Childhood vaccine hesitancy and refusal in Türkiye: a systematic review and meta-analysis

Abstract

Objective: Childhood vaccination is a cornerstone of public health, significantly reducing morbidity and mortality from vaccine-preventable infectious diseases. However, vaccine hesitancy and refusal have emerged as growing global concerns that may undermine immunization efforts. This study aimed to synthesize the existing literature to provide a comprehensive overview of the prevalence, trends, and key determinants of childhood vaccine hesitancy and refusal in T & uuml;rkiye. Materials and Methods: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD 42024513557). A comprehensive literature search was performed in PubMed, Web of Science, Scopus, MEDLINE, and the Cochrane Library for studies published up to March 1, 2024. Risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for Prevalence Studies. Results: A total of nine studies involving 15,429 participants were included. The pooled prevalence of vaccine hesitancy was 15% (95% CI, 11%-20%), while the pooled prevalence of vaccine refusal was 3% (95% CI, 2%-6%). Substantial heterogeneity was observed among studies for both outcomes (vaccine hesitancy: I-2=96.9%, tau(2)=0.2053, p<0.0001; vaccine refusal: I-2=97.8%, tau(2)=0.8517, p<0.0001). Vaccine hesitancy was more pronounced in certain regions, particularly Central Anatolia, and was associated with factors such as misinformation, distrust in healthcare providers, and socioeconomic disparities. Conclusion: Childhood vaccine hesitancy in T & uuml;rkiye demonstrates marked regional variation but mirrors broader global challenges. Addressing this issue requires strengthening health literacy, enhancing trust in healthcare systems, and counteracting misinformation. The experience of T & uuml;rkiye provides valuable insights for improving vaccine acceptance strategies worldwide.