COVID-19 vaccination coverage by district.

Background
Vaccination has been an indispensable step in controlling the coronavirus disease pandemic. In early 2021, Bangladesh launched a mass vaccination campaign to boost the COVID-19 vaccination rate when doses were available and immunized millions in the country. Although deemed a success, disparities became conspicuous in vaccination coverage across population of different socioeconomic background.
Methods
The purpose of this cross-sectional study was to assess the vaccination coverage for three doses and detect disparities in uptake of the COVID-19 vaccine among rural population of hard-to-reach areas and urban individuals belonging to the high-risk group -defined in our study as individuals from elusive population such as floating population/street dwellers, transgender, addicts and disabled population. We conducted household survey (n = 12,298) and survey with high risk group of people (2,520). The collected primary data were analysed using descriptive statistical analysis.
Results
Our findings show that coverage for the first dose of COVID-19 vaccination was high among respondents from both rural Hard-to-reach (HTR) (92.9%) and non-HTR (94.6%) areas. However, the coverage for subsequent doses was observed to reduce significantly, especially for third dose (52.2% and 56.4% for HTR and non-HTR, respectively).
Conclusion
Vaccination coverage among urbanites of high-risk group was found to be critically low. Vaccine hesitancy was also found to be high among individuals of this group. It is essential that the individuals of urban high-risk group be prioritized. Individuals from this group could be provided incentives (transport for disabled, monetary incentive to transgenders; food and medicine for drug user and floating people) and vaccination centers could be established with flexible schedule (morning/afternoon/evening sessions) so that they receive vaccine at their convenient time. Community engagement can be used for both high-risk group and rural population to enhance the COVID-19 vaccination coverage and lower disparities in uptake of the vaccine doses nationwide.

背景
疫苗接种是控制冠状病毒病大流行不可或缺的关键举措。2021年初，孟加拉国在疫苗剂量可供使用之际启动了大规模疫苗接种行动，以提升新型冠状病毒肺炎（COVID-19）疫苗接种率，并为国内数百万民众完成了免疫接种。尽管该行动被认为取得了成功，但不同社会经济背景人群的疫苗接种覆盖率差异愈发显著。

方法
本横断面研究旨在评估三剂次新型冠状病毒肺炎（COVID-19）疫苗的接种覆盖率，并探究交通不便地区（hard-to-reach, HTR）农村人群与城市高危人群——本研究中将其定义为流动人口、露宿者、跨性别者、药物成瘾者及残障人群等难以触及的群体——的疫苗接种差异。本研究开展了家庭入户调查（n = 12,298）与高危人群专项调查（n = 2,520），并采用描述性统计分析对收集到的原始数据进行分析。

结果
研究结果显示，农村交通不便地区（HTR）与非交通不便地区的受访对象中，新型冠状病毒肺炎（COVID-19）疫苗首剂接种覆盖率均较高，分别为92.9%与94.6%。但后续剂次的接种覆盖率出现了显著下降，尤其是第三剂次，HTR地区与非HTR地区的覆盖率分别仅为52.2%与56.4%。

结论
城市高危人群的疫苗接种覆盖率极低，该群体的疫苗犹豫（Vaccine hesitancy）程度也较高。优先为城市高危人群安排接种至关重要。可针对该群体提供针对性激励措施：为残障人士提供接送服务、为跨性别者发放现金补贴、为药物使用者与流动人口提供食物与药品；同时可设置灵活的接种时段（早/中/晚场次），方便其在便利的时间完成接种。此外，可通过社区参与的方式覆盖高危人群与农村人群，以提升全国范围内的新型冠状病毒肺炎（COVID-19）疫苗接种覆盖率，缩小疫苗接种的人群差异。