Vaccine mistrust among family healthcare professionals and vaccine hesitancy in the communities they serve in Turkey in 2019: a cross-sectional study

Figures & data

Table 1. The descriptive statistics of FHPs (midwife, nurse, emergency medicine technician, or medical officer) in Turkey in 2019 (n = 682)

Variables	Mean±SD
Age	n	%
≤24	12	1.8
25–34	268	39.3
35–44	288	42.2
≥45	114	16.7
Title
Midwife	438	64.2
Nurse	191	28.0
Emergency medicine technician or medical officer	53	7.8
Graduation
High school	80	11.7
College	553	81.1
Graduate school	49	7.2
Duration of work (years)
1–10	221	32.4
11–20	238	34.9
≥21	223	32.7

Table 2. Vaccination status and attitudes of family healthcare professionals toward some vaccines in Turkey in 2019 (n = 682)

Variables	n	%
Getting a seasonal influenza vaccine in the past year
Yes	108	15.8
No	574	84.2
Latest tetanus vaccination (years)
0–9 years	521	76.4
≥10 years	146	21.4
No idea	15	2.2
In case of a measles outbreak, attitude toward getting vaccinated (n = 651)
I will get vaccinated	385	59.1
I will not get vaccinated	16	2.4
I had measles	91	13.9
I have been vaccinated before	129	19.9
No idea	30	4.7
Have you got your child vaccinated? (n = 567)
Yes	564	99.5
No	3	0.5
Do you trust the active ingredients in the vaccine?
Yes	539	79.0
No	14	2.1
No idea	129	18.9
Is there a family with vaccine hesitancy in the unit you serve?
Yes	482	70.7
No	200	29.3

Figure 1. The number of vaccine-hesitant families in the family healthcare unit (n = 482)

Table 3. The reasons for vaccine hesitancy in vaccine-hesitant families according to FHPs’ statements (n = 482)

Causes	Number	(%)*
Vaccine mistrust	353	73.2
The belief that they may be harmful to children	283	58.7
The belief that vaccines may cause autism	268	55.6
Being affected by information pollution in media/communication tools	194	40.2
Religious causes	189	39.2
The belief that vaccines have serious side effects	176	36.5
Being influenced by social media	172	35.7
The belief that the companies are malevolent because they generate huge revenues	143	29.7
The belief that vaccines cause infertility	140	29.0
The belief that complementary and alternative medicine are more effective and have less side effects	66	13.7
Being influenced by famous people’s anti-vaccination discourse	109	22.6
Vaccines are not useful	70	14.5
Refusing to vaccinate due to the complication of the previous vaccination	63	13.1
The belief that the children should gain natural immunity against diseases such as chickenpox and measles.	46	9.5
The belief that children are not in the risk group that needs to be vaccinated	33	6.8
The belief that children are not infected with vaccine-preventable disease	28	5.8
The belief that vaccines cause homosexuality	26	5.4
Vaccine-preventable diseases are insignificant	12	2.5
No idea	14	2.9

*Multiple options could be selected by FHPs.

Table 4. Some of the views of FHPs toward vaccination (n = 682)

	I agree		I disagree		No idea
Variables	n	%	n	%	n	%
The decision to vaccinate or not should belong to the family voluntarily	86	12.6	567	83.1	29	4.3
I explain to families that vaccination protects not only themselves but also the society	665	97.5	13	1.9	4	0.6
Sufficient information and counseling are provided in the unit where I work	644	94.4	28	4.1	10	1.5
Vaccines should be compulsory	594	87.1	64	9.4	24	3.5
There must be legal sanctions that involve imprisonment or high fines for vaccine refusal	504	73.9	12	18.6	51	7.5

Table 5. Factors affecting FHPs’ trust in vaccine content (n = 628)

	Trust in vaccine content
	Yes		No
Variables	n	%	n	%	p-value
Getting a measles vaccine
I will get vaccinated	312	81.0	73	19.0	<0.01
I will not get vaccinated	5	31.2	11	68.8
Getting a tetanus vaccine
<10 years	415	79.7	106	20.3	0.55
≥10 years	113	77.4	33	22.6
The decision to vaccinate or not should belong to the family voluntarily
I do not agree	65	56.5	50	43.5	0.0001
I agree/No idea	474	83.6	93	16.4
I explain to families that vaccination protects not only themselves, but also the society
I agree	529	79.5	136	20.5	0.03
I do not agree/No idea	10	58.8	7	41.2
Sufficient information and counseling are provided in the unit where I work
I agree	518	80.4	126	19.6	0.001
I do not agree/No idea	21	55.3	17	44.7
Vaccines should be compulsory
I agree	500	84.2	94	15.8	0.001
I do not agree/No idea	39	44.3	49	55.7
There must be legal sanctions that involve imprisonment or high fines for vaccine refusal
I agree	436	86.5	68	13.5	0.001
I do not agree/No idea	103	57.9	75	42.1
Age
22–34	209	74.6	71	25.4	0.01
≥35	330	82.1	72	17.9
Are there any vaccine-hesitant families?
Yes	379	78.6	103	21.4	0.68
No	160	80.0	40	20.0
Education
High school	66	82.5	14	17.5
College	435	78.7	118	21.3	0.78
Graduate school	38	77.6	11	22.4

Boldface indicates statistical significance (p < 0.05).

Table 6. Factors affecting FHPs’ trust in vaccines according to logistic regression analysis

Variables	OR	CI 95%
The decision to vaccinate or not should belong to the family voluntarily.
Agree	1.00 ^a
Disagree	0.60	0.33–1.08
I explain to families that vaccination protects not only themselves, but also the society.
Agree	1.00 ^a
Disagree	0.75	0.21–2.63
Sufficient information and counseling are provided in the unit where I work.
Agree	1.00 ^a
Disagree	1.77	0.71–4.39
Vaccines should be compulsory.
Agree	1.00 ^a
Disagree	2.78	1.45–5.31
There must be legal sanctions that involve imprisonment or high fines for vaccine refusal.
Agree	1.00 ^a
Disagree	2.68	1.64–4.37
Age
<35	1.61	1.06–2.45
≥35	1.00 ^a
Measles vaccination attitude
Get vaccinated	1.00 ^a
Not get vaccinated	1.01	0.65–1.55

^aReference category.

Boldface indicates statistical significance (p < 0.05).