Parental Childhood Vaccination Hesitancy and Refusal in Türkiye: A Systematic Review of Contributing Factors

Abstract

Background: Childhood vaccinations are among the most successful public health strategies for preventing infectious diseases. However, rising parental vaccine hesitancy and refusal pose a significant threat to immunization coverage in Türkiye. This systematic review aimed to synthesize current evidence on the factors influencing parental hesitancy and refusal to childhood vaccinations in Türkiye. Methods: This review followed PRISMA guidelines and was registered in PROSPERO. A comprehensive search of six databases (Scopus, Web of Science, PubMed, Cochrane Library, Medline and TR Dizin (ULAKBIM) was conducted up to March 2025. Quantitative studies evaluating parental attitudes toward routine childhood and pandemic vaccinations in Türkiye were included. Factors influencing vaccine hesitancy were categorized into individual, familial, social, and structural domains. Results: Of 412 records identified, 26 met the inclusion criteria across diverse regions and samples in Türkiye. Factors including social media misinformation, distrust in healthcare professionals, low health literacy, prior negative vaccine experiences, and religious or cultural beliefs shaped vaccine hesitancy. Education, income, and gender showed mixed associations. Hesitancy was also linked to limited postpartum follow-up and pandemicrelated vaccine experiences. Several studies highlighted the protective role of health literacy, digital competence, and accurate information from trusted healthcare providers. Conclusion: Parental vaccine hesitancy and refusal in Türkiye are shaped by personal beliefs, trust in the health system, and information sources. Implications for practice: Healthcare professionals, policymakers, and public health authorities should implement coordinated, evidence-based strategies to strengthen parental health literacy, address misinformation, build trust, and improve childhood vaccination uptake in Türkiye through targeted education and communication. (c) 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.