SUBJECTS AND METHODS: This online cross-sectional survey of adult Iraqis (n = 754) assessed the attitudes of people who have had both immunizations regarding a potential COVID-19 vaccine booster dosage and to identify potential factors that might impact these attitudes. Factors evaluated in the current study included previously received vaccine type in the first two doses, socioeconomic characteristics, health status, knowledge about COVID-19 and its vaccines and adherence to protective practices.

RESULTS: Overall, 61.1% of participants expressed willingness to receive a COVID-19 booster dose, with a high median score of knowledge and practice toward COVID-19. Participants who did not perceive COVID-19 to be serious, p-value <0.001), participants who believed they would not be infected with COVID-19 in the next 6 months (p-value <0.001), low knowledge score group (p-value <0.001), lower education (p-value <0.001), participants who received the COVID-19 vaccine because of imposed laws (p-value <0.001), participants who received AstraZeneca vaccine (p-value <0.001), younger participants (p-value=0.003), low level of practice (p-value <0.001), participants who did not know someone who had died due to COVID-19 (p-value=0.01), low risk of developing serious side effects if infected with COVID-19 and participants in the low side effects score were significantly less frequently willing to receive a booster COVID-19 dose (p-value <0.001). The main reasons for booster dose hesitancy/refusal were the perceived lack of need for a booster shot, the uselessness of a booster shot and the conspiracy theory of boosting corporate profits through booster shots.