Collective factors for COVID-19 vaccination status among Bangladeshi sanitation and waste workers:Mixed method approach followed workplace setting

Sanitation and waste workers of Bangladesh are the leading fighters against COVID-19 along with other frontline frontiers and silently providing their cleaning services despite not receiving proper recognition and appreciation. It is essential to identify the underlaying factors for COVID-19 vaccination status among these frontline workers for safeguarding them in their grueling work conditions. This study was aimed to explore the factors related to vaccination status among these workers. It was a cross-sectional study with mix-method approach conducted among 800 sanitation or waste workers and 20 administrative authorities of sanitation and waste management department of Dhaka city of Bangladesh. Quantitative data was collected from the signified active sanitation and waste workers from both North and South City Corporation of Dhaka city and qualitative information was gathered from the respective administrative authorities. Multinomial logistic regression model and Chi-square test was used for the quantitative analysis and thematic analysis was done to extract outcome from qualitative data following specific objectives and variables. Most of the workers were found vaccinated (94.6%) notably because of the efficient COVID-19 vaccine policy of Government implemented by the respective authorities in through motivational programs, technical assistance in vaccine registration process etc. Majority (69%) received both the first and second doses and 21% have completed 3rd dose. COVID-19 non-vaccination status found significant among unmarried (OR: 0.19; p<0.01; 95% CI: 0.08-0.48) young group having poor knowledge on infection (6.5%) and vaccination (6.6%). Significant predictors for the complete vaccination status were found among the higher educated older age group (>50 years), from nuclear family (OR: 1.75; p=0.03; 95% CI: 1.07-2.86) who experienced adverse health effect (OR: 12.07; p<0.01; 95% CI: 2.87-50.69) of vaccination. Dominant reasons for non-willingness on vaccination found as some misbelieves and technological incompetence for registration. The necessary action plans need to be formulated and implemented at the policy-making level to ensure vaccination for all up to the third dose, as well as awareness programs among the Bangladeshi sanitation and waste workers.