Knowledge, attitudes, and factors determining the willingness for COVID-19 vaccination among students in Bangladesh: An online-based cross-sectional study

Abstract

Aim

The most effective way to avoid COVID-19 is through immunization against the virus that causes the disease. The primary objective of this study was to assess the extent of knowledge, attitudes, acceptability, and factors influencing COVID-19 vaccination acceptance among higher secondary and university students in Bangladesh.

Subject and methods

A structured questionnaire-based online survey was conducted among 451 students residing in Khulna and Gopalganj cities from February to August, 2022. The willingness to accept the COVID-19 vaccine was compared with a few covariates using the chi-square test, and we then used binary logistic regression to identify the determinants that led Bangladeshi students to receive the COVID-19 vaccine.

Results

During the study period, almost 70% of the students obtained immunizations, with 56% of men and 44% of women reporting having done so. The age range of 26–30 years had the highest percentage of students who had received vaccinations, and 83.9% of students agreed that the COVID-19 vaccine is crucial for students. The results of the binary logistic regression clearly show that gender, degree of education, and respondents' willingness, encouragement, and beliefs have a significant impact on students' eagerness to receive COVID-19 vaccination.

Conclusion

The rising trend in vaccination status among Bangladeshi students is highlighted by this study. Additionally, our results eloquently demonstrate that vaccination status varies by gender, education level, willingness, encouragement, and respondent's viewpoint. The outcomes of this study are essential for health policy makers and other interested parties to successfully organize their immunization program for young adults and children at various levels.

Introduction

Coronavirus disease 2019 (COVID-19) is a predominantly respiratory viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first discovered in Wuhan, China, in December 2019, and spread rapidly throughout the world. The growing case numbers reported compelled the World Health Organization (WHO) to declare COVID-19 a global health emergency on 30 January 2020 (Lin et al. 2020). The virus has infected hundreds of millions of individuals worldwide, with millions of deaths, in particular older adults with serious underlying health conditions (Bari et al. 2021). The disease rapidly spread to 223 countries, leading to the death of 2,624,426 people among 118,278,711 reported cases (WHO 2020a, b). Researchers throughout the world worked hard to create vaccines to fight against COVID-19. As of March 2021, more than 200 vaccine candidates had been introduced, 60 of which were enrolled in clinical trials, and seven different immunizations had been implemented in a number of nations (Abebe et al. 2022). These immunizations have been given the go-ahead for complete, emergency, or provisional usage.

Since the start of the pandemic, there has been significant misunderstanding, misconceptions, and ignorance regarding COVID-19 among the general public in Bangladesh (Adejumo et al. 2021). It has also been expected that there might be considerable misinformation and hesitancy in COVID-19 vaccination. The unwillingness regarding the vaccine led the Bangladesh government to revise its plan to inoculate 3.5 million instead of 6 million, relaxing the age limit to 40 years (Moghadas et al. 2021). The Bangladesh government ordered and paid for 30 million doses of the Oxford-AstraZeneca vaccine and also received another 68 million under the COVAX initiative (WHO 2020a, b). Besides buying several COVID-19 vaccines from the UK, Japan, China, Russia, and India, the government of Bangladesh also received vaccines as a gift (Dhaka Tribune, 2021). In efforts to immunize most of the population, the government launched a COVID-19 vaccination campaign in January 2021, with the vaccine provided free of cost. The first dose has been administered to 76.91% of the population, the second to 71.33%, and the third (booster) dose to 36.74% of the population as of September 2022 (IEDCR 2022). The figures show that there is a considerable gap between the first and second doses and that receipt of booster doses is very low, which indicates that people are still hesitant to be immunized.

Vaccination creates antibodies and basically protects people from severe illness or death. But vaccination campaigns may be significantly hampered by public reluctance, defined as vaccine hesitancy (MacDonald 2015). Many people prefer to wait until other people have received the COVID-19 vaccination, and vaccination preferences differ greatly between nations (Lin et al. 2020). Previous research revealed that in Turkey, Saudi Arabia, Kazakhstan, and Nigeria, the population's level of apprehension against the COVID-19 vaccine ranged from 17.7% to 44.5% (Sonmezer et al. 2022; Issanov et al. 2021; Adejumo et al. 2021). Additionally, a population's adoption of the COVID-19 vaccination might be influenced by a variety of misconceptions and conspiracies about vaccines in particular (Ullah et al. 2021).

Programs for immunization can only be deemed successful if they have a high rate of adoption and coverage. In order to remove all hurdles to vaccine distribution in such a situation, government authorities and politicians must consider the general public's comprehension, behavior, expectations, reluctance, and indicators of the desire to utilize the COVID-19 vaccine. The adult population of Bangladesh has not yet been the subject of any studies looking into the aforementioned COVID-19 vaccine problems. Therefore, this study aimed to examine the level of knowledge, attitudes, acceptance, and determinants of COVID-19 vaccine acceptance among higher secondary and university students in Bangladesh.

Methods and materials

Data source and study participants

This is a cross-sectional study based on an online questionnaire survey and data collected between 1 February and 30 April, 2022. Students from various institutions in Khulna and Gopalganj cities who had access to the internet were able to respond to the questionnaire and were included in this analysis. The authors designed a structured questionnaire to capture the most pertinent data on knowledge, attitudes, and factors determining COVID-19 vaccination status among students in Khulna and Gopalganj. We disseminated the link through social media (Facebook Messenger and Facebook Groups, WhatsApp, Imo, etc.) and electronic mail only for completion of the form.

Sample size determination

In this study we have used convenience sampling, a non-probability sampling technique. Participants who had internet access and were available on various social media platforms were considered eligible for the survey. As the total population size is unknown, the following formula was used to determine the minimum sample size.

$$n=\frac{Z^2\times p\times \left(1,-,p\right)}{{\epsilon }^2}=\frac{1.{96}^2\times 0.5\times \left(1,-,0.5\right)}{0.{0461}^2}\approx 451$$

We collected data from 474 participants from Khulna and Gopalganj. After handling missing values (5%), we obtained our final sample size of 451.

Outcome variable

The major purpose of this analysis is to determine knowledge, attitudes, and influencing factors regarding the COVID-19 vaccine. Thus, the outcome variable of the study is willingness to receive COVID-19 vaccination, and the variable is divided into two categories (coded yes = 1, no = 2).

Independent variables

Different variables are used for conducting research. In this study, we consider 20 independent variables, i.e., gender of the respondent, age group, marital status, current educational level, eligibility, willingness, effectiveness, encouraging family or friends, allergic reaction, overdose, affected by COVID-19, died from COVID-19, refusal reason, reduces risk of death, medical issues, religious objection, confident, believe, essential. All the variables are categorical, and their categories are presented in Table 1.

Table 1.

Summary of the explanatory variables

Variables	Categorization
Gender	Male, female
Age group (years)	16–20, 21–25, 26–30
Marital status	Married, unmarried
Current educational level	Undergraduate degree, master’s degree, others
Eligibility	Yes, no
Effectiveness	Yes, no
Willingness	Definitely, no, undecided
Encouragement	Yes, no, not sure
Allergic reaction	Yes, no
Overdose	Yes, no, don’t know
Affected by COVID-19	Yes, no
Died from COVID-19	Yes, no
Refusal reason	Did not think it was needed, did not have enough information, concerned about side effects, all of them, others
Reduces risk of death	Yes, no
Medical issues	Yes, no
Religious objection	Yes, no
Confident	Protection from COVID-19, cannot cause long-term injury, safety, others
Attitude	Pretty positive, very keen, neutral, against it, don’t know
Belief	Yes, no, don’t know
Essential	Agree, disagree, don’t know

Statistical analysis

Frequency and percentage distribution were used to show the background characteristics of the respondents. A chi-square test was applied to determine the association between COVID-19 vaccination status and related factors. Finally, binary logistic regression was fitted to determine the predictors of vaccination status among students in Bangladesh. In this analysis, the significance level for the study is 5% and the associated factors are described based on the odds ratio (OR). All the data analyses were executed using the R program, version 4.0.0.

Results

Sociodemographic characteristics and participants’ knowledge and attitudes towards COVID-19 vaccination status

Table 2 summarizes the sociodemographic attributes of the participants along with their knowledge and attitudes towards COVID-19 vaccination. The results show that 70.2% (316) of the students had received the COVID-19 vaccine and 29.8% (134) of the students were not yet vaccinated. In this study, 15.7% (71) of students were aged between 16 and 20 years, 61.2% (276) were in the 21–25-year age group, and 23.1% (104) were 25–30 years of age. The results showed that 18.9% (85) of students were married and 81.1% (364 students) were unmarried. With regard to educational level, 38.5% (173) of students were studying at an undergraduate level, 31.4% (141) were at a master's level, and 30.1% (135) were at another education level. In response to the question of eligibility to receive the vaccine on priority, 96.6% (432) of students reported that they were eligible, whereas only 3.4% (15) thought that they were not eligible. We can see from our study that 90% (403) of the students were aware of the effectiveness of the COVID-19 vaccine and 10% (45) of the students were not. Our analysis revealed that 90.9% (400) of students were willing to be vaccinated if the vaccine were offered to them, whereas 3% (13) showed their unwillingness to vaccinate and 6.1% (27) remained undecided. Results show that 90.4% (406) of students encouraged their family or friends to be vaccinated, 1.6% (7) did not encourage them, and 8.0% (36) of students said they were not sure. In addition, 14.4% (64) of students believed that the COVID-19 vaccine increased allergic reactions, and 85.6% (381 students) did not believe that it increased allergic reactions.

Table 2.

Sociodemographic characteristics and participants’ awareness and perception towards COVID-19, February–April 2022, Bangladesh

Variable	Category	Frequency	Percentage (%)
Gender	Male Female	253 198	56.1 43.9
Age group (years)	16–20 21–25 26–30	71 276 104	15.7 61.2 23.1
Marital status	Married Unmarried	85 364	18.9 81.1
Current educational level	Undergraduate Master’s Others	173 141 135	38.5 31.4 30.1
Eligibility	Yes No	432 15	96.6 3.4
Effectiveness	Yes No	403 45	90.0 10.0
Willingness	Definitely No Undecided	400 13 27	90.9 3.0 6.1
Encouragement	Yes No Not sure	406 7 36	90.4 1.6 8.0
Vaccine status	Yes No	316 134	70.2 29.8
Allergic reaction	Yes No	64 381	14.4 85.6
Overdose	Yes No Maybe	180 41 215	41.3 9.4 49.3
Affected by COVID-19	Yes No	121 320	27.4 72.6
Death after getting vaccine	Yes No	81 350	18.8 81.2
Refusal reason	Did not think it was needed Did not have enough information Concerned about side effects All of the above Others	80 97 173 21 47	19.1 23.2 41.4 5.0 11.2
Vaccination reduces risk of death	Yes No	365 77	82.6 17.4
Medical issues	Yes No	34 401	7.8 92.2
Religious objection	Yes No	24 420	5.4 94.6
Making more confident	Protection from COVID-19 Cannot cause long-term injury Safety Others	218 37 167 19	49.4 8.4 37.9 4.3
Attitude towards receiving vaccine	Pretty positive Very keen Neutral Against it Don’t know	304 17 97 4 22	68.5 3.8 21.8 .9 5.0
Belief that it cannot affect young people	Yes No Don’t know	38 336 69	8.6 75.8 15.6
Essential	Agree Disagree Don’t know	365 26 44	83.9 6.0 10.1

In terms of the COVID-19 vaccine overdose issue, 41.3% (180) of students agreed that an overdose is dangerous, 9.4% (41) said no, and 49.3% (215) said a COVID-19 vaccine overdose may be dangerous for their health. Our study showed that 27.4% (121) of the students were affected by COVID-19 and the remaining 72.6% were not affected. In response to the question of whether the respondent personally knew someone in their family, friends, or community who had died of COVID-19 after getting the vaccine, 18.8% (81) of students said yes, and 81.2% (350) said no. With regard to vaccine refusal reasons, 19.1% (80) of students thought that the vaccine was not needed, 23.2% (97) did not have enough information about the COVID-19 vaccine, and 41.4% (173) were concerned about side effects, whereas 5% (21) mentioned all of these reasons, and 11.2% (47) mentioned other reasons. The results showed that 82.6% (365) of students believed that vaccination reduces the risk of death and 17.4% (77) did not, and the analysis also showed that 7.8% (34) of students had medical issues related to receiving the COVID-19 vaccine and 92.2% (401) had no medical issues. In addition, 5.4% (24) of students had a religious objection in receiving the COVID-19 vaccine, and 94.6% (420) had no religious objection.

In this study, when asked what they needed to know to feel more confident about the COVID-19 vaccine, 49.4% (218) agreed that the vaccine protects against COVID-19, 8.4% (37) agreed that the vaccine cannot cause any long-term harm, 37.7% (167) noted safety as important, and 4.3% (19) mentioned other issues. Attitudes towards receiving the COVID-19 vaccine were pretty positive for 68.5% (304) of students, very keen for 3.8% (17) of students, and neutral for 21.8% (97) of students, whereas 9% (4) of students were against it, and 5% (22) of students did not know. To answer the question of the effect of COVID-19 on young people, 8.6% (38) of students believed that COVID-19 could not affect young people, 75.8% (336) believed that COVID-19 could affect young people, and 15.6% (69) of students did not know. The results also showed that 83.9% (365) of students agreed that taking a COVID-19 vaccine is essential, 6% (26) disagreed, and 10.1% (44) did not know.

Association of COVID-19 vaccine status with sociodemographic and other factors

Table 3 shows the association between COVID-19 vaccination status and sociodemographic characteristics among students in Bangladesh. It can be seen that the relationship between student’s gender and their vaccination status was highly significant (p < 0.001). The highest proportion of vaccination adoption was among the students aged 26–30 years (99%), while vaccination adoption was lower among the students aged 16–20 years (16.9%). The p-value (p < 0.001) between age group and vaccination indicates a strong association between the two variables at a 1% level of significance. There was a significant association between a respondent's education level and vaccination status. About 90.8% of students at the undergraduate level had received the vaccine, compared to only 9.2% of undergraduate students who had not received the vaccine, which is very low.

Table 3.

Assessment of the association between vaccine status and selected covariates

Variable	COVID-19 vaccine status		Chi-square (p-value)
	Yes No. (%)	No No. (%)
Gender
Male    Female	206 (81.7) 110 (55.6)	46 (18.3) 88 (44.4)	<0.001
Age group (years)
16–20    21–25    26–30	12 (16.9) 201 (73.1) 103 (99.0)	59 (83.1) 74 (26.9) 1 (1.0)	<0.001
Marital status
Married    Unmarried	68 (80.0) 248 (68.3)	17 (20.0) 115 (31.7)	0.033
Current educational level
Undergraduate degree    Master’s degree    Others	157 (90.8) 138 (98.6) 21 (15.6)	16 (9.2) 2 (1.4) 114 (84.4)	<0.001
Eligibility
Yes    No	308 (71.5) 7 (46.7)	123 (28.5) 8 (53.3)	0.038
Effectiveness
Yes    No	289 (71.9) 25 (55.6)	113 (28.1) 20 (44.4)	0.023
Willingness
Definitely    No    Undecided	298 (74.7) 5 (38.5) 9 (33.3)	101 (25.3) 8 (61.5) 18 (66.7)	<0.001
Encouraged family members
Yes    No    Not sure	294 (72.6) 3 (42.9) 19 (52.8)	111 (27.4) 4 (57.1) 17 (47.2)	0.012
Allergic reaction
Yes    No	37 (57.8) 279 (73.4)	27 (42.2) 101 (26.6)	0.011
Overdose
Yes    No    Maybe	116 (64.4) 34 (82.9) 161 (75.2)	64 (35.6) 7 (17.1) 53 (24.8)	0.014
Affected by COVID-19
Yes    No	94 (77.7) 216 (67.7)	27 (22.3) 103 (32.3)	0.041
Died after getting vaccine
Yes    No	64 (80.0) 232 (66.3)	16 (20.0) 118 (33.7)	0.046
Reason for refusing vaccine
Did not think it was needed    Did not have enough information    Concerned about side effects    All of the above    Others	54 (67.5) 79 (81.4) 101 (58.0) 18 (90.0) 45 (95.7)	26 (32.5) 18 (18.6) 73 (42.0) 2 (10.0) 2 (4.3)	<0.001
Vaccination reduces risk of death
Yes    No	263 (72.1) 44 (57.9)	102 (27.9) 32 (42.1)	0.015
Medical issues
Yes    No	8 (23.5) 293 (73.1)	26 (76.5) 108 (26.9)	<0.001
Religious objection
Yes    No	4 (16.7) 306 (72.9)	20 (83.3) 114 (27.1)	<0.001
Making more confident
Protection from COVID-19    Cannot cause long-term injury    Safety    Others	149 (68.3) 20 (54.1) 122 (73.5) 17 (89.5)	69 (31.7) 17 (45.9) 44 (26.5) 2 (10.5)	0.027
Attitude towards receiving vaccine
Pretty positive    Very keen    Neutral    Against it    Don’t know	199 (65.7) 13 (76.5) 78 (81.2) 3 (75.0) 17 (77.3)	105 (34.5) 4 (23.5) 18 (18.8) 1 (25.0) 5 (22.7)	0.046
Believe that it cannot affect young people
Yes    No    Don’t know	29 (76.3) 224 (66.9) 56 (81.2)	9 (23.7) 111 (33.1) 13 (18.8)	0.041
Essential
Agree    Disagree    Don’t know	267 (73.2) 14 (53.8) 26 (60.5)	98 (26.8) 12 (46.2) 17 (39.5)	0.033

Furthermore, regarding the effectiveness of the COVID-19 vaccine, almost 71.5% of students who understood the effectiveness of the vaccine had been vaccinated, and 55.6% of students who did not understand the effectiveness of vaccination had been vaccinated. The results show that 80.0% of married students had been vaccinated and 68.3% of unmarried students had been vaccinated. In addition, seven out of ten (72.6%) students who encouraged their family and friends to receive the vaccine were vaccinated. In the case of allergic reactions, a high percentage of students (73.4%) who did not believe that vaccination increases allergic reactions were vaccinated, while a high percentage of students (42.2%) who believed that vaccination increases allergic reactions were unvaccinated. From Table 3, it is also apparent that in terms of reasons for refusing the vaccine, 67.5% of students who did not think it was needed were vaccinated, compared to 81.4% of students who did not have enough information about the COVID-19 vaccine, 58% of students concerned about side effects, 90% of students mentioning all of the reasons, and 95.7% of students mentioning other reasons.

About 76.3% of students who believed that young people are not affected by COVID-19 were vaccinated, and 81.2% of students who did not know were vaccinated. In terms of essentiality, approximately 73.3% of students who agreed that vaccination was essential for students were vaccinated. Finally, participants’ marital status, encouraging family members, overdose, whether affected by COVID-19, died after receiving vaccine, belief that vaccination reduces risk of death, increasing confidence, and attitude towards receiving vaccine were significantly (p < 0.05) correlated with vaccination status among Bangladeshi students (Table 3).

Factors associated with COVID-19 vaccination status among various levels of students in Bangladesh

Table 4 illustrates the odds of COVID-19 vaccination status among students in Bangladesh. The results show that female students were about 0.219 times less likely to be vaccinated than male students, but the category is significant, having a p-value of 0.014 (CI 0.66–0.732). The results also show that respondents whose current educational level was a master’s degree had a significantly higher (OR = 1.73) vaccination rate than the other educational levels.

Table 4.

Logistic regression results by all covariates associated with vaccination status

Variables	Category	Odds ratio(OR)	95% Confidence interval (CI)		p-value
			Lower	Upper
Gender	Female Male (ref.)	0.219	0.66	0.732	0.014
Age group (years)	16–20 21–25 26–30 (ref.)	0.173 0.236	0.046 0.465	0.645 0.853	0.995 0.995
Current educational level	Undergraduate Master’s Others (ref.)	0.135 1.731	0.015 2.016	1.215 27.56	0.457 0.001
Overdose	Yes No Maybe (ref.)	0.828 0.181	0.260 0.020	2.633 1.660	0.749 0.131
Willingness	Definitely No Undecided (ref.)	2.433 0.077	0.127 0.008	46.70 0.789	0.031 0.555
Encourage	Yes No Not sure (ref.)	0.056 0.042	0.021 0.010	0.311 7.314	0.226 0.001
Confident	Protection from COVID-19 Cannot cause long-term injury Safety Others (ref.)	13.676 21.059 22.572	0.165 0.210 0.288	1.132 2.112 1.767	0.223 0.266 0.140
Attitude	Pretty positive Very keen Neutral Don’t know (ref.)	1.287 1.856 0.658	0.092 0.041 0.034	18.04 84.62 11.99	0.852 0.751 0.778 0.999
Believe	Yes No Don’t know (ref.)	0.577 3.755	0.200 1.370	7.692 38.07	0.377 0.020
Essential	Agree Disagree Don’t know (ref.)	1.693 1.309	0.150 0.250	19.16 6.84	0.750 0.671

Students who did not encourage their family and friends to receive the COVID-19 vaccine were 0.042 times less likely to be vaccinated than those who were not sure about that. Similarly, respondents who willingly received vaccines were 2.433 times more likely to be vaccinated than the students in the undecided category (p < 0.05). From Table 4, students who did not believe that COVID-19 could not affect young people were 3.755 times more likely to be vaccinated than the students who said they did not know. This category is significant, having a p-value of 0.020, indicating a significant association with the dependent variable (CI 1.370–38.07).

Discussion

The COVID-19 outbreak is a common crisis for all nations, and one of the most effective approaches to preventing such a global pandemic is mass vaccination (Moghadas et al. 2021). On 8 February 2021, Bangladesh began a widespread COVID-19 vaccination program (Hossain et al. 2021). Based on this, the main objective of this study was to determine the knowledge, attitude, and dominant factors regarding COVID-19 vaccination in Bangladesh. It was well known that various COVID-19 vaccines were being distributed in many countries, including Bangladesh. Therefore, the adoption rate of the COVID-19 vaccine in Bangladesh depends on one's level of knowledge and attitude, and this study revealed that about two thirds of the respondents were vaccinated. However, according to the vaccination registration policy in Bangladesh, the vaccination program should primarily cover all areas (Unicef 2022).

In our analysis, the degree of positive attitude towards the COVID-19 vaccine was found to be 68%; these results were consistent with several low- and middle-income countries such as Ethiopia (Aklil and Temesgan 2022), Ghana (Okai and Abekah-Nkrumah 2022), and India (Danabal et al. 2021). According to knowledge about the COVID-19 vaccine, the majority of the population believed that vaccination reduces the risk of death and protects against COVID-19. This is consistent with recent studies in Bangladesh (Rahman et al. 2022; Bari et al. 2021), India (Soni et al. 2021), and Ethiopia (Aklil and Temesgan 2022), which found that higher levels of knowledge could increase vaccination coverage.

Various determining factors such as gender, education, willingness, encouragement, and belief were found to have a significant relationship with vaccination status. This study found that female students were 78% less likely to be vaccinated than male students. Our analysis showed that a higher education level (master’s degree) can increase the intention to receive the COVID-19 vaccine compared to lower educational levels. Obviously, better education will provide better awareness about the effects of COVID-19 and preventive measures. Very few studies were found that supported this study result (Haque et al. 2021; Lazarus et al. 2020). The results of this study revealed that people who were not willing to vaccinate and did not encourage others were more than 90% less likely to be vaccinated than others. As we mentioned earlier, students who believed that COVID-19 may affect young people were 3.75 times more likely to be vaccinated than those who did not.

Strengths, limitations, and further study

The study's strength is that it was carried out at a time when students had physically resumed classroom attendance after a long break and people had returned to their regular lives. At this time, many people had the impression that herd immunity had been developed, so they were less concerned about the severity of COVID-19. In this context, it is critical to assess the students' knowledge, attitudes, and other variables that affect their COVID-19 inoculation. Our investigation amply discloses certain context-specific insights that are helpful for evaluating the scenario. Our study also identifies the salient sociodemographic factors using a statistical model in relation to the students' knowledge and attitudes towards vaccination, providing a thorough framework for analyzing such future data.

Like all other studies, our study has some limitations as well. The study followed a convenience sampling approach, which is nonrandom and non-probability in nature, and the study sample does not represent the whole country. Another weakness of our sampling is that those who did not have internet access during the study period were not able to respond to our questionnaire. Another limitation of the study is that the online self-reporting method used here may have introduced bias.

Further studies should consider all individuals in Bangladesh on a large scale. The current study used only logistic regression analysis; for further research, other types of analysis can be used to determine the associated factors. The current study is cross-sectional; a broad national longitudinal study should be evaluated for further analysis.

Conclusions

We can conclude from the findings of our study that current educational level, age range, gender, perception regarding the essentiality of COVID-19 vaccine and its overdose, willingness to receive the COVID-19 vaccine, encouraging family or friends to vaccinate, and students’ belief about the effects of COVID-19 on young people are significant factors determining COVID-19 vaccination status among the students of Bangladesh. The insights from the findings of our study could help health planners and other stakeholders working to promote vaccination programs in their efforts to develop and implement necessary measures to increase the uptake of COVID-19 vaccine doses. Because of the higher favorable perception of persons with a history of COVID-19 infection, public health intervention initiatives should focus more on enhancing the perception of the disease severity. Stronger interventions, particularly for those who are unwilling to receive vaccination doses, are needed to control the spread of the pandemic by increasing vaccination dose uptake. The findings also suggest that health authorities should implement quick health education campaigns and provide more accurate information to bridge the gap regarding the essentiality of COVID-19 vaccination in order to curb the infection rate.

Authors' contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Ashis Talukder and Soheli Sharmin. Chuton Deb Nath, Iqramul Haq, Md. Ismail Hossain, Md. Jakaria Habib, and Sabiha Shirin Sara prepared the draft of the manuscript. Ashis Talukder supervised the project. All authors approved the final version of the manuscript.

Declarations

Ethics statement

All procedures performed in this study involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All participants of this study were informed prior to data collection about the purpose of the study. Consent was obtained from the participants prior to data collection. Participant anonymity and confidentiality of data were ensured, and participants were provided with information about the nature and purpose of the study, the procedure, and the right to withdraw their data from the study.

Ethics approval

This study was approved by the academic committee of Statistics Discipline, Khulna University, Bangladesh. In this way, it was carried out in conformity with the ethical principles of the Helsinki Declaration of 1964.

Consent to participate

Prior to taking part in the study, each participant read and signed an informed consent form. Each participant was given a copy of the detailed study description prior to signing the consent form. They were informed that they might leave the study at any time in this format.

Consent for publication

Not applicable.

Conflicts of interest

All authors declare no conflict of interest.