The introduction of a childhood rotavirus vaccination program in Bangladesh for 14.78 million under-five children is projected to prevent approximately 1.54 million rotavirus cases during the first 2 years including 0.7 million severe rotavirus infections. This study shows that among the WHO-prequalified rotavirus vaccines, the net societal benefit is the highest if the vaccination program adopts ROTAVAC® rather than Rotarix® or ROTASIIL®. For every dollar invested in the outreach-based ROTAVAC® vaccination program, society would gain $2.03 in return, while in a facility-based vaccination program, society would gain up to about $2.2. The findings of this study demonstrate that a universal childhood rotavirus vaccination program is a cost-beneficial investment of public money. Thus, the government should consider the introduction of rotavirus vaccination in their Expanded Program on Immunization since the rotavirus immunization policy in Bangladesh will be economically justifiable.

Pharmacovigilance of COVID-19 Vaccine Among Health Care Workers in Chittagong Medical College Hospital

Background: Successive waves of COVID-19, the pandemic of 2020 is still sweeping throughout the world in terms of morbidity and mortality. The speed of development of the vaccines, preclinical trials, clinical trials, all are unprecedented. So there remained a concern about the short- and long-term health effects (Wanted and unwanted) of these vaccines. Bangladesh is fortunate enough to get supply of vaccine (Oxford-AstraZeneca) early in the course. As expected, the vaccination program was phased and the population was stratified according to health risk. Health care workers were among the first groups receiving that vaccine in Bangladesh. A study was conducted with the objectives of assessing and describing the adverse events following vaccination against SARSCoV-2 and also of establishment of a post vaccination support clinic in Chittagong Medical College Hospital (CMCH) Bangladesh from February 2021 to June 2021. Materials and methods: Prospective surveillance was done among the vaccine recipients healthcare workers of CMCH and their family members. Participants were enrolled after the start of first dose vaccination from February in CMCH and also after the second dose vaccination from April 2021. A number of 1334 participants were signed-up after first dose of vaccination and were followed up through second dose. The initiative was taken to address the complications arising from vaccination among the vaccine recipients both over telephone and also in ward 16 of CMCH for those whose complaints warranted a physical examination. Results: A total of 1334 Oxford-AstraZeneca COVID-19 vaccine (AZD1222) (Covishield) vaccinated health care workers and their family members participated in the study, with age range from 18 to 89 years. More than 78% of them were within their 2nd to 6th decade of age. 19.2% of respondents were above 60 years old. Males were predominant in numbers than females (61.3% Vs 38.7%). Among the respondents, the majority were physicians by profession (51.4%). Among the recipients, about 30% had previous comorbid diseases; hypertension and diabetes mellitus being more common (18.6% &amp; 14.4%). An elaborate distribution of ‘Adverse Events Following Immunization’ (AEFI) was furnished. 37.3% participants were identified as suffering from symptoms after receiving the first dose of COVID–19 vaccinations, while only 11.4% were affected after taking the second dose. Common symptoms experienced by the respondents after first and second doses of the vaccination were as follows: mild fever (Temp&lt; 38° C), muscle pain, pain at immunization site, tenderness and soreness at injection site, headache, tiredness, fatigue, chills, dizziness etc. Recipients aged more than 50 years suffered significantly more symptoms. Gender and comorbidities did not influence in developing symptoms. There was no serious or fatal event. Conclusion: According to the findings of this study the used vaccine Oxford-AstraZeneca AZ AZD1222 (Covishield) appear to be reasonably safe in adult population with few physical discomforts which are neither life threatening nor serious. JCMCTA 2022 ; 33 (1) : 4-8

The influence of demographic and meteorological factors on temporal patterns of rotavirus infection in Dhaka, Bangladesh.

To quantify the potential impact of rotavirus vaccines and identify strategies to improve vaccine performance in Bangladesh, a better understanding of the drivers of pre-vaccination rotavirus patterns is required. We developed and fitted mathematical models to 23 years (1990–2012) of weekly rotavirus surveillance data from Dhaka with and without incorporating long-term and seasonal variation in the birth rate and meteorological factors. We performed external model validation using data between 2013 and 2019 from the regions of Dhaka and Matlab. The models showed good agreement with the observed age distribution of rotavirus cases and captured the observed shift in seasonal patterns of rotavirus hospitalizations from biannual to annual peaks. The declining long-term trend in the birth rate in Bangladesh was the key driver of the observed shift from biannual to annual winter rotavirus patterns. Meteorological indices were also important: a 1°C, 1% and 1 mm increase in diurnal temperature range, surface water presence and degree of wetness were associated with a 19%, 3.9% and 0.6% increase in the transmission rate, respectively. The model demonstrated reasonable predictions for both Dhaka and Matlab, and can be used to evaluate the impact of rotavirus vaccination in Bangladesh against changing patterns of disease incidence.

Causes of death through verbal autopsy: findings from a sub-study of single dose oral cholera vaccination in urban Dhaka, Bangladesh

Background Verbal autopsy can play a key crucial to identify significant causes of death in a developing country like Bangladesh where post-death pathological or forensic examination is not common. Single-dose Cholera Vaccination in Bangladesh (SCVB) was an individually randomized, placebo-controlled, double-blind study where verbal autopsy had been conducted for the participants who died within three months of receiving study agents This study aim was to determine the major causes of death through a verbal autopsy in a defined urban population. Methods The trial was conducted in urban slums of Dhaka among persons aged one year and older. A census was carried out bi-annually in the study area (Mirpur) including collecting death information from every household. Screening data on death was matched with the vaccination database to confirm whether the participants received the investigational products (IP) or not. The trained physician conducted a verbal autopsy usually within 7 days of notification. Results The screening period for verbal autopsy was from May 22 to July 18, 2014. Among 250 detected deaths, 99 received study agents (50 vaccines and 49 placeboes). The Verbal autopsy could not be completed for 10 deaths due to the unavailability of a next of kin respondent. Of the total of 240 verbal autopsies performed, 217 were in adults aged 18 years and above, 6 in 5-17 years of age, and rest were ≤ 5 years. The Most common causes of death were non-communicable diseases. 163 deaths occurred at home, 59 in a hospital and others died in different places. No significant difference in cause of death among vaccine and placebo group was found from this analysis. Conclusions Verbal autopsies usefully identified probable causes of death in participants in an oral cholera vaccine trial. The findings highlight that in this urban slum, noncommunicable diseases account for most of deaths.

Mathematical analysis of a COVID-19 model with double dose vaccination in Bangladesh

COVID-19 is an infectious disease that kills millions of people each year and it is a major public health problem around the globe. The current COVID-19 situation is still now concerning, though the vaccination program is running. In this study, we considered a COVID-19 model with a double-dose vaccination strategy to control the current outbreak situation in Bangladesh. The fundamental qualitative analysis of this mathematical model has been performed. The conditions of positive invariance, boundedness with suitable initial conditions were analyzed. We have estimated the basic reproduction number (R0) for disease transmission and determined that our model contains two equilibrium points: the disease-free equilibrium and a disease-endemic equilibrium. We used the Routh-Hurwitz criteria to determine the stability of the equilibria. The disease will be eradicated from the community if R0 < 1, otherwise the disease persists in the population. To support the qualitative analysis of our model, we performed numerical simulations using MATLAB routine and estimated model parameters. Sensitivity analysis is used to explore the association for Mild and Critical cases concerning the corresponding model parameters. We observed that the most significant parameter to spread the virus is the transmission rate. The numerical simulations showed that a full dose vaccination program significantly reduces the mild and critical cases and has potential impact to eradicate the virus from the community. The information that we generated from our analysis may help the public health professionals to impose the best strategy effectively to control the outbreak situation of the virus in Bangladesh.

COVID-19 vaccine inequity, dependency, and production capability in low-income and middle-income countries: the case of Bangladesh

COVID-19 vaccine inequity, dependency, and production capability in low-income and middle-income countries: the case of Bangladesh

Knowledge, acceptance and perception about COVID-19 vaccines in Bangladesh: Findings from a web-based cross-sectional study

Abstract Background and Aims: Vaccination is the only way to fight the ongoing COVID-19 pandemic. The importance of vaccines has already been established in almost every country. However, the acceptance rate entirely depends on socio-demographic characteristics. This research aims to investigate the knowledge, attitude, and opinion about COVID-19 vaccines in Bangladesh. Methods: We conducted this cross-sectional study from March 1 to March 31, 2021 among 704 persons in Bangladesh 18 years and older. We assessed the level of knowledge, attitude, and opinion of the participants about COVID-19 vaccines. Results: About 95% of respondents were aware of COVID- 19 symptoms, and two-thirds of them believed that it is a treatable disease. Among the respondents, COVID-19-related knowledge differed significantly based on the educational level of the respondents. Respondents with a professional risk of getting COVID-19 were more willing to have the COVID-19 test. Awareness about COVID-19 treatment varies by marital status, profession, COVID-19 history, and professional risk of COVID-19 of respondents. Knowledge about the effectiveness of COVID-19 vaccines depends on the respondent’s education, profession, and family history. Also, the awareness about COVD-19 vaccination in Bangladesh varies by sex, marital status, education, profession, family history, and risk of infection of respondents. Respondents with professional risk and family history of COVID-19 were more willing to be vaccinated. Conclusion: This research reflects the inadequate knowledge about vaccines but a positive attitude and opinion toward vaccination programs in Bangladesh. Thus, the respective authorities can arrange awareness programs related to COVID-19 and its vaccines for the general population.

The COVID-19 Pandemic and Access to Vaccination in Bangladesh: a Critical Review

This paper delineates the diverse perspectives of the vicious COVID-19 pandemic and access to vaccination in Bangladesh. It also depicts the discrepancies as to access to vaccine and vaccination campaign aside from assorted socio-economic impacts and challenges in Bangladesh with plausible way-outs. The fight for combating the demonized coronavirus is laudable amid the country’s limited resources, vulnerable healthcare system and vaccine hesitation. But the estimated cost of vaccination is under criticism because the country has received a substantial amount of vaccines as gift or free of cost donation from rich countries especially from the United States. Due to the pandemic, the socio-economic loss sustained by the country has created extra burden for the economy. No doubt, the coronavirus has taken an acid test of the global healthcare system. Even the economically advanced countries with sophisticated healthcare facilities have experienced the horrific fatality of the pandemic for a long time. But during the pandemic, the world has witnessed further polarization of the countries with major political and economic power dynamics in the name of coordinated fighting of the persisting crisis. Together with the financial constraints of low-income countries in Africa and Asia, the vaccine crisis and monopoly caused by the profit-driven attitude of most multinational pharma companies and geopolitical interests of some high income countries have galvanized the global vaccine inequity undermining the notion of distributive justice with a few exceptions. But the contagious coronavirus taught that people’s safety of a particular country is not possible without safety of other countries. Most existing papers on the COVID-19 pandemic linking Bangladesh depict its various detrimental impacts from health science and socio-economic aspects. But this paper critically reviews the chronological aspects of the COVID-19 pandemic in Bangladesh starting from influx of the virus to its all-out combating measures highlighting human casualty, advent of vaccine, vaccine inequity, access to vaccination, vaccine diplomacy, campaign, hesitation and rerated constraints along with prevailing as well as post COVID-19 socio-economic impacts.

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

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. 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. 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). 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.

Side Effects Following Administration of the First Dose of Oxford-AstraZeneca's Covishield Vaccine in Bangladesh: A Cross-Sectional Study.

In response to the raging COVID-19 pandemic, Bangladesh started its vaccine administration in early 2021; however, due to the rapid development and launch of the vaccines in the market, many people had concerns regarding the safety of these vaccines. The purpose of this study was to evaluate the side effects that were experienced by the Bangladeshi residents after receiving the first dose of the Oxford-AstraZeneca’s Covishield vaccine (ChAdOx1nCoV-19). The study was conducted using both online and printed questionnaires and the data were analysed using SPSS. The results included the responses of 474 vaccine recipients from March–April 2021. Pain at the site of injection, fever, myalgia, fatigue and headache were the most commonly reported symptoms, and the overall side effects were found to be significantly more prevalent in the younger population (p ≤ 0.05). These findings were consistent with the results indicated by the clinical trial of ChAdOx1nCoV-19. Logistic regression analysis further revealed that compared to people aged 70 years or above, the incidence of reported side effects was significantly higher in people aged 18–30 years (odds ratio (OR) = 8.56), 31–40 years, (OR = 5.05), 41–50 years (OR = 4.08), 51–60 years (OR = 3.77) and 61–70 years (OR = 3.67). In addition, a significantly higher percentage of female participants suffered from post-vaccination side effects compared to males (OR = 1.51). It was concluded that the Covishield vaccine was well-tolerated among people of different age groups. Nevertheless, further long-term follow-up study with a larger sample size is warranted to establish the long-term safety of the COVID-19 vaccine.

A Retrospective Cross-Sectional Study Assessing Self-Reported Adverse Events following Immunization (AEFI) of the COVID-19 Vaccine in Bangladesh.

Background: The Oxford–AstraZeneca vaccine (Covishield) was the first to be introduced in Bangladesh to fight the ongoing global COVID-19 pandemic. As this vaccine had shown some side-effects in its clinical trial, we aimed to conduct a study assessing short-term adverse events following immunization (AEFIs) in Bangladesh. Method: A cross-sectional study was conducted on social and electronic media platforms by delivering an online questionnaire among people who had taken at least one dose of the COVID-19 vaccine. The collected data were then analysed to evaluate various parameters related to the AEFIs of the respondents. Results: A total of 626 responses were collected. Of these, 623 were selected based on complete answers and used for the analysis. Most of the respondents were between 30–60 years of age, and 40.4% were female. We found that a total of 8.5% of the total respondents had been infected with the SARS-CoV-2 virus. Our survey revealed that out of 623 volunteers, 317 reported various side-effects after taking the vaccine, which is about 50.88% of the total participants. The majority of participants (37.07%, 231/623) reported swelling and pain at the injection site and fever (25.84%, 162/623); these were some of the common localized and generalized symptoms after the COVID-19 vaccine administration. Conclusion: The side-effects reported after receiving the Oxford–AstraZeneca vaccine (Covishield) are similar to those reported in clinical trials, demonstrating that the vaccines have a safe therapeutic window. Moreover, further research is needed to determine the efficacy of existing vaccines in preventing SARS-CoV-2 infections or after-infection hospitalization.

Life-Course Approach to Vaccination in Bangladesh for Meeting the Health and Health-Related Sustainable Development Goals: A Commentary

Bangladesh is entering from low-income to lower-middle-income status in 2020, and this will be completed in the next 5 years. With gross national income growing, vaccines will need to be procured through private market for the Expanded Program on Immunization. A cost-benefit analysis is needed to evaluate vaccine demand in different socioeconomic groups in the country, to inform this procurement. Moreover, disease burden studies and awareness of importance of specific vaccines are needed as we move forward. A life-course approach to vaccination may enable whole society to realize the full potential of vaccination and address most significant threats to its success over time.