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An overview of the etiology of vaccine hesitancy and refusal

Year 2025, Volume: 19 Issue: 3, 143 - 147, 14.05.2025

İrem Altınışık , Eda Özaydın , Aysun Kara Uzun

https://doi.org/10.12956/tchd.1693041

Abstract

Vaccination is among the most cost-effective interventions for protecting populations against infectious diseases. Individuals exhibiting vaccine hesitancy may eventually accept some or all vaccines, may delay them, or may reject specific ones. In contrast, vaccine refusal denotes the complete voluntary rejection of all vaccines in the current immunization program. Vaccine refusal represents a significant public health concern, threatening both individual and community health. Opposition to vaccines has existed since their inception and continues to grow, particularly with the influence of the internet and social media. Some of the reasons for vaccine refusal include concerns about the vaccine components, distrust in vaccines, religious beliefs, reservations about the pharmaceutical industry, and fear of adverse effects. This review aims to explore the etiology of vaccine refusal based on current literature.

Keywords

Child etiology vaccine hesitancy vaccine refusal

References

  • World Health Organization (WHO). How do vaccines work? [Internet]. [cited 2023 Jul 12]. Available from: https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work
  • Bekis Bozkurt H. An overview of vaccine rejection and review of literature. Kafkas J Med Sci. 2018;8(1):71-6. https://doi.org/10.5505/kjms.2018.12754
  • Report of the SAGE Working Group on Vaccine Hesitancy [Internet]. 2014 Nov 12. [cited 2023 Jul 12].
  • Nelson MC, Rogers J. The right to die? Anti-vaccination activity and the 1874 smallpox epidemic in Stockholm. Soc Hist Med. 1992;5(3):369-88. https://doi.org/10.1093/shm/5.3.369
  • Durbach N. Bodily matters: The anti-vaccination movement in England, 1853-1907. Durham, NC: Duke University Press; 2005. https://doi.org/10.1215/9780822386506
  • Prabhu M. Ye olde anti-vaxxers. Gavi, the Vaccine Alliance [Internet]. [cited 2023 Jul 19]. Available from:
  • Swales JD. The Leicester anti-vaccination movement. Lancet. 1992;340(8826):1019-21. https://doi.org/10.1016/0140-6736(92)93021-E
  • Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ. 2002;325(7361):430-2. https://doi.org/10.1136/bmj.325.7361.430
  • Ołpiński M. Anti-vaccination movement and parental refusals of immunization of children in USA. Pediatr Pol. 2012;87(4):381-5. https://doi.org/10.1016/j.pepo.2012.05.003
  • Nuwarda RF, Ramzan I, Weekes L, Kayser V. Vaccine hesitancy: Contemporary issues and historical background. Vaccines (Basel). 2022;10(2):247. https://doi.org/10.3390/vaccines10101595
  • Kulenkampff M, Schwartzman JS, Wilson J. Neurological complications of pertussis inoculation. Arch Dis Child. 1974;49(2):46-9. https://doi.org/10.1136/adc.49.1.46
  • Badur S. Anti-vaccination: vaccine hesitancy and refusal. Ankem Derg. 2011;25(2):82-6.
  • Centers for Disease Control and Prevention (CDC). Guillain-Barré Syndrome and vaccines [Internet]. [cited 2023 Jul 19]. Available from: https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html
  • Confavreux C, Suissa S, Saddier P, Bourdes V, Vukusic S. Vaccinations and the risk of relapse in multiple sclerosis. N Engl J Med. 2001;344(5):319-26. https://doi.org/10.1056/NEJM200102013440501
  • Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, et al. Retracted: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351(9103):637-41. https://doi.org/10.1016/S0140-6736(97)11096-0
  • Jegede AS. What led to the Nigerian boycott of the polio vaccination campaign? PLoS Med. 2007;4(3):e73. https://doi.org/10.1371/journal.pmed.0040073
  • Smith TC. Vaccine rejection and hesitancy: A review and call to action. Open Forum Infect Dis. 2017;4(3):ofx146. https://doi.org/10.1093/ofid/ofx146
  • Kara A, Çiftçi E, Tezer H, Somer A, editors. Aşı ve Bağışıklama. Aşılar ve Civa İddiaları. 1st ed. Ankara: Selen Medya Yayıncılık. 2021; 877-878.
  • Kara A, Çiftçi E, Tezer H, Somer A, editors. Aşı ve Bağışıklama. Aşılar ve Otizm İddiaları. 1st ed. Ankara: Selen Medya Yayıncılık; 2021:897-904.
  • Taylor LE, Swerdfeger AL, Eslick GD. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014 ;32(29):3623-9. https://doi.org/10.1016/j.vaccine.2014.04.085
  • T.C. Sağlık Bakanlığı. Aşılar ile otizm arasında ilişki var mıdır? [Internet]. [cited 2023 Jul 25]. Available from: https://asi.saglik.gov.tr
  • Bults M, Beaujean DJMA, Richardus JH, van Steenbergen JE, Voeten HACM. Pandemic influenza A (H1N1) vaccination in The Netherlands: Parental reasoning underlying child vaccination choices. Vaccine. 2011;29(37):6226-35. https://doi.org/10.1016/j.vaccine.2011.06.075
  • Yağcı-Küpeli B, Kiper N. Interactions between physicians and drugindustry. Cukurova Med J. 2016;41:777-81. https://doi.org/10.17826/cutf.254526
  • Ağalar C, Ağalar F, Sayek İ. The interactions between doctorsand pharmaceutical companies. Çocuk Sağlığı ve Hastalıkları Dergisi. 2005;48:273-83.
  • Taşçı Ö, Gökler ME. Aşı karşıtlarının sosyal medya paylaşımlarının incelenmesi: Instagram örneği. Med Res Rep. 2021;4(2):23-30.
  • Etesaminia S, Bağcı Derinpınar K. The role of social media in vaccıne hesitation. Usaysad Derg. 2021;7(2):377-90.
  • Türkiye İstatistik Kurumu (TÜİK). Hanehalkı Bilişim Teknolojileri Kullanım Araştırması 2022 [Internet]. [cited 2023 Jul 27]. Available from: https://data.tuik.gov.tr
  • T.C. Sağlık Bakanlığı. Aşı içerikleri [Internet]. [cited 2023 Jul 13]. Available from: https://covid19asi.saglik.gov.tr
  • Büyükkalay BN. Vaccine Rejection and Motivation Sources of Vaccine Rejected People. Int Soc Mentality Res Thinkers J. 2022;8(65):2116-26. https://doi.org/10.29228/smryj.65987
  • Fourn L, Haddad S, Fournier P, Gansey R. Determinants of parents’ reticence toward vaccination in urban areas in Benin (West Africa). BMC Int Health Hum Rights. 2009;9(Suppl 1):S1-5. https://doi.org/10.1186/1472-698X-9-S1-S14
  • The Liberty Beacon. The vaccine illusion: How vaccination compromises our natural immunity and what we can do to regain our health [Internet]. [cited 2023 Aug 10]. Available from: https://www.thelibertybeacon.com
  • McKee CP, Bohannon KB. Exploring the reasons behind parental refusal of vaccines. J Pediatr Pharmacol Ther. 2016;21(2):104-9. https://doi.org/10.5863/1551-6776-21.2.104
  • Dirlik R. Aşıyı ve tapınak tıbbını savunan katil. [Internet]. [cited 2023 Aug 10]. Available from: https://ruhadirlik.blogspot.com/2016/01/asiyi-ve-tapinak-tibbini-savunan.html
  • Immunization Action Coalition. Vaccine work [Internet]. Available from: https://www.immunize.org/catg.d/p4037.pdf
  • Hızel Bülbül S, Turgut M, Köylüoğlu S. Çocuklarda tıp dışı alternatif uygulamalar konusunda ailelerin görüşleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2009;52:195-202.
  • Çıtak G, Aksoy Duran Ö. An Important Obstacle in Vaccination: Vaccination Rejection. Erciyes Univ Health Sci Fac J. 2020;7(2):15-20.
  • Cobos Muñoz D, Monzón Llamas L, Bosch-Capblanch X. Exposing concerns about vaccination in low- and middle-income countries: A systematic review. Int J Public Health. 2015;60(7):767-80. https://doi.org/10.1007/s00038-015-0715-6
  • Khowaja AR, Khan SA, Nizam N, Bin Omer S, Zaidi A. Parental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: A mixed methods study. Bull World Health Organ. 2012;90:822-30. https://doi.org/10.2471/BLT.12.106260
  • Cumhuriyet. Yargıtay’dan aşı kararına ikinci ret [Internet]. [cited 2023 Jul 19]. Available from: https://www.cumhuriyet.com.tr/haber/yargitaydan-asi-kararina-ikinci-ret-531726
  • Gür E. Vaccine hesitancy - vaccine refusal. Turk Pediatri Ars. 2019;54(1):1-2. https://doi.org/ 10.14744/TurkPediatriArs.2019.79990
  • Betsch C, Böhm R, Chapma GB. Using behavioral insights to increase vaccination policy effectiveness. Policy Insights from the Behavioral and Brain Sciences, 2018;5(1):61-9. https://doi.org/10.1177/2372732217752066
  • Larson HJ, Gakidou E, Murray CJL. The vaccine-hesitant moment. New England Journal of Medicine, 202;387(1):58-65. https://doi.org/10.1056/NEJMra2106441
  • World Health Organization. Behavioural and social drivers of vaccination: Tools and practical guidance for achieving high uptake. 2023
  • Kempe A, Saville AW, Albertin C, Zimet G, Breck A, Helmkamp L, Dickinson LM. Parental hesitancy about routine childhood and influenza vaccinations: A national survey. Pediatrics 2020;146(1):e20193852. https://doi.org/10.1542/peds.2019-3852

Aşı Reddi Nedenlerine ve Tarihçesine Genel Bir Bakış

Year 2025, Volume: 19 Issue: 3, 143 - 147, 14.05.2025

İrem Altınışık , Eda Özaydın , Aysun Kara Uzun

https://doi.org/10.12956/tchd.1693041

Abstract

Aşılama, bulaşıcı hastalıklardan korunmada en maliyet etkin halk sağlığı müdahalelerinden biridir. Aşı tereddüdü gösteren bireyler, zamanla bazı veya tüm aşıları kabul edebilir, uygulamayı erteleyebilir ya da belirli aşıları reddedebilir. Buna karşılık, aşı reddi, mevcut bağışıklama programındaki tüm aşıların gönüllü olarak tamamen reddedilmesini ifade eder. Aşı reddi, bireysel ve toplumsal bağışıklığı tehlikeye atan ciddi bir halk sağlığı sorunu teşkil etmektedir. Aşı karşıtlığı, aşıların tarihsel olarak ilk uygulanmaya başlandığı dönemden bu yana varlığını sürdürmekte olup, özellikle internet ve sosyal medya aracılığıyla son yıllarda artış göstermektedir. Aşı reddi nedenlerinden bazıları; aşıların içeriği ile ilgili endişeler, aşılara karşı güvensizlik, dini inanışlar, ilaç endüstrisi ile ilgili çekinceler, aşıların yan etkileri ile ilgili endişeler olarak sıralanabilir. Bu derlemenin amacı, mevcut literatür ışığında aşı reddinin etiyolojisini incelemektir.

Keywords

Çocuk etiyoloji aşı tereddütü aşı reddi

References

  • World Health Organization (WHO). How do vaccines work? [Internet]. [cited 2023 Jul 12]. Available from: https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work
  • Bekis Bozkurt H. An overview of vaccine rejection and review of literature. Kafkas J Med Sci. 2018;8(1):71-6. https://doi.org/10.5505/kjms.2018.12754
  • Report of the SAGE Working Group on Vaccine Hesitancy [Internet]. 2014 Nov 12. [cited 2023 Jul 12].
  • Nelson MC, Rogers J. The right to die? Anti-vaccination activity and the 1874 smallpox epidemic in Stockholm. Soc Hist Med. 1992;5(3):369-88. https://doi.org/10.1093/shm/5.3.369
  • Durbach N. Bodily matters: The anti-vaccination movement in England, 1853-1907. Durham, NC: Duke University Press; 2005. https://doi.org/10.1215/9780822386506
  • Prabhu M. Ye olde anti-vaxxers. Gavi, the Vaccine Alliance [Internet]. [cited 2023 Jul 19]. Available from:
  • Swales JD. The Leicester anti-vaccination movement. Lancet. 1992;340(8826):1019-21. https://doi.org/10.1016/0140-6736(92)93021-E
  • Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ. 2002;325(7361):430-2. https://doi.org/10.1136/bmj.325.7361.430
  • Ołpiński M. Anti-vaccination movement and parental refusals of immunization of children in USA. Pediatr Pol. 2012;87(4):381-5. https://doi.org/10.1016/j.pepo.2012.05.003
  • Nuwarda RF, Ramzan I, Weekes L, Kayser V. Vaccine hesitancy: Contemporary issues and historical background. Vaccines (Basel). 2022;10(2):247. https://doi.org/10.3390/vaccines10101595
  • Kulenkampff M, Schwartzman JS, Wilson J. Neurological complications of pertussis inoculation. Arch Dis Child. 1974;49(2):46-9. https://doi.org/10.1136/adc.49.1.46
  • Badur S. Anti-vaccination: vaccine hesitancy and refusal. Ankem Derg. 2011;25(2):82-6.
  • Centers for Disease Control and Prevention (CDC). Guillain-Barré Syndrome and vaccines [Internet]. [cited 2023 Jul 19]. Available from: https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html
  • Confavreux C, Suissa S, Saddier P, Bourdes V, Vukusic S. Vaccinations and the risk of relapse in multiple sclerosis. N Engl J Med. 2001;344(5):319-26. https://doi.org/10.1056/NEJM200102013440501
  • Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, et al. Retracted: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351(9103):637-41. https://doi.org/10.1016/S0140-6736(97)11096-0
  • Jegede AS. What led to the Nigerian boycott of the polio vaccination campaign? PLoS Med. 2007;4(3):e73. https://doi.org/10.1371/journal.pmed.0040073
  • Smith TC. Vaccine rejection and hesitancy: A review and call to action. Open Forum Infect Dis. 2017;4(3):ofx146. https://doi.org/10.1093/ofid/ofx146
  • Kara A, Çiftçi E, Tezer H, Somer A, editors. Aşı ve Bağışıklama. Aşılar ve Civa İddiaları. 1st ed. Ankara: Selen Medya Yayıncılık. 2021; 877-878.
  • Kara A, Çiftçi E, Tezer H, Somer A, editors. Aşı ve Bağışıklama. Aşılar ve Otizm İddiaları. 1st ed. Ankara: Selen Medya Yayıncılık; 2021:897-904.
  • Taylor LE, Swerdfeger AL, Eslick GD. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014 ;32(29):3623-9. https://doi.org/10.1016/j.vaccine.2014.04.085
  • T.C. Sağlık Bakanlığı. Aşılar ile otizm arasında ilişki var mıdır? [Internet]. [cited 2023 Jul 25]. Available from: https://asi.saglik.gov.tr
  • Bults M, Beaujean DJMA, Richardus JH, van Steenbergen JE, Voeten HACM. Pandemic influenza A (H1N1) vaccination in The Netherlands: Parental reasoning underlying child vaccination choices. Vaccine. 2011;29(37):6226-35. https://doi.org/10.1016/j.vaccine.2011.06.075
  • Yağcı-Küpeli B, Kiper N. Interactions between physicians and drugindustry. Cukurova Med J. 2016;41:777-81. https://doi.org/10.17826/cutf.254526
  • Ağalar C, Ağalar F, Sayek İ. The interactions between doctorsand pharmaceutical companies. Çocuk Sağlığı ve Hastalıkları Dergisi. 2005;48:273-83.
  • Taşçı Ö, Gökler ME. Aşı karşıtlarının sosyal medya paylaşımlarının incelenmesi: Instagram örneği. Med Res Rep. 2021;4(2):23-30.
  • Etesaminia S, Bağcı Derinpınar K. The role of social media in vaccıne hesitation. Usaysad Derg. 2021;7(2):377-90.
  • Türkiye İstatistik Kurumu (TÜİK). Hanehalkı Bilişim Teknolojileri Kullanım Araştırması 2022 [Internet]. [cited 2023 Jul 27]. Available from: https://data.tuik.gov.tr
  • T.C. Sağlık Bakanlığı. Aşı içerikleri [Internet]. [cited 2023 Jul 13]. Available from: https://covid19asi.saglik.gov.tr
  • Büyükkalay BN. Vaccine Rejection and Motivation Sources of Vaccine Rejected People. Int Soc Mentality Res Thinkers J. 2022;8(65):2116-26. https://doi.org/10.29228/smryj.65987
  • Fourn L, Haddad S, Fournier P, Gansey R. Determinants of parents’ reticence toward vaccination in urban areas in Benin (West Africa). BMC Int Health Hum Rights. 2009;9(Suppl 1):S1-5. https://doi.org/10.1186/1472-698X-9-S1-S14
  • The Liberty Beacon. The vaccine illusion: How vaccination compromises our natural immunity and what we can do to regain our health [Internet]. [cited 2023 Aug 10]. Available from: https://www.thelibertybeacon.com
  • McKee CP, Bohannon KB. Exploring the reasons behind parental refusal of vaccines. J Pediatr Pharmacol Ther. 2016;21(2):104-9. https://doi.org/10.5863/1551-6776-21.2.104
  • Dirlik R. Aşıyı ve tapınak tıbbını savunan katil. [Internet]. [cited 2023 Aug 10]. Available from: https://ruhadirlik.blogspot.com/2016/01/asiyi-ve-tapinak-tibbini-savunan.html
  • Immunization Action Coalition. Vaccine work [Internet]. Available from: https://www.immunize.org/catg.d/p4037.pdf
  • Hızel Bülbül S, Turgut M, Köylüoğlu S. Çocuklarda tıp dışı alternatif uygulamalar konusunda ailelerin görüşleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2009;52:195-202.
  • Çıtak G, Aksoy Duran Ö. An Important Obstacle in Vaccination: Vaccination Rejection. Erciyes Univ Health Sci Fac J. 2020;7(2):15-20.
  • Cobos Muñoz D, Monzón Llamas L, Bosch-Capblanch X. Exposing concerns about vaccination in low- and middle-income countries: A systematic review. Int J Public Health. 2015;60(7):767-80. https://doi.org/10.1007/s00038-015-0715-6
  • Khowaja AR, Khan SA, Nizam N, Bin Omer S, Zaidi A. Parental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: A mixed methods study. Bull World Health Organ. 2012;90:822-30. https://doi.org/10.2471/BLT.12.106260
  • Cumhuriyet. Yargıtay’dan aşı kararına ikinci ret [Internet]. [cited 2023 Jul 19]. Available from: https://www.cumhuriyet.com.tr/haber/yargitaydan-asi-kararina-ikinci-ret-531726
  • Gür E. Vaccine hesitancy - vaccine refusal. Turk Pediatri Ars. 2019;54(1):1-2. https://doi.org/ 10.14744/TurkPediatriArs.2019.79990
  • Betsch C, Böhm R, Chapma GB. Using behavioral insights to increase vaccination policy effectiveness. Policy Insights from the Behavioral and Brain Sciences, 2018;5(1):61-9. https://doi.org/10.1177/2372732217752066
  • Larson HJ, Gakidou E, Murray CJL. The vaccine-hesitant moment. New England Journal of Medicine, 202;387(1):58-65. https://doi.org/10.1056/NEJMra2106441
  • World Health Organization. Behavioural and social drivers of vaccination: Tools and practical guidance for achieving high uptake. 2023
  • Kempe A, Saville AW, Albertin C, Zimet G, Breck A, Helmkamp L, Dickinson LM. Parental hesitancy about routine childhood and influenza vaccinations: A national survey. Pediatrics 2020;146(1):e20193852. https://doi.org/10.1542/peds.2019-3852
There are 44 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Review
Authors

İrem Altınışık 0009-0001-6575-0094

Eda Özaydın 0000-0002-3609-9183

Aysun Kara Uzun 0000-0002-1028-5949

Publication Date May 14, 2025
Submission Date May 7, 2025
Acceptance Date May 9, 2025
Published in Issue Year 2025 Volume: 19 Issue: 3

Cite

APA Altınışık, İ., Özaydın, E., & Kara Uzun, A. (2025). An overview of the etiology of vaccine hesitancy and refusal. Türkiye Çocuk Hastalıkları Dergisi, 19(3), 143-147. https://doi.org/10.12956/tchd.1693041
AMA Altınışık İ, Özaydın E, Kara Uzun A. An overview of the etiology of vaccine hesitancy and refusal. Turkish J Pediatr Dis. May 2025;19(3):143-147. doi:10.12956/tchd.1693041
Chicago Altınışık, İrem, Eda Özaydın, and Aysun Kara Uzun. “An Overview of the Etiology of Vaccine Hesitancy and Refusal”. Türkiye Çocuk Hastalıkları Dergisi 19, no. 3 (May 2025): 143-47. https://doi.org/10.12956/tchd.1693041.
EndNote Altınışık İ, Özaydın E, Kara Uzun A (May 1, 2025) An overview of the etiology of vaccine hesitancy and refusal. Türkiye Çocuk Hastalıkları Dergisi 19 3 143–147.
IEEE İ. Altınışık, E. Özaydın, and A. Kara Uzun, “An overview of the etiology of vaccine hesitancy and refusal”, Turkish J Pediatr Dis, vol. 19, no. 3, pp. 143–147, 2025, doi: 10.12956/tchd.1693041.
ISNAD Altınışık, İrem et al. “An Overview of the Etiology of Vaccine Hesitancy and Refusal”. Türkiye Çocuk Hastalıkları Dergisi 19/3 (May2025), 143-147. https://doi.org/10.12956/tchd.1693041.
JAMA Altınışık İ, Özaydın E, Kara Uzun A. An overview of the etiology of vaccine hesitancy and refusal. Turkish J Pediatr Dis. 2025;19:143–147.
MLA Altınışık, İrem et al. “An Overview of the Etiology of Vaccine Hesitancy and Refusal”. Türkiye Çocuk Hastalıkları Dergisi, vol. 19, no. 3, 2025, pp. 143-7, doi:10.12956/tchd.1693041.
Vancouver Altınışık İ, Özaydın E, Kara Uzun A. An overview of the etiology of vaccine hesitancy and refusal. Turkish J Pediatr Dis. 2025;19(3):143-7.
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