Adult vaccination hesitancy in Turkey: sociodemographic influences and strategies for increasing acceptance

Immunization prevents 3.5–5 million deaths annually from diseases like diphtheria, tetanus, pertussis, and measles. However, vaccine hesitancy—defined as delayed acceptance or refusal despite availability—poses a global health challenge. Addressing hesitancy is crucial for improving vaccine acceptance. This study aimed to assess adult attitudes toward immunization and explore strategies to increase vaccine acceptance, focusing on sociodemographic factors. A descriptive, single-center study was conducted in Istanbul, Turkey at the University of Health Sciences Şişli Hamidiye Etfal Training and Research Hospital between August and October 2022. A total of 1,006 adult participants (aged 18 and above) were surveyed using a 14-item questionnaire that collected sociodemographic data and evaluated attitudes toward vaccination. Data were analyzed using SPSS 20 with Chi-Square and Kruskal-Wallis tests. Among 1,006 participants (mean age 37.47 ± 8.27 years), 42.1% were male, and 73.4% had a high school or higher education. Vaccine hesitancy was reported by 41.8% (n = 421), with fear of side effects being the most cited reason (41.3%). Despite this, 88.7% had received at least one dose of the COVID-19 vaccine, and 50% had experienced COVID-19 illness. Higher education levels were significantly associated with positive attitudes toward vaccination (p < 0.001), while age was not (p = 0.278). Additionally, 77.2% reported knowing individuals with anti-vaccination attitudes, and 9.9% supported anti-vaccination movements. This study highlights the significant influence of educational attainment on adult vaccine acceptance and the pervasive impact of fear and misinformation on hesitancy toward adult vaccination. Family physicians play a critical role in addressing hesitancy through education and emphasizing the importance of lifelong adult immunization. Increasing awareness and addressing missed vaccination opportunities are essential for improving adult immunization rates.