Reasons for Childhood Vaccine Refusal: A Cross-Sectional Study in South-Eastern Türkiye

Background/Objectives: Vaccine hesitancy has intensified worldwide, and measles and pertussis have resurged across the WHO European Region. In Türkiye, a regulation introduced in May 2024 made documentation of every parental refusal mandatory, rendering 2025 the first calendar year for which provincial refusal data can be considered systematically ascertained. Methods: We conducted a retrospective, registry-based cross-sectional study of all vaccine refusal notifications submitted to the Batman Provincial Health Directorate between 1 January and 31 December 2025, covering all six districts of the province. Sociodemographic data were extracted from the notification database, and reasons for refusal were obtained using a structured questionnaire administered by primary healthcare personnel. Parents could endorse more than one reason. Results: A total of 4118 notifications were analysed. Mothers completed 62.4% of notifications; 44.2% of parents had primary education only and 58.3% belonged to low-income households. The diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b (DTaP-IPV-Hib) combination vaccine (28.4%) and measles-mumps-rubella (MMR) vaccine (22.1%) were the most frequently refused vaccines. Exposure to media or community reports was the most frequently endorsed reason (71.3%), followed by concern about adverse effects (68.9%) and doubts about vaccine safety (65.4%). Parents endorsed a mean of 3.6 reasons each. Doubts about safety predominated in lower socioeconomic strata, whereas the perception that vaccination is unnecessary predominated in higher strata. Conclusions: Refusal in this setting rests on a cluster of mutually reinforcing beliefs rather than a single misconception, and the concerns reported differ systematically by socioeconomic position. Differentiated rather than uniform communication strategies are required.