Safe and effective prophylactic vaccines are needed to control rapidly advancing COVID-19, which has devastating medical, economic, and social consequences. It is believed that one of the most critical obstacles to vaccination activities is negative attitudes towards vaccines. This study aimed to identify factors associated with COVID-19 vaccine rejection and hesitation after initiation of the national vaccination program. Materials and Methods: The study was conducted using an online

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... ire. Participants' socio-demographic and clinical data and COVID-19 outbreak experiences, attitudes towards the vaccine of COVID-19 were collected through a specially designed structured questionnaire. The participants were also asked to complete Death Anxiety Scale (DAS) and Health Anxiety Scale (HAS). Multiple logistic regression analyses were performed to reveal the factors predicting vaccine hesitancy and rejection. Results: A total of 1,546 completed responses were received. Vaccine hesitation and refusal rates were 8.9% and 9%, respectively. Older age, high education level and lower concern on the vaccine was observed in participants that accepted vaccination compared to patients who refused and hesitated vaccination. High education levels and healthcare workers had decreased risk of vaccine hesitancy. High Death Anxiety Score and being a healthcare worker had decreased risk for vaccine refusal. Concern about the vaccines was the most important risk factor for vaccine hesitancy and refusal. Conclusion: Our study suggested that vaccine hesitancy was related to lower education level, and negative concern about the vaccine. Vaccine refusal was related to history of COVID-19 infection, negative concern on the vaccine, non-healthcare occupation, and higher level of death anxiety scale.