Exploring the underlying factors of COVID-19 vaccination hesitancy in Ahvaz, Iran: a comprehensive cross-sectional study

Purpose: Around 70% of the Iranian population had received two doses of coronavirus dis-ease 2019 (COVID-19) vaccines by the end of 2021. In this study, we evaluated the reasons for vaccination refusal among people in Ahvaz, Iran. Materials and Methods: In this cross-sectional study, 800 participants (400 vaccinated and 400 unvaccinated) were recruited. A demographic questionnaire was completed through interviews. The unvaccinated participants were asked about the reasons for their refusal. The Shapiro-Wilk test, independent t-test, chi-square test, and logistic regression were used for analyzing data. Results: Older people were 1.018 times more likely to refrain from vaccination (95% confidence interval [CI], 1.001-1.039; p=043). People who were manual workers as well as those who were unemployed/housewives were 0.288 and 0.423 times less likely to receive vaccination, respec-tively. Those with high school education and married women were 0.319 and 0.280 times less likely to receive vaccination, respectively (95% CI, 198-0.515; p< 0.001; 95% CI, 0.186-0.422; p< 0.001). Participants who had hypertension or suffered from neurological disorders were more likely to receive the vaccination. Finally, people affected with severe COVID-19 infection were 3.157 times more likely to get vaccinated (95% CI, 1.672-5.961; p< 0.001). Conclusion: The results of this study showed that lower level of education and older age were contributed to reluctance for vaccination, while having chronic diseases or being already in-fected with severe COVID-19 infection were associated with more acceptance of vaccination.