• SARA BAYRAM DAWOD High Diploma Student, Directorate of Health in Duhok, Community Medicine, Duhok, Kurdistan Region, Iraq
  • KAMERAN HASSAN ISMAIL Professor at the College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Keywords: Covid-19, , Healthcare workers, Vaccine hesitancy, Vaccine acceptance


Background: Healthcare workers have a great role in contributing the vaccination among the population and their oriented health attitude is thought to be of major significance for protection against covid-19. The aim of this study was to determine the vaccination acceptance and refusal among healthcare workers and the possible causes, also to investigate the socio-economic-demographic factors affecting their attitude. 

Methods: A cross-sectional study was conducted in Duhok governorate to assess the attitude of healthcare workers toward covid-19 vaccine, and this was held by direct interview with the participants. The questionnaire was of 2 parts, the socio-demographics and the attitude of healthcare workers toward the vaccine. 

Results: A total of 562 healthcare workers participated in this survey; 94.1% of them displayed a positive attitude toward the vaccine while 5.9% revealed a negative attitude. 67.3% of the participants had received the vaccine, and 72.7% of the unvaccinated participants claimed their main cause of refusal was their concern about the safety of the vaccine. There was a statistically significant relation between healthcare workers’ occupation and vaccine acceptance (p = 0.048), where pharmacists had the highest rate of vaccination (100%) compared to the cleaning staff (77.3%). Also participants’ age group (45-60) years showed higher acceptance rate than other age groups.

Conclusions: Covid-19 vaccine acceptance among healthcare workers in the Duhok governorate was high. The findings may help the management authorities to give more information about the vaccine and contribute to improving healthcare workers’ attitudes to reach the  goal of 100% vaccination.


Download data is not yet available.


1. World Health Organization. COVID-19 dashboard. update 12 August 2022. Accessed July 17, 2022.
2. Health Organization. In and Out of Lockdowns, and What Lockdown Anyway? Policy Issues in Transitions. 2022. Available online: (accessed on 15 April 2022).
3. Al-Jumaili MH, Hamed AS. Coronavirus Disease-19: Outbreaks in Iraq. Dep Med Lab Tech Al-maarif Univ Coll Iraq. 2020.
4. Mallapaty S. Delta threatens rural regions that dodged earlier COVID waves. Nature. 2021 Aug 5; 596(7872): 325-6.
5. Alagoz O, Sethi AK, Patterson BW, Churpek M, Safdar N. Effect of timing of and adherence to social distancing measures on COVID-19 burden in the United States: a simulation modeling approach. Annals of internal medicine. 2021 Jan; 174(1): 50-7.
6. Yendewa SA, Ghazzawi M, James PB, Smith M, Massaquoi SP, Babawo LS, Deen GF, Russell JB, Samai M, Sahr F, Lakoh S. COVID-19 Vaccine Hesitancy among Healthcare Workers and Trainees in Freetown, Sierra Leone: A Cross-Sectional Study. Vaccines. 2022 May 11; 10(5): 757.
7. Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Marc GP, Moreira ED, Zerbini C, Bailey R. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. New England journal of medicine. 2020 Dec 10.
8. Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, Diemert D, Spector SA, Rouphael N, Creech CB, McGettigan J. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. New England journal of medicine. 2020 Dec 30.
9. World Health Organization. COVID-19 Vaccine Tracker and Landscape. 2021. Available online: (accessed on 17 July 2022)
10. World Health Organization. COVID-19 Advice for the Public: Getting Vaccinated. 2021. Available online: (accessed on 17 July 2022).
11. Carvalho Aguiar Melo M, de Sousa Soares D. Impact of social distancing on mental health during the COVID-19 pandemic: An urgent discussion. International Journal of Social Psychiatry. 2020 Sep;66(6):625-6.
12. World Health Data Platform . Draft Landscape and Tracker of COVID-19 Candidate Vaccines. Available online at: (accessed July 15, 2022). 13-MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015 Aug 14; 33(34): 4161-4.
13. Biswas N, Mustapha T, Khubchandani J, Price JH. The nature and extent of COVID-19 vaccination hesitancy in healthcare workers. Journal of community health. 2021 Dec; 46(6): 1244-51.
14. World Health Organization. Director-General's Opening Remarks at the World Health Assembly - 24 May 2021. WHO (2021). Available online at:−24-may-2021 (accessed July 20, 2022).
15. Chew NW, Cheong C, Kong G, Phua K, Ngiam JN, Tan BY, Wang B, Hao F, Tan W, Han X, Tran BX. An Asia-Pacific study on healthcare workers’ perceptions of, and willingness to receive, the COVID-19 vaccination. International Journal of Infectious Diseases. 2021 May 1; 106:52-60.
16. Nzaji MK, Ngombe LK, Mwamba GN, Ndala DB, Miema JM, Lungoyo CL, Mwimba BL, Bene AC, Musenga EM. Acceptability of vaccination against COVID-19 among healthcare workers in the Democratic Republic of the Congo. Pragmatic and observational research. 2020; 11:103.
17. Qattan AM, Alshareef N, Alsharqi O, Al Rahahleh N, Chirwa GC, Al-Hanawi MK. Acceptability of a COVID-19 vaccine among healthcare workers in the Kingdom of Saudi Arabia. Frontiers in Medicine. 2021 Mar 1; 8:644300.
18. Barry M, Temsah MH, Aljamaan F, Saddik B, Al-Eyadhy A, Alenezi S, Alamro N, Alhuzaimi AN, Alhaboob A, Alhasan K, Alsohime F. COVID-19 vaccine uptake among healthcare workers in the fourth country to authorize BNT162b2 during the first month of rollout. Vaccine. 2021 Sep 24;39(40):5762-8.
19. Gadoth A, Halbrook M, Martin-Blais R, Gray A, Tobin NH, Ferbas KG, Aldrovandi GM, Rimoin AW. Cross-sectional assessment of COVID-19 vaccine acceptance among health care workers in Los Angeles. Annals of internal medicine. 2021 Jun; 174(6): 882-5.
20. Amuzie CI, Odini F, Kalu KU, Izuka M, Nwamoh U, Emma-Ukaegbu U, Onyike G. COVID-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in Abia State, Southeastern Nigeria: a cross-sectional study. The Pan African Medical Journal. 2021; 40.
21. Khamis F, Badahdah A, Al Mahyijari N, Al Lawati F, Al Noamani J, Al Salmi I, Al Bahrani M. Attitudes towards COVID-19 vaccine: a survey of health care workers in Oman. Journal of Epidemiology and Global Health. 2022 Mar; 12(1): 1-6.
22. Koh SW, Liow Y, Loh VW, Liew SJ, Chan YH, Young D. COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore. BMC primary care. 2022 Dec; 23(1): 1-9.
23. Amin DP, Palter JS. COVID-19 vaccination hesitancy among healthcare personnel in the emergency department deserves continued attention. The American journal of emergency medicine. 2021 Oct; 48: 372.
24. Kałucka S, Kusideł E, Głowacka A, Oczoś P, Grzegorczyk-Karolak I. Pre-Vaccination Stress, Post-Vaccination Adverse Reactions, and Attitudes towards Vaccination after Receiving the COVID-19 Vaccine among Health Care Workers. Vaccines. 2022 Mar 6;10(3): 401.
25. Frank K, Arim R. Canadians'Willingness to Get a COVID-19 Vaccine when One Becomes Available:What Role Does Trust Play? 2020. [Accessed 20/7/2022]. Available from: n1/pub/45-28-0001/2020001/article/00073-eng.htm .
26. Gagneux-Brunon A, Detoc M, Bruel S, Tardy B, Rozaire O, Frappe P, Botelho-Nevers E. Intention to get vaccinations against COVID-19 in French healthcare workers during the first pandemic wave: a cross-sectional survey. Journal of Hospital Infection. 2021 Feb 1; 108: 168-73.
27. Fares S, Elmnyer MM, Mohamed SS, Elsayed R. COVID-19 vaccination perception and attitude among healthcare workers in Egypt. Journal of primary care & community health. 2021 Apr; 12: 21501327211013303.
28. Aoun AH, Aon MH, Alshammari AZ, Moussa SA. COVID-19 Vaccine hesitancy among health care workers in the Middle East region. The Open Public Health Journal. 2021 Aug 24; 14(1).
29. Bianchi FP, Stefanizzi P, Brescia N, Lattanzio S, Martinelli A, Tafuri S. COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis. Expert Review of Vaccines. 2022 Jul 1:1-2.
30. Iguacel I, Maldonado AL, Ruiz-Cabello AL, Samatán E, Alarcón J, Orte MÁ, Mateos SS, Martínez-Jarreta B. Attitudes of healthcare professionals and general population toward vaccines and the intention to Be vaccinated against COVID-19 in Spain. Frontiers in public health. 2021;9.
31. Kanyike AM, Olum R, Kajjimu J, Ojilong D, Akech GM, Nassozi DR, Agira D, Wamala NK, Asiimwe A, Matovu D, Nakimuli AB. Acceptance of the coronavirus disease-2019 vaccine among medical students in Uganda. Tropical medicine and health. 2021 Dec; 49(1): 1-1.
32. Mohammed R, Nguse TM, Habte BM, Fentie AM, Gebretekle GB. COVID-19 vaccine hesitancy among Ethiopian healthcare workers. PloS one. 2021 Dec 17; 16(12): e0261125.
33. Qattan AM, Alshareef N, Alsharqi O, Al Rahahleh N, Chirwa GC, Al-Hanawi MK. Acceptability of a COVID-19 vaccine among healthcare workers in the Kingdom of Saudi Arabia. Frontiers in Medicine. 2021 Mar 1; 8: 644300.
34. Papagiannis D, Rachiotis G, Malli F, Papathanasiou IV, Kotsiou O, Fradelos EC, Giannakopoulos K, Gourgoulianis KI. Acceptability of COVID-19 vaccination among Greek health professionals. Vaccines. 2021 Feb 28; 9(3): 200.
35. Dzieciolowska S, Hamel D, Gadio S, Dionne M, Gagnon D, Robitaille L, Cook E, Caron I, Talib A, Parkes L, Dubé È. Covid-19 vaccine acceptance, hesitancy, and refusal among Canadian healthcare workers: A multicenter survey. American journal of infection control. 2021 Sep 1;49(9): 1152-7.
36. Paterlini M. Covid-19: Italy makes vaccination mandatory for healthcare workers.
37. Wise J. Covid-19: Is the UK heading towards mandatory vaccination of healthcare workers?
38. 38-Kałucka S, Kusideł E, Głowacka A, Oczoś P, Grzegorczyk-Karolak I. Pre-Vaccination Stress, Post-Vaccination Adverse Reactions, and Attitudes towards Vaccination after Receiving the COVID-19 Vaccine among Health Care Workers. Vaccines. 2022 Mar 6; 10(3): 401.
39. Al‐Metwali BZ, Al‐Jumaili AA, Al‐Alag ZA, Sorofman B. Exploring the acceptance of COVID‐19 vaccine among healthcare workers and general population using health belief model. Journal of evaluation in clinical practice. 2021 Oct; 27(5): 1112-22.
How to Cite