Background: The outbreak of coronavirus disease 2019 (COVID-19) has resulted in huge morbidity and mortality since its onset in 2019. By June 24, 2023, only 32.2% of people in low-income countries have received at least one dose. This paper explores the perceptions and trust of vaccine refusers based on the thematic analysis. Methods: In this study, we used a descriptive qualitative research design to explore the perceptions of the persons who did not believe in receiving the COVID-19 vaccine in Iraqi Kurdistan. This approach allowed us to explore the COVID-19 vaccine issue in-depth. Individual interviews were conducted with 14 participants in Kurdistan, Iraq. Results: Results showed that the participants had a great fear of the serious side effects of COVID-19 vaccines. Some believed that the virus was not natural and had been made by humans for different reasons including making profits from vaccines. Some believed that there was a silver material inside the vaccine that would force people to receive more doses in the future. Few believed that receiving COVID-19 vaccines was crossing the borders of God. Reinfection was a factor in selling more doses of vaccines. The participants were affected by the advice of the community and social media and not receiving the COVID-19 vaccines from healthcare workers, lack of responsibility from the government and companies, and not having trust in vaccines in this region. Conclusions: Conspiracy thinking, perceived negative effects, fear, reinfection, side effects of COVID-19 vaccines could be related to perceived vulnerability and seriousness among vaccine refusers.
