Vaccination, Compliance with Preventive Measures and Mental Health during COVID-19 among Adults in Bangladesh: Do Vaccination and Compliance with Preventive Measures Improve Mental Health?


  • Bipasha Singha Department of Psychology, University of Dhaka, Dhaka-1000, Bangladesh and Water and Environmental Engineering Laboratory, Department of Earth System Science and Technology, Kyushu University, Kasuga-Koen 6-1, Kasuga-shi, Fukuoka 816-8588, Japan
  • Shamal Chandra Karmaker Department of Statistics, University of Dhaka, Dhaka-1000, Bangladesh and International Institute for Carbon-Neutral Energy Research (WPI-I2CNER), Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka 819-0395, Japan
  • M. Mazharul Islam Department of Statistics, College of Science, Sultan Qaboos University, Oman
  • Kareman Eljamal Department of Clinical Pharmacology, Graduate School of Medical Sciences, Kyushu University, Japan
  • Bidyut Baran Saha International Institute for Carbon-Neutral Energy Research (WPI-I2CNER), Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka 819-0395, Japan



Vaccination, Mental health, Anxiety, COVID-19, Depression, Preventive measures, Stress, Bangladesh


Background and Objective: In addition to the reduction of risk of COVID-19 transmission and mortality, vaccination and compliance with the preventive measures of COVID-19 may have important additional benefits for the improvement of mental health. This study examined the levels and determinants of vaccination, compliance with preventive measures, and anxiety, depression and stress among Bangladeshi adults. It also examined the effects of vaccination and compliance with preventive measures on mental health status among Bangladeshi adults.

Methods: Data for the study come from an online survey conducted during November and December 2021 among Bangladeshi adults. A total of 615 adults participated in the survey. A 21-item Depression, Anxiety, and Stress scale (DASS 21) were used for collecting data on mental health. Both descriptive and inferential statistical methods including multiple logistic regression were used for data analysis.

Results: About 69% of Bangladeshi adults were vaccinated with at least one dose; 87% of adults believed that vaccines are moderate to highly effective in reducing COVID-19 infection. Among the preventive measures during a pandemic, the level of complete compliance with wearing masks and hand washing was almost universal, while the compliance level with other preventive measures was moderate. Vaccinated people had a 55% (OR=0.45; 95%CI:0.26-0.82), 67% (OR=0.33; 95%CI:0.12-0.91), and 44% (OR=0.56; 95%CI:0.27-0.97) lower chance of suffering from depression, anxiety, and stress, respectively than non-vaccinated people. People with complete compliance had 64% (OR= 0.36; 95%CI:0.18-0.72), 71% (OR=0.29; 95%CI:0.15-0.58), and 74% (OR=0.26; 95%CI:0.13-0.50) lower risk of suffering from depression, anxiety, and stress, respectively, than respondents with irregular preventive behaviors.

Conclusion: This study documents the important psychological benefits of vaccination and compliance with preventive measures of COVID-19.


Baj J, Karakuła-Juchnowicz H, Teresiński G, Buszewicz G, Ciesielka M, Sitarz E, et al. COVID-19: Specific and non-specific clinical manifestations and symptoms: The current state of knowledge. J Clin Med 2020; 9: 1-22. DOI:

Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated Psychological Problems. Asian J Psychiatr 2020; 51: 102092. DOI:

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020; 395: 912-20. DOI:

O’Connor RC, Wetherall K, Cleare S, McClelland H, Melson AJ, Niedzwiedz CL, et al. Mental health and well-being during the COVID-19 pandemic: Longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. Br J chPsyiatry 2021; 218: 326-33. DOI:

Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu T, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl) 2020; 133: 1015-24. DOI:

Serafini G, Parmigiani B, Amerio A, Aguglia A, Sher L, Amore M. The psychological impact of COVID-19 on the mental health in the general population. An Int Joural Med 2020; 113: 229-35. DOI:

WHO. Coronavirus disease (COVID-19) pandemic. WHO 2020.

Bedford J, Enria D, Giesecke J, Heymann *David L, Chikwe Ihekweazu, Kobinger G, et al. Towards Controlling the Pandemic. Lancet 2020; 395: 1015-8. DOI:

Khatatbeh M. Efficacy of Nationwide Curfew to Encounter Spread of COVID-19: A Case From Jordan. Front Public Heal 2020; 8: 19-21. DOI:

Al Dhaheri AS, Bataineh MF, Mohamad MN, Ajab A, Al Marzouqi A, Jarrar AH, et al. Impact of COVID-19 on mental health and quality of life: Is there any effect? A crosssectional study of the MENA region. PLoS One 2021; 16: 1-17. DOI:

Nyashanu M, Karonga T, North G, Mguni M, Nyashanu W. COVID-19 lockdown and mental health: Exploring triggers of mental health distress among women in the Copperbelt province, Zambia. Int J Ment Health 2021; 0: 1-14. DOI:

Ettman CK, Abdalla SM, Cohen GH, Sampson L, Vivier PM, Galea S. Verstraelen S, Maglennon G, Hollanders K, Boonen F, Adriaens E, Alépée N, et al. Reprint of “CON4EI: Bovine Corneal Opacity and Permeability (BCOP) test for hazard identification and labelling of eye irritating chemicals.” Toxicol Vitr 2018; 49: 53-64. DOI:

Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw Open 2020; 3. DOI:

Siddique RF, Ahmed O, Hossain KN. Relationship between the fear of COVID-19 disease and sleep quality: the mediating role of stress. Heliyon 2021; 7: e07033. DOI:

Grossman ER, Benjamin-Neelon SE, Sonnenschein S. Alcohol consumption during the covid-19 pandemic: A cross-sectional survey of us adults. Int J Environ Res Public Health 2020; 17: 1-10. DOI:

Pollard MS, Tucker JS, Green HD. Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US. JAMA Netw Open 2020; 3: e2022942. DOI:

Boserup B, McKenney M, Elkbuli A. Alarming trends in US domestic violence during the COVID-19 pandemic. Am J Emerg Med 2020; 38: 2753-5. DOI:

Tessler H, Choi M, Kao G. The Anxiety of Being Asian American: Hate Crimes and Negative Biases During the COVID-19 Pandemic. Am J Crim Justice 2020; 45: 636-46. DOI:

Pervez S, Naher S, Ur M, Pranta R, Banik R. Perception and experiences regarding COVID-19 pandemic among urban young adults in Bangladesh : a mixed-method study 2021. DOI:

Lange KW, Nakamura Y. Movement and nutrition in COVID-19 | 89 Movement and Nutrition in Health and Disease. Movement-NutritionDe 2020; 4: 89-94.

Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. The Lancet Psychiatry 2020; 7: 611-27. DOI:

Ning L, Niu J, Bi X, Yang C, Liu Z, Wu Q, et al. The impacts of knowledge, risk perception, emotion and information on citizens’ protective behaviors during the outbreak of COVID-19: a cross-sectional study in China. BMC Public Health 2020; 20: 1-12. DOI:

Shiina A, Niitsu T, Kobori O, Idemoto K, Hashimoto T, Sasaki T, et al. Relationship between perception and anxiety about COVID-19 infection and risk behaviors for spreading infection: A national survey in Japan. Brain, Behav Immun - Heal 2020; 6: 100101. DOI:

Spoorthy MS. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr 2020; 51. DOI:

Lurie N, Saville M. Developing Covid-19 Vaccines at Pandemic Speed. N Engl J Med 2020; 31: 1969-73. DOI:

WHO. COVID-19 vaccine tracker and landscape. WHO 2021.

Troiano G, Nardi A. Vaccine hesitancy in the era of COVID-19. Public Health 2021; 194: 245-51. DOI:

Willis DE, Andersen JA, Bryant-Moore K, Selig JP, Long CR, Felix HC, et al. COVID-19 vaccine hesitancy: Race/ethnicity, trust, and fear. Clin Transl Sci 2021; 14: 2200-7. DOI:

Malik AA, McFadden SAM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. E Clinical Medicine 2020; 26: 100495. DOI:

Tregoning JS, Flight KE, Higham SL, Wang Z, Pierce BF. Progress of the COVID-19 vaccine effort: viruses, vaccines and variants versus efficacy, effectiveness and escape. Nat Rev Immunol 2021; 21: 626-36. DOI:

Tande AJ, Pollock BD, Shah ND, Farrugia G, Virk A, Swift M, et al. Impact of the Coronavirus Disease 2019 (COVID-19) Vaccine on Asymptomatic Infection Among Patients Undergoing Preprocedural COVID-19 Molecular Screening. Clin Infect Dis 2022; 74: 59-65. DOI:

Cook TM, Roberts JV. Impact of vaccination by priority group on UK deaths, hospital admissions and intensive care admissions from COVID-19. Anaesthesia 2021; 76: 608-16. DOI:

Chau N, Vinh VN, My N, Nguyet LA, Quang VM, Ny NTH, et al. An observational study of breakthrough SARS-CoV-2 Delta variant infections among vaccinated healthcare workers in Vietnam. EClinicalMedicine 2021; 41: 101143. DOI:

Koltai J, Raifman J, Bor J, McKee M, Stuckler D. COVID-19 Vaccination and Mental Health: A Difference-In-Difference Analysis of the Understanding America Study. Am J Prev Med 2022; 62: 679-87. DOI:

Souliotis K, Peppou LE, Giannouchos T V., Samara M, Sifaki-Pistolla D, Economou M, et al. COVID-19 Vaccination and Mental Health Outcomes among Greek Adults in 2021: Preliminary Evidence. Vaccines 2022; 10: 1-7. DOI:

Sasaki N, Kuroda R, Tsuno K, Imamura K, Kawakami N. COVID-19 vaccination did not improve employee mental health: A prospective study in an early phase of vaccination in Japan. Neuropsychopharmacol Reports 2022; 42: 230-2. DOI:

Lovibond S, Lovibond P. Manual for the Depression Anxiety Stress Scales. 2nd ed. Psychology Foundation of Australia, 1995. DOI:

Gloster AT, Rhoades HM, Novy D, Klotsche J, Senior A, Kunik M, et al. Psychometric properties of the Depression Anxiety and Stress Scale-21 in older primary care patients. J Affect Disord 2008; 110: 248-59. DOI:

Oei TPS, Sawang S, Goh YW, Mukhtar F. Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures. Int J Psychol 2013; 48: 1018-29. DOI:

Murphy J, Vallières F, Bentall RP, Shevlin M, McBride O, Hartman TK, et al. Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat Commun 2021; 12: 1-15. DOI:

Perez-Arce F, Angrisani M, Bennett D, Darling J, Kapteyn A, Thomas K. COVID-19 vaccines and mental distress. PLoS One 2021; 16: 1-11. DOI:

Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. The Lancet Psychiatry 2020; 7: 300-2. DOI:

Shaukat N, Ali DM, Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: A scoping review. Int J Emerg Med 2020; 13: 1-8. DOI:

Naser AY, Dahmash EZ, Al-Rousan R, Alwafi H, Alrawashdeh HM, Ghoul I, et al. Mental health status of the general population, healthcare professionals, and university students during 2019 coronavirus disease outbreak in Jordan: A cross-sectional study. Brain Behav 2020; 10: 1-13. DOI:

Islam MM, Wesonga R, Hasani I Al, Manei A Al. Prevalence and determinants of mental health issues among university students during COVID-19 pandemic in Oman : An Online Cross-sectional Study. Int Res J Public Environ Heal 2022; 9: 43-54.

Islam MS, Sujan MSH, Tasnim R, Sikder MT, Potenza MN, van Os J. Psychological responses during the COVID-19 outbreak among university students in Bangladesh. PLoS One 2020; 15: e0245083. DOI:

Ochnik D, Rogowska AM, Kuśnierz C, Jakubiak M, Schütz A, Held MJ, et al. Mental health prevalence and predictors among university students in nine countries during the COVID-19 pandemic: a cross-national study. Sci Rep 2021; 11: 1-13. DOI:

Hossain AHMK, Ahmed HU, Oshru RT, Yunus MY. Anxiety and Depression among Tertiary Level Students in Bangladesh during COVID-19 Outbreak. Iran J Heal Psychol 2020; 3: 19-30.

Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020; 584: 430-6. DOI:

Lee M, Kang BA, You M. Knowledge, attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in South Korea. BMC Public Health 2021; 21: 1-10. DOI:

Cori L, Bianchi F, Cadum E. Risk perception and communication. Reliab Risk, Safety, Three Vol Set 2020: 1303-4. DOI:

Wright L, Steptoe A, Fancourt D. Patterns of compliance with COVID-19 preventive behaviours: a latent class analysis of 20 000 UK adults. J Epidemiol Community Health 2022; 76: 247-53. DOI:




How to Cite

Singha, B. ., Karmaker, S. C. ., Islam, M. M. ., Eljamal, K. ., & Saha, B. B. . (2022). Vaccination, Compliance with Preventive Measures and Mental Health during COVID-19 among Adults in Bangladesh: Do Vaccination and Compliance with Preventive Measures Improve Mental Health?. International Journal of Statistics in Medical Research, 11, 175–185.



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