The COVID-19 pandemic intensified vaccine hesitancy, driven by misinformation and conspiracy theories, even among healthcare professionals. Psychological impacts, such as post-traumatic stress disorder (PTSD), observed with higher prevalence in females, contributed to this hesitancy. This study examines the interrelations between PTSD, anxiety, perceived stress, and gender dynamics among healthcare professionals managing the challenges of the pandemic.

A cross-sectional study was conducted from February to November 2022 in Morocco’s Oriental region. Using snowball sampling, 221 healthcare professionals participated in face-to-face surveys. Data were collected via a structured questionnaire assessing vaccine perceptions, perceived stress, anxiety, and PTSD symptoms. Statistical analyses included correlation tests, linear regressions, and moderated mediation to explore gender, stress, and anxiety interactions.

Females constituted 68.3 % of the sample, with PTSD prevalence higher among females (11.9 %) than males (5.7 %). Correlation analysis showed strong relationships between PTSD, anxiety ( ), and perceived stress ( ) among females. Moderated mediation analysis revealed that the effect of gender on PTSD was indirect, mediated through anxiety. Perceived stress moderated the effect of gender on anxiety: higher perceived stress strengthened the relationship between gender and anxiety. Anxiety then mediated the effect of gender on PTSD, indicating that in high-stress contexts, gender indirectly influenced PTSD severity via anxiety, particularly among females.

This study highlights the indirect effect of gender on PTSD through anxiety, with perceived stress amplifying this pathway. Specific interventions addressing gender and stress are critical to supporting healthcare professionals during health crises and improving resilience and vaccine confidence.