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 self-perceiving 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

COVID-19 and Iraqi Kurdistan: A regional case in the middle east

The unfolding Covid-19 is posing worldwide health and socio-economic threats. As most of the world attention is concentrated upon a few countries, in many fragile areas, the impact of the pandemic on the health systems might be even higher, but risks staying hidden from public consideration. This is the case of Iraq where Covid-19 is a further burden on an already weakened public health system. This study draws attention to the Autonomous Region of the Iraqi Kurdistan, that before the emergency was investing in the rebuilding of its public health system after decades of tensions and conflicts. Information on governmental measures for COVID-19 containment and response, management approaches, prevention interventions, and public opinion reactions have been collected from official sources, websites and from interviews with the local staff working in the field. The experience of the Iraqi Kurdistan opens new opportunities for reflection on how a war-torn region is dealing with the COVID-19 outbreak. Acquiring knowledge on the health needs of such a fragile area holds a paramount importance for providing preparedness planning and enhancing resilience of the public health system in case of future disasters. The lesson learnt might be useful for other regions living in similar contexts