Parental hesitancy and refusal toward routine childhood vaccination after the COVID-19 vaccination period: a...

The COVID-19 pandemic intensified public debates on vaccines, amplifying concerns about safety, side effects, rapid development, and institutional trust. These concerns may be associated with current attitudes toward routine childhood immunization. This study assessed parental intentions regarding routine childhood vaccination among parents whose children had previously completed routine immunizations.

This cross-sectional analytical study included 320 parents of children aged 4-8 years who had completed routine childhood vaccinations and registered at Dokuz Eylul University Training Family Health Centers. Participants were selected by simple random sampling. Data were collected using a sociodemographic questionnaire, literature-based items on vaccine attitudes, and the Vaccine Hesitancy Scale. Analyses employed descriptive statistics, chi-square, t-tests, ANOVA and multinomial logistic regression.

Among parents whose children had completed routine immunizations before the pandemic, 9.7% reported refusal and 23.4% reported hesitancy if deciding today. In the multivariable model, lower educational status was independently associated with hesitancy, whereas lower income was associated with outright refusal. Previous acceptance of non-reimbursed childhood vaccines was inversely associated with both hesitancy and refusal. Side-effect perception, concerns about vaccine production and distrust in healthcare providers were independently associated with hesitancy, while vaccine effectiveness concerns and distrust in healthcare providers were independently associated with refusal.

Hesitancy and refusal were observed among parents whose children had previously completed routine immunizations. Educational and socioeconomic factors, prior optional vaccine acceptance, vaccine-related concerns and healthcare provider trust were associated with current vaccination intention. Primary care-based, individualized vaccine communication is needed, while causal attitude changes cannot be inferred from this cross-sectional design.