Vaccination is undoubtedly one of the most effective strategies to halt the COVID-19 pandemic. The current study aimed to investigate the acceptance of COVID-19 vaccination and its associated factors using two health behavior change frameworks: the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). A total of 639 Bangladeshi adults (mean age: 24 years) participated in a cross-sectional online study between July and August 2021. The questionnaire covered questions regarding vaccine intentions, sociodemographic features, health status, perceived trust in/satisfaction with health authorities, reasons for vaccine hesitancy, and factors related to the health behavior change frameworks. Hierarchical logistic regression was employed to determine associations between these predictors and vaccine acceptance. The intention to get a COVID-19 vaccination was expressed among 85% of the participants. In fully adjusted models, students and respondents with more normal body weights reported higher intentions to get vaccinated. Respondents were also more likely to seek vaccination if they reported greater levels of perceived susceptibility, benefits, and cues to action, as well as lower levels of barriers and self-efficacy. Fear of future vaccine side effects was the most common reason for COVID-19 vaccine hesitancy and was expressed by 94% of the vaccine-hesitant respondents. These factors should be considered by health authorities in Bangladesh and perhaps other countries when addressing the plateauing COVID-19 vaccination rates in many populations.

Department of Clinical Laboratories and Forensic Medicine Jordan University Hospital Amman 11942 Jordan

Department of Environmental Science and Disaster Management Bangabandhu Sheikh Mujibur Rahman Science and Technology University Gopalganj 8100 Bangladesh

Department of Global Health Policy Graduate School of Medicine The University of Tokyo Tokyo 113 0033 Japan

Department of Parks Recreation and Tourism Management Clemson University Clemson SC 29634 USA

Department of Pathology Microbiology and Forensic Medicine School of Medicine The University of Jordan Amman 11942 Jordan

Environment and Sustainability Research Initiative Khulna 9208 Bangladesh

Environmental Science Discipline Life Science School Khulna University Khulna 9208 Bangladesh

Environmental Technology and Engineering University of Chemistry and Technology 16628 Prague Czech Republic

Institute of Disaster Management Khulna University of Engineering and Technology Khulna 9203 Bangladesh

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