Vaccine hesitancy is a major barrier challenging the control of infectious diseases. Previous studies demonstrated high rates of COVID-19 vaccine hesitancy in the Middle East. The current study aimed to investigate the attitudes towards COVID-19 vaccination and COVID-19 vaccine uptake among the adult population in Iraq. This cross-sectional self-administered survey-based study was conducted in August-September 2022. Recruitment of possible participants was done using chain-referral sampling. The survey instrument assessed participants demographics, attitudes toward COVID-19 vaccination, beliefs in COVID-19 misinformation, vaccine conspiracy beliefs, and sources of information regarding the vaccine. The study sample comprised a total of 2544 individuals, with the majority reporting the uptake of at least one dose of COVID-19 vaccination (n=2226, 87.5%). Positive attitudes towards COVID-19 vaccination were expressed by the majority of participants (n=1966, 77.3%), while neutral attitudes were expressed by 345 participants (13.6%), and negative attitudes were expressed by 233 participants (9.2%). Strong, moderate, slight, and absence of COVID-19 misinformation were expressed by 12.4%, 22.6%, 36.2%, and 28.7% participants, respectively. The majority of participants showed a neutral attitude towards COVID-19 vaccine conspiracies (n=1464, 57.5%), while 607 participants embraced these conspiracies (23.9%), and 473 disagreed with such beliefs (18.6%). In the multivariate analysis, factors associated with positive attitudes towards COVID-19 vaccination included disbelief in COVID-19 misinformation and disagreement with vaccine conspiracies. Higher COVID-19 vaccine uptake was significantly associated with history of COVID-19 infection, higher income, residence outside the capital, disbelief in COVID-19 misinformation, disagreement with vaccine conspiracies, and reliance on reputable information sources. COVID-19 vaccine coverage prevailed among the participants, with a majority having positive attitudes towards COVID-19 vaccination. Disbelief in COVID-19 misinformation and disagreement with vaccine conspiracies were correlated with positive vaccine attitudes and higher vaccine uptake. These insights can inform targeted interventions to enhance vaccination campaigns.

The authors have declared no competing interest.

This research received no external funding.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The current study was approved by the Scientific and Ethical Unit at Al-Kindy College of Medicine, University of Baghdad (approved by the Council of Al-Kindy College of Medicine in session No. 20, date: 6 July 2022 under no specific reference number).

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The data presented in this study are available on request from the corresponding author (Malik Sallam).