Public Perception and Acceptance of COVID-19 Vaccines in Iraq During the Pandemic.

Background and Objective: The rapid development and deployment of COVID-19 vaccines constituted a critical global public health response; however, vaccine hesitancy posed a substantial challenge, particularly in low- and middle-income countries such as Iraq. Mistrust, misinformation and sociopolitical factors were reported to influence vaccine uptake. This study aimed to assess public perception, acceptance and hesitancy toward COVID-19 vaccines in Iraq during the pandemic and to identify key sociodemographic and informational determinants influencing vaccination behavior. Materials and Methods: A cross-sectional survey was conducted among 1,747 participants across Iraq. Vaccine acceptance was defined as receipt of at least one vaccine dose, while hesitancy included delayed or refused vaccination due to concerns regarding safety, efficacy, or other factors. Public perception reflected attitudes and beliefs toward vaccination irrespective of vaccination status. Data were analyzed using descriptive statistics and inferential tests to examine associations between sociodemographic variables, exposure to misinformation and vaccine acceptance, with statistical significance set at p<0.05. Results: Among the participants, 42.7% were vaccinated and 57.3% were unvaccinated. Vaccine acceptance was significantly higher among men, older individuals and participants with higher educational attainment (p<0.001). The most commonly reported reasons for vaccine hesitancy were concerns about long-term side effects (72.4%) and distrust in vaccine manufacturers (41.9%). Exposure to misinformation via social media platforms showed a significant association with increased vaccine hesitancy (p = 0.03). Conclusion: The findings identify critical sociodemographic and informational factors influencing COVID-19 vaccine acceptance in Iraq. Targeted public health interventions focusing on women, younger populations and individuals with lower educational levels are warranted. Strengthening evidence-based communication strategies to counter misinformation and rebuild public trust may improve vaccine uptake. Future studies should explore longitudinal trends and intervention effectiveness to address persistent vaccine hesitancy.