Hesitancy towards Covid-19 vaccination among the healthcare workers in Iraqi Kurdistan

Objective: To investigate Covid-19 vaccine hesitancy among Iraqi healthcare workers-HCWs. Study design: Cross-sectional survey. Methods: In February 2021, an anonymous questionnaire on the willingness of receiving Covid-19 vaccination was submitted to a sample of HWCs in the Dohuk Governorate, Iraqi Kurdistan Region. Overall, 1704 questionnaires were analysed by means of univariate and multivariate statistics. Results: The sample included 978 males and 726 females (Mean age: 36.9 +/- 10.1), working in Primary Health Centres (65.8%) or in Public Hospitals (34.2%). Professions ranged from being physician/paramedics (39.3%) to administrative/laboratory staff (31.7%); 17.0% had attended up to secondary school, the rest had a higher education. Considering health conditions, 1.8% reported a poor health status and 11.5% a chronic disease. Overall, 475 people (27.9%) reported Covid-19 vaccine hesitancy, with fear of side-effects (41.4%) and lack of confidence in using the vaccine (23.5%) being the most common perceived barriers. Midwifes (61.1%) and assistant nurses (45.5%) were the most hesitant; physicians the less (12.3%). According to a binary logistic model, holding lower educational level (adjOR = 2.158; 95% CI:1.654-2.815), being female (adjOR = 1.622; 95% CI:1.289-2.040), having pre-existing chronic disease (adjOR = 1.954; 95% CI:1.280-2.983), and selfperceiving a poor health status (adjOR = 3.673; 95% CI:1.610-8.379) were independent predictors of higher odds of hesitancy. Conclusion: Covid-19 vaccine hesitancy among HCWs represents an important public health concern, since they play a paramount role for a successful vaccination campaign within the community. Our results show the need in Iraq to implement educational interventions for strengthening the confidence of HWCs towards the Covid-19 vaccine, therefore positively influencing the general public's attitude.