Medical Journal of the Islamic Republic Of Iran

en Vaccine Refusal and Hesitancy among Iranians Participated in the National COVID-19 Vaccine Hesitancy Survey: A Qualitative Study Epidemiology Epidemiology Original Research Original Research Background: Success in COVID-19 vaccination depends on understanding why people refuse or hesitate to take the vaccine. This study aims to explore vaccine refusal and hesitancy among Iranians who participated in the national COVID-19 vaccine hesitancy survey.    Methods: A qualitative content analysis approach was used. Twenty-six participants were selected by purposive sampling. In-depth, semi-structured telephone interviews were conducted during the year 2022. A directed content analysis approach was used for analyzing the data by extracting the codes, subcategories, and categories.    Results: Four major categories and their respective subcategories related to refusal and/ or hesitancy against COVID-19 vaccination emerged: “lack of confidence” (distrust in policymakers and pharmaceutical companies, distrust in national media, belief in conspiracy theory, and lack of confidence in the vaccine's safety and effectiveness), “complacency” (Fatalism and philosophical beliefs, low perceived risk, and belief in the adequacy of the precautionary principles), “constrains” (personal and psychological barriers), and “coercion” (coercion by relatives and unsteady imposed mandatory vaccination by the government).    Conclusion: Distrust, fatalism, low perceived risk, and overconfidence in traditional Persian medicine were important barriers to COVID-19 vaccine acceptability needing a variety of measures for improving COVID-19 vaccine uptake, including enhancing public trust in government and policymakers, clarifying vaccine safety and effectiveness, dealing with religious fatalism, and regulating anti-science messages on social media.   Vaccine hesitancy, Vaccine Refusal, COVID-19, Qualitative Research, Iran 327 335 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8473-1&slc_lang=en&sid=1 Hajar Nazari Kangavari hajar.nazarihhh@gmail.com 200319475328460089006 200319475328460089006 No Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Ahmad Hajebi hajebi.ahmad@gmail.com 200319475328460089007 200319475328460089007 No Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), & Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Hamid Peyrovi peyrovi.h@iums.ac.ir 200319475328460089008 200319475328460089008 No Nursing and Midwifery Care Research Center/School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran Masoud Salehi salehi74@yahoo.com 200319475328460089009 200319475328460089009 No Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Mohammad Hossein Taghdisi taghdisi.mh@gmail.com 200319475328460089010 200319475328460089010 No Public Health Department, Faculty of Health and Medical Engineering, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Abbas Motevalian motevalian.a@iums.ac.ir 200319475328460089011 200319475328460089011 Yes Preventive Medicine and Public Health Research Center, Psychosocial HealthResearch Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran