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The Relationship Between COVID-19 Vaccine Regret, Distrust of the Healthcare System, and Future Vaccine Intentions

Ali Tayhan¹, Bilge Azakli¹

¹Department of Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey.

Journal of Evaluation in Clinical Practice

|July 19, 2026

Abstract

Background:

Vaccines are one of the most effective interventions used by public health services to reduce infectious diseases. However, individuals' attitudes toward vaccines are also crucial to vaccine effectiveness. Experiences with vaccines and trust in healthcare services can guide future vaccination decisions.

Aims:

The aim of this study was to examine the relationship between COVID-19 vaccine regret, distrust of the healthcare system, and future vaccination intentions.

Methods:

In this cross-sectional study with a qualitative component, data were obtained through face-to-face interviews (n = 402). Data were collected using the Decision Regret Scale (DRS), the Health System Distrust Scale (HCSDS), and open-ended questions regarding the reasons for COVID-19 vaccine regret. To ensure clarity of the findings, quantitative and qualitative data were integrated.

Results:

Of the participants in the study, 87.1% did not experience any adverse effects from the COVID-19 vaccine. 56.2% of participants regretted getting the COVID-19 vaccine. Additionally, 35.8% reported being 'undecided' about accepting a new vaccine in the future. Among participants, it was found that experiencing a side effect after the COVID-19 vaccine increased distrust in the healthcare system (p < 0.05). A weak positive correlation was found between participants' HCSDS and DRS scores (r = 0.282, p < 0.001). Qualitative analyses showed that participants' regrets regarding the COVID-19 vaccine were mainly grouped around two themes: (1) 'Concern about long-term effects', (2) 'Perception that the vaccine is unnecessary'.

Conclusions:

Based on these findings, it can be said that the phenomenon of COVID-19 vaccine regret and the level of distrust in the healthcare system will make it even more difficult to control future pandemics and infectious diseases. In addition, the findings highlight the need for communication strategies aimed at increasing trust in vaccines and the healthcare system.

Keywords:

COVID‐19 vaccine regret health system distrust intention to get vaccinated

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