Pa ge 1 Pa ge 20 American Journal of Multidisciplinary Research and Innovation (AJMRI) Understanding Motivations Behind COVID-19 Vaccination Uptake: Insights from a Cross-Sectional Study in Northern Bangladesh Mohammad Zahidul Islam1*, Md Awal Kabir2 Volume 3 Issue 1, Year 2024 ISSN: 2158-8155 (Online), 2832-4854 (Print) DOI: https://doi.org/10.54536/ajmri.v3i1.2488 https://journals.e-palli.com/home/index.php/ajmri Article Information ABSTRACT Received: July 13, 2023 Accepted: December 27, 2023 Published: February 10, 2024 The emergence of COVID-19 has prompted global vaccination campaigns as a cornerstone of mitigation strategies. Understanding the factors influencing vaccine uptake is essential for designing targeted interventions to enhance immunization coverage. A cross-sectional study was conducted in northern Bangladesh, involving 1564 respondents aged 12 years and above. Data on COVID-19 vaccine uptake motivations and socio-demographic characteristics were collected through structured interviews. Descriptive statistics and multivariate logistic regression analyses were employed to explore associations between socio-demographic factors and vaccine uptake motivations. The study identified two key motivations for COVID-19 vaccine uptake: belief in the vaccine’s efficacy in reducing the risk of contracting the virus and feeling safe to engage in daily activities after vaccination. Socio- demographic factors such as age, education level, occupation, marital status, and disease status were significantly associated with these motivations. This study sheds light on the motivations driving COVID-19 vaccine uptake in Bangladesh and highlights the importance of addressing socio-demographic disparities in vaccine acceptance. Targeted interventions aimed at improving vaccine confidence and accessibility are crucial for promoting widespread immunization and combating the pandemic. Further research is needed to explore additional factors influencing vaccine uptake behavior and assess the long-term impact of vaccination campaigns on public health outcomes. Keywords COVID-19, Vaccination, Socio- Demographic Factors, Bangladesh INTRODUCTION The emergence of COVID-19 in late 2019 presented a global health crisis of unprecedented scale, demanding rapid and coordinated responses from governments, healthcare systems, and communities worldwide (Muralidar, Ambi, Sekaran, & Krishnan, 2020). In this context, vaccination campaigns emerged as a cornerstone of mitigation strategies, offering hope for curbing transmission, protecting individuals, and reducing the burden on healthcare systems (Largeron, Lévy, Wasem, Bresse, & policy, 2015; Rémy, Zöllner, Heckmann, & policy, 2015). However, the success of these campaigns hinges on widespread vaccine uptake, a complex phenomenon influenced by a multitude of factors (Yin et al., 2022). Understanding the factors that influence people’s decision- making regarding COVID-19 vaccination is paramount for designing targeted interventions to enhance vaccine uptake and achieve population immunity (Kabir, Rahman, & Khan, 2022; Naidoo, Meyer-Weitz, & Govender, 2023; Soares et al., 2021). While numerous studies have explored vaccination attitudes and behaviors in various contexts, there remains a critical need for localized insights to inform tailored strategies at the regional level (Habersaat & Jackson, 2020; Hopkins et al., 2023). In Bangladesh, where COVID-19 vaccination programs have been implemented, it is essential to elucidate the motivations driving vaccine acceptance among the population, particularly in different geographic regions with unique socio-demographic characteristics (Abedin et al., 2021; Khan, Kabir, Shariff, & Rahman, 2022; Lee et al., 2022). Previous studies have highlighted vaccine hesitancy as a significant barrier to achieving widespread immunization (Galagali, Kinikar, & Kumar, 2022; Khanam & Kabir, 2023). Moreover, factors such as perceived safety, efficacy, and trust in healthcare authorities have been identified as significant predictors of vaccine acceptance among various populations (Joshi et al., 2021; Kalam et al., 2021; Khan, Alam, Chowdhury, Kabir, & Khan, 2023; Le, Nguyen, & Do, 2022; Roy, Ali, Sarker, Islam, & Azam, 2023). Additionally, socio-demographic factors at the individual level have been found to influence vaccine uptake (Reichmuth et al., 2023). However, existing studies often report conflicting associations and are often limited to specific population groups (Backhaus & Health, 2023; de Figueiredo, Simas, & Larson, 2023; Kabir et al., 2022; Lapo-Talledo, Talledo- Delgado, Portalanza, Ballaz, & Siteneski, 2023), making them less applicable for informing broader policy and program-making efforts. To address these gaps in knowledge, we conducted this study to identify the motivations behind COVID-19 vaccination uptake in Bangladesh and explore their associations with socio-demographic factors. METHODOLOGY Study Setting Data were collected from five districts (Kishorgonj, Gazipur, Netrokona and Jamalpur) spanning two divisions of Bangladesh: Dhaka and Mymensingh. While 1 Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh 2 Department of Social Work, Pabna University of Science and Technology, Pabna, Bangladesh * Corresponding author’s e-mail: zahid100779@gmail.com Pa ge 21 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 the choice of divisions was purposeful, the selection of districts within these divisions was done randomly. Sample Data were collected from a total of 1564 respondents aged 12 years or older. The inclusion criteria stipulated that respondents must have either received at least one dose of the COVID-19 vaccine or registered for vaccination. Outcome Variables The perception of respondents regarding motivations for vaccination was considered as the outcome variable. This encompassed two key factors: the belief that vaccination reduces the risk of contracting the coronavirus (yes, no) and the feeling of safety to engage in daily activities after vaccination (yes, no). Explanatory Variables The socio-demographic characteristics of respondents were considered as explanatory variables in this study. These variables were selected based on a review of relevant literature and their availability in the survey dataset. They included respondents’ age, gender, education, occupation, marital status, living area, smoking status, monthly income, and disease status. Statistical Analysis Descriptive statistics, including frequency and percentage, were employed to characterize the respondents. Multivariate logistic regression analysis was conducted to identify factors associated with two outcome variables: the belief that vaccination reduces the risk of contracting the coronavirus and the feeling of safety to engage in daily activities after vaccination. Separate models were constructed for each outcome variable. Prior to running each model, multicollinearity among variables was assessed. In cases where evidence of multicollinearity was detected, relevant variables were removed, and the models were rerun. Results are presented as odds ratios (aOR) along with their corresponding confidence intervals. All analyses were performed using Stata version 15.1. RESULTS Background Characteristics of the Respondents The background characteristics of the respondents are presented in Table 1. The descriptive statistics revealed that the majority of respondents fell within the age range of 31-60 years (51.4%), followed by those aged 12-30 years (43.2%), with a mean age of 36.34 years (SE=0.338). Regarding gender distribution, males comprised a larger proportion (64.6%) compared to females (35.4%). In terms of education, the highest percentage of respondents had completed at least 10 years of education (38.6%), while 30.7% had 6-10 years of education. Occupation-wise, the respondents were diverse, with a notable proportion being housewives (23.8%), followed by businessmen and self-employed individuals (20.6%). The majority of respondents were married (70.3%), residing mainly in villages (47.3%). A significant portion reported never having smoked (58.7%), while 27.3% currently smoked. The mean monthly income was 16,472.05 Taka (SE=300.46), with most respondents earning between 500 and 16,472 Taka (50.3%). A sizable proportion reported having a disease (30.6%), while the majority did not (69.4%). Table 1: Background characteristics of the respondents Socio-demographic characteristics Frequency Percentage (%) Mean (SE) Respondents’ age (in years) 36.34 (0.338)12-30 675 43.2 31-60 804 51.4 ≥ 61 85 5.4 Respondents’ gender Male 1011 64.6 Female 553 35.4 Respondents’ education 8.84 (0.130)Illiterate 182 11.6 1 - 5 298 19.1 6 - 10 480 30.7 ≥ 10 604 38.6 Respondents’ occupation Employee 326 20.8 Businessman and Self-employed 322 20.6 Housewife 373 23.8 Farmer and Worker 270 17.3 Others (Student, Unemployed, Retired) 273 17.5 Pa ge 22 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 Respondents’ marital status Married 1100 70.3 Unmarried (Separated, Single) 405 25.9 Widow / Widower 59 3.8 Respondents’ living area District 374 23.9 Sub- District 451 28.8 Village 739 47.3 Respondents’ smoking status Currently, do 427 27.3 I never did 918 58.7 I used to do it but now I don't 79 5.1 I do it occasionally 140 9.0 Respondents’ monthly income 500 - 16472 787 50.3 16472.05 (300.46)16473 - 80000 585 37.4 Respondents’ disease status Yes 479 30.6 No 1085 69.4 Perceptions of COVID-19 Vaccine Uptake Benefits among the Respondents Table 2 presents the distribution of respondents’ perceptions regarding COVID-19 vaccination benefits, categorized by demographic characteristics. Overall, a large majority of respondents expressed belief in the effectiveness of vaccination in reducing the risk of contracting the coronavirus, with 87.1% affirming this perception. Similarly, a substantial proportion reported feeling safe to engage in daily activities after vaccination, with 91.2% expressing this sentiment. Analysis by age groups revealed that younger respondents aged 12-30 years exhibited slightly lower levels of belief in vaccination effectiveness (35.5%) compared to older age groups, while feeling safe after vaccination was more prevalent among respondents aged 31-60 years (47.6%). Regarding gender, male respondents demonstrated slightly higher levels of belief in vaccination effectiveness (56.5%) and feeling safe after vaccination (58.6%) compared to female respondents. Education-wise, respondents with higher levels of education exhibited greater belief in vaccination effectiveness and feeling safe after vaccination. Similar trends were observed across different occupational groups, marital status categories, living areas, smoking status, income levels, and disease status, with variations in percentages but consistent overall patterns of belief in vaccination benefits. Table 2: Respondents’ perceptions of the benefits of COVID-19 vaccine uptake across their socio-demographic characteristics Socio-demographic characteristics Belief that vaccination reduces the risk of contracting the coronavirus Feeling of safety to engage in daily activities after vaccination Yes (%) No (%) Yes (%) No (%) 1362 202 1427 137 (87.1) (12.9) (91.2) (8.8) Respondents’ age (in years) 12-30 556 (35.5) 119 (7.6) 602 (38.5) 73 (4.7) 31-60 728 (46.5) 76 (4.9) 744 (47.6) 60 (3.8) ≥ 61 78 (5.0) 7 (0.4) 81 (5.2) 4 (0.3) Respondents’ gender Male 884 (56.5) 127 (8.1) 916 (58.6) 95 (6.1) Female 478(30.6) 75 (4.8) 511 (32.7) 42 (2.7) Respondents’ education Illiterate 149 (9.5) 33 (2.1) 167 (10.7) 15 (1.0) Pa ge 23 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 1 - 5 268 (17.1) 30 (1.9) 284 (18.2) 14 (0.9) 6 - 10 442 (28.3) 38 (2.4) 439 (28.1) 41 (0.9) ≥ 10 503 (32.2) 101 (6.5) 537 (34.3) 67 (4.3) Respondents’ occupation Employee 290 (18.5) 36 (2.3) 299 (19.1) 27 (1.7) Businessman and Self-employed 297 (19.0) 25 (1.6) 287 (18.4) 35 (2.2) Housewife 329 (21.0) 44 (2.8) 345 (22.1) 28 (1.8) Farmer and Worker 241 (15.4) 29 (1.9) 248 (15.9) 22 (1.4) Others (Student, Unemployed, Retired) 205 (13.1) 68 (4.3) 248 (15.9) 25 (1.6) Respondents’ marital status Married 991 (63.4) 109 (7.0) 1007 (64.4) 93 (5.9) Unmarried (Separated, Single) 321 (20.5) 84 (5.4) 365 (23.3) 40 (2.6) Widow / Widower 50 (3.2) 9 (0.6) 55 (3.5) 4 (0.3) Respondents’ living area District 312 (19.9) 62 (4.0) 335 (21.4) 39 (2.5) Sub- District 396 (25.3) 55 (3.5) 415 (26.5) 36 (2.3) Village 654 (41.8) 85 (5.4) 677 (43.3) 62 (4.0) Respondents’ smoking status Currently, do 381 (24.4) 46 (2.9) 394 (25.2) 33 (2.1) I never did 795 (50.8) 123 (7.9) 832 (53.2) 86 (5.5) I used to do it but now I don't 71 (4.5) 8 (0.5) 71 (4.5) 8 (0.5) I do it occasionally 115 (7.4) 25 (1.6) 130 (8.3) 10 (0.6) Respondents’ monthly income 500 - 16472 684 (43.7) 103 (6.6) 722 (46.2) 65 (4.2) 16473 - 80000 527 (33.7) 58 (3.7) 537 (34.3) 48 (3.1) Respondents’ disease status Yes 413 (26.4) 66 (4.2) 436 (27.9) 43 (2.7) No 949 (60.7) 136 (8.7) 991 (63.4) 94 (6.0) Factors Associated with Positive Perception of COVID-19 Vaccine Uptake Table 3 presents the factors associated with respondents’ perception that vaccination reduces the risk of contracting the coronavirus. Among respondents’ age groups, those aged 31-60 years and ≥61 years showed statistically significant associations with higher odds of believing in vaccination effectiveness compared to the reference group (aged 12-30 years), with odds ratios of 1.690 (95% CI: 1.103-2.590) and 2.982 (95% CI: 1.166- 7.627), respectively. Gender, education level, occupation, marital status, living area, and smoking status did not show statistically significant associations with perception of vaccination effectiveness. However, respondents with education levels of ≥10 years exhibited lower odds of believing in vaccination effectiveness (OR: 0.531, 95% CI: 0.293-0.963) compared to illiterate individuals. Additionally, respondents without any reported diseases had lower odds of perceiving vaccination effectiveness (OR: 0.620, 95% CI: 0.430-0.894) compared to those with reported diseases. Other socio-demographic characteristics such as gender, occupation, marital status, living area, smoking status, and monthly income did not show statistically significant associations with respondents’ perception of vaccination effectiveness. Table 3: Factors associated with respondents’ perception that vaccination reduces the risk of contracting the coronavirus Characteristics p-value Odds ratio 95% CI Respondents’ age (in years) Lower Bound Upper Bound 12-30 1.00 31-60 0.016 1.690 1.103 2.590 ≥ 61 0.023 2.982 1.166 7.627 Respondents’ gender Male 1.00 Pa ge 24 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 Table 4 presents the factors associated with respondents’ feeling of safety to engage in daily activities after vaccination. Among respondents’ age groups, those aged 31-60 years showed a statistically significant association with higher odds of feeling safe after vaccination compared to the reference group (aged 12-30 years), with an odds ratio of 1.637 (95% CI: 1.029-2.604). Gender did not show a statistically significant association with feeling safe after vaccination. Regarding education level, individuals with 1-5 years of education exhibited significantly higher odds of feeling safe after vaccination (OR: 3.143, 95% CI: 1.539-6.418) compared to illiterate individuals. However, no statistically significant associations were found for education levels of 6-10 years or ≥10 years. Occupation- wise, individuals who were currently employed as businessmen and self-employed showed lower odds of feeling safe after vaccination (OR: 0.587, 95% CI: 0.340- 1.013) compared to employees. Marital status, living area, smoking status, monthly income, and disease status did not show statistically significant associations with feeling safe after vaccination. Female 0.791 1.073 0.637 1.805 Respondents’ education Illiterate 1.00 1 - 5 0.978 1.008 0.563 1.805 6 - 10 0.153 1.425 0.877 2.317 ≥ 10 0.037 0.531 0.293 0.963 Respondents’ occupation Employee 1.00 Businessman and Self-employed 0.214 1.419 0.817 2.463 Housewife 0.964 0.984 0.497 1.949 Farmer and Worker 0.486 1.264 0.671 2.311 Others (Student, Unemployed, Retired) 0.198 0.677 0.375 1.225 Respondents’ marital status Married 1.00 Unmarried (Separated, Single) 0.330 0.666 0.295 1.504 Widow / Widower 0.329 0.779 0.471 1.288 Respondents’ living area District 1.00 Sub- District 0.705 1.085 0.710 1.658 Village 0.349 1.218 0.806 1.839 Respondents’ smoking status Currently, do 1.00 I never did 0.746 1.081 0.675 1.732 I used to do it but now I don't 0.923 1.042 0.453 2.397 I do it occasionally 0.079 0.607 0.348 1.060 Respondents’ monthly income 500 - 16472 1.00 16473 - 80000 0.123 1.364 0.920 2.023 Respondents’ disease status Yes 1.00 No 0.011 0.620 0.430 0.894 Table 4: Factors associated with respondents’ feeling of safety to engage in daily activities after vaccination Characteristics p-value Odds ratio 95% CI Respondents’ age (in years) Lower Bound Upper Bound 12-30 1.00 31-60 0.037 1.637 1.029 2.604 ≥ 61 0.063 2.979 0.941 9.425 Pa ge 25 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 Respondents’ gender Male 1.00 Female 0.052 1.913 0.995 3.680 Respondents’ education Illiterate 1.00 1 - 5 0.002 3.143 1.539 6.418 6 - 10 0.048 1.650 1.004 2.713 ≥ 10 0.135 1.731 0.842 3.558 Respondents’ occupation Employee 1.00 Businessman and Self-employed 0.055 0.587 0.340 1.013 Housewife 0.485 0.743 0.323 1.709 Farmer and Worker 0.150 0.599 0.299 1.203 Others (Student, Unemployed, Retired) 0.187 1.649 0.785 3.466 Respondents’ marital status Married 1.00 Unmarried (Separated, Single) 0.643 1.145 0.646 2.029 Widow / Widower 0.758 0.840 0.277 2.029 Respondents’ living area District 1.00 Sub- District 0.133 1.469 0.890 2.425 Village 0.528 1.163 0.727 1.862 Respondents’ smoking status Currently, do 1.00 I never did 0.031 0.572 0.345 0.949 I used to do it but now I don't 0.241 0.601 0.257 1.407 I do it occasionally 0.941 1.029 0.487 2.173 Respondents’ monthly income 500 - 16472 1.00 16473 - 80000 0.362 1.233 0.786 Respondents’ disease status Yes 1.00 No 0.073 0.679 0.445 1.037 DISCUSSION The objectives of this study were twofold: firstly, to elucidate the motivations driving COVID-19 vaccination uptake in Bangladesh, and secondly, to investigate the associations between these motivations and various socio-demographic factors. Our analysis focused on two primary motivations for vaccine uptake: the belief that vaccination reduces the risk of contracting the coronavirus and the feeling of safety to engage in daily activities after vaccination. We identified several socio- demographic factors among respondents that were significantly associated with these motivations. Firstly, the study reveals age as a pivotal determinant of individuals’ perceptions regarding vaccination efficacy and post-vaccination safety. This is comparable to the previous studies in LMICs (Al-Mohaithef & Padhi, 2020; Viswanath et al., 2021). Notably, older respondents aged 31-60 years exhibited significantly higher odds of believing in vaccination effectiveness and feeling safe after vaccination compared to younger counterparts aged 12-30 years (Viswanath et al., 2021). This aligns with existing literature suggesting that older age groups, who are often more susceptible to severe COVID-19 outcomes, may perceive greater benefits from vaccination due to perceived vulnerability and higher perceived severity of the disease (Ibrahim, Fadila, & Elmawla, 2023). Conversely, younger individuals may harbor more skepticism or uncertainty about vaccination benefits, influenced by factors such as perceived invulnerability, vaccine misinformation, or concerns about vaccine side effects (Anas, Salifu, & Zakaria, 2023; Kabir & Islam, 2022). Secondly, the study sheds light on the role of education in shaping vaccination perceptions, as found in other Pa ge 26 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 LMICs (Al-Mohaithef & Padhi, 2020; Backhaus & Health, 2023; Habersaat & Jackson, 2020; Hopkins et al., 2023; Khramchenko, 2023). Interestingly, individuals with lower levels of education (1-5 years) exhibited significantly higher odds of feeling safe after vaccination compared to illiterate individuals, suggesting a potential association between education and vaccine confidence(Khramchenko, 2023). This finding underscores the importance of health literacy and effective communication strategies in promoting vaccine acceptance, particularly among populations with lower educational attainment (Le et al., 2022). However, the study also identified a decline in perceived vaccination effectiveness among individuals with higher education levels (≥10 years), highlighting the need for tailored communication approaches that address varying informational needs and concerns across educational strata (Kaufman et al., 2018). Moreover, the study explored the influence of occupation on vaccination perceptions, revealing intriguing patterns. Businessmen and self-employed individuals exhibited lower odds of feeling safe after vaccination compared to employees, although this association did not reach statistical significance (Wismans, van der Zwan, & Thurik, 2023). This finding suggests potential occupational factors or contextual considerations that may influence vaccine perceptions, warranting further exploration (Roy, Biswas, Islam, & Azam, 2022). For instance, individuals with flexible employment arrangements or entrepreneurial pursuits may experience unique barriers or motivations related to vaccine uptake, such as concerns about productivity losses, access barriers, or differing risk perceptions in non-traditional work settings (Osetek, 2018). Additionally, the study examined the impact of disease status on vaccination perceptions, revealing an intriguing association (Xia & Liu, 2014). Respondents without reported diseases exhibited lower odds of perceiving vaccination effectiveness compared to those with reported diseases (Goodman et al., 2001). This unexpected finding prompts reflection on potential underlying mechanisms or confounding factors that may influence vaccination perceptions among healthier individuals (Al-Mohaithef & Padhi, 2020). It also underscores the need for nuanced approaches to vaccine messaging and outreach that consider individual health status, risk perception, and perceived susceptibility to COVID-19 (Goodman et al., 2001). Overall, the study findings contribute valuable insights to the evolving discourse on COVID-19 vaccine acceptance and public health strategies (Habersaat & Jackson, 2020). By elucidating the multifaceted determinants of vaccination perceptions across diverse socio-demographic groups, the study informs targeted interventions and communication strategies aimed at enhancing vaccine confidence and uptake (Hopkins et al., 2023). However, the study’s cross-sectional design limits causal inference and necessitates longitudinal investigations to validate the observed associations and elucidate temporal trends in vaccination perceptions over time (Joshi et al., 2021). Future research endeavors should also explore additional contextual factors, including cultural norms, social networks, and access barriers, to provide a comprehensive understanding of vaccination decision-making and inform evidence-based interventions to promote public health and mitigate the impact of the COVID-19 pandemic (Ibrahim et al., 2023; Kaufman et al., 2018). This study has several strengths and a few limitations. This study analysed data collected from data from a diverse sample of respondents across multiple districts in Bangladesh, thereby providing a broad representation of the population’s perspectives on COVID-19 vaccination. Rigorous statistical methods, including multivariate logistic regression analysis, were employed to identify factors associated with vaccine uptake motivations, enhancing the validity and reliability of the findings. Additionally, the study benefitted from a large sample size, with data collected from over 1500 respondents, providing substantial statistical power for more accurate assessments of associations between socio-demographic factors and vaccine uptake motivations. Moreover, by focusing on Bangladesh, the study offers valuable localized insights into the factors influencing COVID-19 vaccine acceptance within a specific geographic and socio-cultural context, which can inform targeted public health interventions. However, several limitations should be noted. The cross- sectional design of the study limits the ability to establish causal relationships between socio-demographic factors and vaccine uptake motivations, warranting the need for longitudinal studies to provide more robust evidence over time. Additionally, reliance on self-reported data for vaccination status and motivations may introduce recall bias or social desirability bias, potentially influencing the accuracy of the results. Furthermore, while the study offers insights into vaccine acceptance in Bangladesh, its findings may not be generalizable to other populations with different socio-cultural contexts or healthcare systems. Moreover, the presence of unmeasured or residual confounders could impact the observed associations between socio-demographic factors and vaccine uptake motivations. Lastly, the study focused on a limited set of variables, and additional factors such as vaccine efficacy, safety concerns, and access to healthcare services were not comprehensively explored, suggesting the need for future research to incorporate a broader range of variables for a more holistic understanding of vaccine uptake behavior. CONCLUSION This study provides valuable insights into the motivations driving COVID-19 vaccine uptake in Bangladesh and the associated socio-demographic factors. Our findings highlight the importance of understanding the diverse range of factors influencing individuals’ decisions to vaccinate against COVID-19. Belief in the vaccine’s efficacy in reducing the risk of contracting the virus Pa ge 27 https://journals.e-palli.com/home/index.php/ajmri Am. J. Multidis. Res. Innov. 3(1) 20-28, 2024 and the feeling of safety to engage in daily activities after vaccination emerged as key motivators for vaccine acceptance among respondents. However, socio- demographic characteristics such as age, education level, occupation, marital status, and disease status were found to significantly influence these motivations. These findings underscore the need for targeted public health interventions tailored to specific demographic groups to address vaccine hesitancy and promote widespread immunization. Strategies aimed at improving vaccine confidence and addressing concerns related to safety and efficacy should be prioritized, particularly among groups with lower vaccine acceptance rates. Additionally, efforts to enhance access to vaccination services and promote health education and awareness campaigns can further support vaccine uptake initiatives. Acknowledgements The authors express their gratitude to the Departments of Population Science at Jatiya Kabi KAzi Nazrul Islam University, Bangladesh, for providing support during the conduct of this study. REFERENCES Abedin, M., Islam, M. A., Rahman, F. N., Reza, H. M., Hossain, M. 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