Background: The high COVID-19 incidence rates among health care workers (HCWs) worldwide has exacerbated the strain on the healthcare system. Poor vaccination coverage hinders the containment of the pandemic. HCWs with unfavorable attitude toward COVID-19 vaccination are generally less likely to be vaccinated or to recommend vaccination. We conducted this study to identify factors contributing to HCWs’ attitude towards COVID-19 vaccination, with the aim to develop strategies to improve vaccination.

Methods: We conducted a nationally representative cross-sectional study using a multi-stage stratified sample design and interviewed 1,217 HCWs in 168 health care facilities in Armenia, Georgia, and Moldova. Questionnaires standardized across the countries included sections on factors contributing to and barriers for COVID-19 vaccination. Estimates were weighted to obtain nationally representative results.

Results: Among HCWs, 99% were vaccinated in Armenia, 79% in Georgia, and 95% in Moldova. The desire to protect themselves and others was a factor contributing to vaccination for 68% HCWs in Armenia, and for 92% in Georgia and Moldova, each. Illness and death among relatives or patients influenced to get vaccinated 67% of HCWs in Moldova, 28% in Georgia, and 16% in Armenia. Percentage of reportedly unvaccinated HCWs ranged from 21% in Georgia to 4% in Moldova and 1% in Armenia. Among unvaccinated HCWs in Georgia, most common reason for not being vaccinated were fear of side effects (36%) and having history of COVID-19 disease (36%). In Moldova, concerns that the vaccine is not tested (30%), fear of side effects (25%), and having history of COVID-19 disease (20%) were reported. In both countries, 75% of unvaccinated HCWs didn’t work in COVID-19 health facilities.

Conclusions: Developing appropriate communication strategies by including identified in our study factors that contribute to attitude towards vaccination and barriers to getting vaccinated are critical in improving vaccination coverage.