Determinants of vaccine hesitancy among primary healthcare workers in Türkiye

Healthcare workers (HCWs) are pivotal to sustaining public confidence in vaccination. This study assessed attitudes toward vaccine hesitancy, vaccine-related knowledge, and professional factors among primary healthcare workers (PHCWs) in Türkiye. We conducted a cross-sectional study among PHCWs in Erzurum (Eastern Anatolia), Türkiye. A structured, interviewer-administered questionnaire captured sociodemographics, vaccine-related knowledge, practices and recommendations, and the 21‑item Vaccine Hesitancy Scale (higher scores=greater hesitancy). Analyses included descriptive statistics, correlations, group comparisons, and multivariable logistic regression using a median split of the scale as the binary outcome. Of the 253 participants, 79.1% described themselves as high vaccine acceptance, 5.1% as anti-vaccine, and 15.8% as hesitant. Formal education was the most cited information source. Perceived competence was modest across domains (e.g. 39.5% felt sufficient in approaching vaccine refusal). Knowledge of selected adult vaccines (influenza, varicella, MMR) and recent training on vaccines or vaccine‑preventable diseases were associated with lower hesitancy. Recommending vaccines outside the routine schedule (e.g. HPV, meningococcal, influenza) was also associated with lower hesitancy. In regression analyses, higher odds of hesitancy were observed among those not recommending profession‑related vaccines (adjusted OR ≈1.4), personnel other than family physicians/midwives (OR ≈ 1.7), those feeling insufficient in addressing vaccine refusal (OR ≈ 2.4), and those unaware that HCWs should receive hepatitis B vaccine (OR ≈ 2.0); longer primary‑care tenure showed a small positive association (OR ≈ 1.03). Model fit was acceptable (Nagelkerke R² = 0.15; Hosmer - Lemeshow p = .718). Overall attitudes toward vaccination among PHCWs were positive, yet hesitancy varied by role, knowledge, and training. Targeted, continuing education that strengthens domain‑specific knowledge and communication skills - including confidence to recommend vaccines - may reduce hesitancy and bolster immunization advocacy in primary care.