Despite numerous recommendations concerning individual and social preventive measures, including quarantine, wearing a mask, physical distancing, and handwashing, vaccination with effective and safe vaccines is still the most effective measure to break the chain of coronavirus SARS-Co2 transmission; still, vaccine hesitancy is a significant barrier to achieve high vaccination coverage against infectious diseases. An observational cross-sectional study was conducted among students of different universities (medical and non-medical) in Baghdad city Iraq using an online structured google form questionnaire from October 20 to November 20, 2021, and a final number of 658 students were included in the study. Causes of acceptance and rejection of the coronavirus vaccine were tested through the questionnaire. Of the total 658 participants, 557(84.7%) had received the vaccine before the start of the study and only 101 (15.3%) were not vaccinated; of them, more than half , 58(57.4%) were willing to, and the remaining 43(42.6%) refused to receive COVID-19 vaccination. Accordingly, the acceptance rate of the vaccine among the total participants was 93.5%, and the rejection rate was only 6.5%. The most chosen cause of vaccine acceptance was that they believed the vaccine protected them, their families and the community against COVID-19 infection and its complications with 63.5%. The most chosen rejection cause was fear of side effects of the vaccine, with 62% of the rejecting participants, followed by 28% having doubts about the vaccine's efficiency in protecting against COVID-19 infection. In this study, although the majority of the participants were willing to be vaccinated, still around one-third of them were under pressure from the government obligations and did not accept the vaccine due to their own convictions; education programs should be designed and directed to remove barriers to negative vaccine beliefs and perception to increase the vaccine coverage in the community. Keywords: COVID-19 vaccination, university students, vaccine acceptance, vaccine rejection.
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