Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 9;22(1):84.
doi: 10.3390/ijerph22010084.

Physicians' Intentions to Recommend Influenza Vaccine: A Multi-Centered Hospital-Based Study Using the Theory of Planned Behavior in Bangladesh

Md Abdullah Al Jubayer Biswas  1   2 , Mahbubur Rahman  3 , Sazzad Hossain Khan  1 , Ahamed Khairul Basher  1 , Md Ariful Islam  1   4 , Ashrak Shad Pyash  1 , Homayra Rahman Shoshi  1 , Md Altaf Ahmed Riaj  1 , Md Nazrul Islam  5 , Md Arif Rabbany  5 , Md Azizul Haque  6 , Shishir Ranjan Chakraborty  7 , Syeda Rukhshana Parvin  8 , Mahmudur Rahman  9 , Fahmida Chowdhury  1 , Tahmina Shirin  3 , Md Zakiul Hassan  1   10
Affiliations

Physicians' Intentions to Recommend Influenza Vaccine: A Multi-Centered Hospital-Based Study Using the Theory of Planned Behavior in Bangladesh

Md Abdullah Al Jubayer Biswas et al. Int J Environ Res Public Health. .

Abstract

Background: Influenza remains a significant public health challenge in low- and middle-income countries (LMICs) like Bangladesh, where vaccine uptake remains low despite the substantial disease burden. Physicians play a vital role in promoting vaccination, yet their intentions and influencing factors are not well understood.

Methods: We conducted a cross-sectional study from June to October 2022 across four tertiary-level hospitals in Bangladesh using a questionnaire grounded in the Theory of Planned Behavior (TPB). Hierarchical logistic regression was employed to identify factors associated with vaccine recommendation intentions.

Results: Among 972 physicians with an average age of 32.1 years, 40.1% intended to recommend and administer the influenza vaccine. Most (85.3%) agreed vaccination reduces risk, 65.5% desired vaccination for self-protection, 63.5% would vaccinate if available at work, and 85.3% anticipated Ministry of Health support. Male (OR = 1.9, 95% CI: 1.5-2.3) and married (OR = 1.5, 95% CI: 1.1-1.9) physicians were more likely to recommend vaccination. Each unit increase in attitude score doubled the likelihood of recommending the vaccine (OR = 2.0, 95% CI: 1.4-3.0).

Conclusions: Physicians' influenza vaccine recommendations in Bangladesh are suboptimal, influenced by gender, marital status, and attitudes. Targeted educational interventions addressing attitudinal barriers and leveraging institutional support could improve recommendation practices.

Keywords: Bangladesh; Theory of Planned Behavior (TPB); influenza vaccine; intention to recommend; physician attitudes and behaviors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
TPB framework to investigate physicians’ intention to recommend and administer influenza vaccine.
Figure 2
Figure 2
Physicians’ responses across TPB-component-related questions for influenza vaccination attitudes, subjective norms, and perceived behavioral control.
See this image and copyright information in PMC

References

    1. World Health Organization Global Influenza Strategy 2019–2030. [(accessed on 20 October 2024)]. Available online: https://www.who.int/publications/i/item/9789241515320.
    1. Ortiz J.R., Neuzil K.M. Influenza immunization in low-and middle-income countries: Preparing for next-generation influenza vaccines. J. Infect. Dis. 2019;219:S97–S106. doi: 10.1093/infdis/jiz024. - DOI - PubMed
    1. World Health Organization Influenza (Seasonal) Fact Sheet. [(accessed on 20 October 2024)]. Available online: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
    1. Wang X., Li Y., Mei X., Bushe E., Campbell H., Nair H. Global hospital admissions and in-hospital mortality associated with all-cause and virus-specific acute lower respiratory infections in children and adolescents aged 5–19 years between 1995 and 2019: A systematic review and modelling study. BMJ Glob. Health. 2021;6:e006014. doi: 10.1136/bmjgh-2021-006014. - DOI - PMC - PubMed
    1. Drobnik J., Pobrotyn P., Witczak I.T., Antczak A., Susło R. Influenza as an important factor causing increased risk of patients’ deaths, excessive morbidity and prolonged hospital stays. Arch. Med. Sci. AMS. 2023;19:941. doi: 10.5114/aoms/138145. - DOI - PMC - PubMed

Substances

LinkOut - more resources