Promoting COVID-19 vaccination in rural Bangladesh

The objective of the proposed study is to identify the most effective strategy to promote large scale vaccination among adults in Bangladesh. Towards this end, the eligible sample of unvaccinated individuals will be randomly assigned to a control group and one of the three treatment arms. There will be three treatment groups: Information will be disseminated about the available vaccines, benefits, and costs associated with getting vaccinated via awareness campaign from a reliable source to all the three treatment groups. While the first treatment group will receive only the information treatment, the other two treatment groups will receive additional interventions. Thus, in addition to the information campaign, the other two treatment groups will receive one of the two different interventions (accessibility vis-à-vis campaign to address misconception via an ambassador) to isolate the effect of each of the different treatments. The three different treatments that we will focus on in the proposed project are as follows: Treatment 1 (T1): Information campaign only. Treatment 2 (T2): Information campaign + Accessibility (helping them with registration/enrolment, travelling to get vaccinated, and reminding/encouraging them to get vaccinated at the right time via brief telephone reminders). The gentle and brief reminder will be provided both through a phone call as well as a SMS about two weeks after the intervention is delivered. We will help the target group with the registration procedure and will track their progress from registration to vaccination, reminding them to get vaccinated (all free of cost). They will also be provided help with identifying the nearest vaccination center and travelling to the same, and any travelling cost using the most convenient travel mode as locally available. This intervention will be provided by the staff of the NGO partner, GDRI (Global Development Research Institute), who will work closely under the supervision of the research team. Treatment 3 (T3): Information + campaign/motivation by eminent figures in the community (e.g., village leaders, teachers, doctors, etc). We will approach village leaders to identify the most respected and trusted eminent figure in their community (e.g., religious leaders, teachers, doctors) and ask him/her to campaign and propagate information to address misconceptions related to the available vaccines. To be more convincing and credible, the selected individuals should already be vaccinated or at least have registered to get vaccinated. Campaigning by eminent figures will start as soon as he/she is selected. Specifically, the selected eminent figures (we call them 'Ambassadors')will be asked to campaign and propagate specific information (in addition to basic information being provided to all) to address misconceptions related to the available vaccines. Ambassadors will speak with the unvaccinated selected individuals one-to-one by visiting them while following strict health protocols (e.g., every respondent and ambassador will wear mask, maintain 1.5 meters between individuals, open air space), and try to convince them to get vaccinated. The meeting will occur once during the campaign period (1 month) and each meeting will last for a maximum 1 hour. The campaign will be based on context-specific information and guidelines provided by the central and local government bodies and will dispel misperceptions about the disease, the available vaccines, distribution of infection and fatality rates and improve knowledge about COVID-19 prevention and transmission etc. The control group on the other hand will receive no such information campaign about the vaccines or any specific incentives. The research team will visit the participants about one month after the intervention to verify their vaccination status. They will be visited again one month after the first verification to update the vaccination status and conduct the endline and spillover surveys (which will ask randomly selected individuals from the villages about their vaccination status- to understand if the intervention also influenced other people to get vaccinated). The vaccination status will be verified using the registration information and text messages sent by the govt's department of public health confirming the dose of the vaccine and the date being vaccinated. We will select a total of 685 locations (villages), with 10-20 unvaccinated people (average 13 participants per village) from each of these locations. From each household, we will focus on adult individuals who are eligible for COVID19 vaccine free of cost and are unvaccinated. Only one participant will be recruited for the purpose of the survey and the intervention. Randomization into treatment and control groups will be done next at the village level. About 9,000 selected individuals identified from the 685 locations will be randomised (using a computer program), with 137 locations in the pure control (T0) and information campaign only (T1) arms, 205 locations in T2 and 206 locations in the T3 arm. All these changes were happened prior to enrolment commencement