Vaccine Hesitancy and Refusal in Children: A Review in Light of the Literature and Current Data

Abstract

Vaccination is one of the most effective public health interventions for preventing infectious diseases in childhood. However, vaccine hesitancy and vaccine refusal have emerged as growing public health challenges worldwide and in Türkiye, threatening the sustainability of childhood immunization programs. This review aims to evaluate the current situation, prevalence, trends, underlying causes, and risk factors of vaccine hesitancy and refusal among children in Türkiye, and to discuss evidence-based solutions.
This review was conducted based on national and international epidemiological studies, reports, and review articles. Türkiye-specific data were examined using publications from the Ministry of Health, the Turkish Medical Association, and community-based research findings. Evidence indicates a marked increase in vaccine refusal cases in Türkiye since the early 2010s, accompanied by a recent decline in childhood vaccination coverage rates. Major drivers of vaccine hesitancy and refusal include concerns about vaccine safety and ingredients, misinformation linking vaccines to autism and other serious conditions, social media–driven misinformation, low perceived risk of vaccine-preventable diseases, and decreased trust in health authorities. Identified risk factors include low health literacy, reliance on non-professional information sources, use of complementary and alternative medicine, and the broader impact of the COVID-19 pandemic on public trust.
Vaccine hesitancy and refusal among children in Türkiye represent a complex, multifactorial threat to herd immunity. Addressing this challenge requires coordinated strategies, including communication-focused approaches in primary care, community-based interventions to improve health literacy, proactive management of digital misinformation, and strengthened monitoring systems. The development of multidisciplinary and sustainable public health strategies is urgently needed.