Gebelikte Aşı Tereddüdü ve İlişkili Faktörler: Kesitsel Bir Çalışma

Öz

Amaç: Bu çalışma, Türkiye’nin doğu illerinden Muş’ta yaşayan gebelerin çocukluk çağı aşılarına yönelik tereddüt düzeylerini belirlemeyi ve bu tutumlara etki eden sosyodemografik, davranışsal ve sağlık sistemiyle ilişkili etmenleri analiz etmeyi amaçlamaktadır. Yöntem: Ocak–Şubat 2024 tarihleri arasında Muş Devlet Hastanesi Kadın Doğum Polikliniği’ne başvuran 313 gebe ile yürütülen bu kesitsel araştırmada, veri toplama aracı olarak sosyodemografik bilgiler, sağlık davranışları, aşıya yönelik tutumlar ve Aşı Tereddüdü Ölçeği’ni içeren anket formu kullanılmıştır. Bulgular: Katılımcıların Aşı Tereddüdü Ölçek puan ortalaması 19,01±6,33 olarak saptanmıştır. Lise ve üzeri eğitim düzeyine sahip olan gebelerde ve eşlerinde, il/ilçe merkezinde yaşayanlarda, ilk gebelikte olanlarda ve kısmen sağlıklı beslendiğini belirtenlerde tereddüt düzeyleri daha yüksek bulunmuştur. Gebelik ve çocuk sayısı arttıkça aşı tereddüdü anlamlı olarak azalmaktadır. Aile hekimine güven düzeyi arttıkça tereddüt düzeyleri düşmekte, ancak sadece hekimi tanımak bu konuda etkili olmamaktadır. Sonuç: Aşı tereddüdü, bireysel özellikler, sağlık davranışları ve sağlık sistemine duyulan güven gibi çok boyutlu etmenlerle şekillenmektedir. Bulgular, özellikle eğitimli ve kentsel nüfus başta olmak üzere belirli gruplarda hedefli iletişim stratejileri geliştirilmesi gerektiğini göstermektedir. Ayrıca, sağlık çalışanlarının güven sağlayan bir iletişim tarzı benimsemeleri, tereddüdü azaltmada kritik öneme sahiptir.

Anahtar Kelimeler

• gebelik
• halk sağlığı
• Aşılama
• Aşı kararsızlığı

Factors Associated with Vaccine Hesitancy During Pregnancy: A Cross-Sectional Study

Öz

Aim: This study aims to assess the level of vaccine hesitancy among pregnant women residing in Muş, a province in eastern Türkiye, and to analyze the influence of sociodemographic characteristics, health-related behaviours, and factors related to the healthcare system on their attitudes towards childhood vaccinations. Method: A cross-sectional survey was conducted between January and February 2024 with 313 pregnant women who attended the Obstetrics and Gynecology Outpatient Clinic of Muş State Hospital. Data were collected using a structured questionnaire comprising sociodemographic information, health behaviours, attitudes towards vaccination, and the Vaccine Hesitancy Scale. Results: The mean score on the Vaccine Hesitancy Scale was 19.01 ± 6.33. Higher levels of hesitancy were observed among participants with higher educational attainment, those residing in urban areas and those in their first pregnancy. As the number of pregnancies and children increased, vaccine hesitancy significantly decreased. Greater trust in family physicians was associated with lower hesitancy, whereas mere acquaintance with a physician did not appear to influence hesitancy levels. Conclusion: The findings highlight the need for tailored communication strategies, particularly for more educated and urban populations. Moreover, the ability of healthcare professionals to establish trust through effective communication is essential in reducing vaccine hesitancy.

Anahtar Kelimeler

• pregnancy
• public health
• vaccination
• vaccine hesitancy

Kaynakça

1. Plotkin SA, Orenstein W, Offit PA. Vaccines: Elsevier Health Sciences; 2008.
2. Zhou F. Health and economic benefits of routine childhood immunizations in the era of the Vaccines for Children program—United States, 1994–2023. MMWR Morbidity and Mortality Weekly Report. 2024;73.
3. Ministry of Health of the Republic of Türkiye. Immunization Program and Vaccination Schedule 2025 [updated 28.05.2025. Available from: https://asi.saglik.gov.tr/bagisiklama-programi-ve- asi-takvimi/asi-takvimi.html.
4. MacDonald NE. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161-4.
5. Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007–2012. Vaccine. 2014;32(19):2150-9.
6. Roozenbeek J, Schneider CR, Dryhurst S, Kerr J, Freeman AL, Recchia G, et al. Susceptibility to misinformation about COVID-19 around the world. Royal Society open science. 2020;7(10):201199.
7. Chadwick A, Kaiser J, Vaccari C, Freeman D, Lambe S, Loe BS, et al. Online social endorsement and Covid-19 vaccine hesitancy in the United Kingdom. Social media+ society. 2021;7(2):20563051211008817.
8. Romer D, Jamieson KH. Conspiratorial thinking, selective exposure to conservative media, and response to COVID-19 in the US. Social Science & Medicine. 2021;291:114480.

9. Montagni I, Ouazzani-Touhami K, Mebarki A, Texier N, Schück S, Tzourio C, et al. Acceptance of a Covid-19 vaccine is associated with ability to detect fake news and health literacy. Journal of public health. 2021;43(4):695-702.
10. Minta AA. Progress toward measles elimination—worldwide, 2000–2022. MMWR Morbidity and Mortality Weekly Report. 2023;72.
11. Gür E. Aşı kararsızlığı. Turkiye Klinikleri Social Pediatrics-Special Topics. 2021;2(1):28-33.
12. Health Statistics Yearbook 2023. Available from: https://dosyasb.saglik.gov.tr/Eklenti/50208/0/siy2023ingilizce31012025pdf.pdf.
13. Gür E. Vaccine hesitancy-vaccine refusal. Turkish Archives of Pediatrics/Türk Pediatri Arşivi. 2019;54(1):1.
14. Çetin K, Sögüt SC. The relationship between vaccine hesitancy and health literacy in pregnant women: a cross-sectional study. BMC Women's Health. 2024;24(1):361.
15. Cox E, Sanchez M, Taylor K, Baxter C, Crary I, Every E, et al. A mother’s dilemma: the 5-P model for vaccine decision-making in pregnancy. Vaccines. 2023;11(7):1248.
16. Nichol B, McCready JL, Steen M, Unsworth J, Simonetti V, Tomietto M. Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review. Plos one. 2023;18(3):e0282525.
17. Shapiro GK, Tatar O, Dube E, Amsel R, Knauper B, Naz A, et al. The vaccine hesitancy scale: Psychometric properties and validation. Vaccine. 2018;36(5):660-7.
18. Önal Ö, Eroğlu HN, Evcil FY, Kişioğlu AN, Uskun E. Validity and reliability of Turkish version of the Vaccine Hesitancy Scale. Turkish Archives of Pediatrics. 2021;56(3):230.
19. Yörük S, Güler D. Factors associated with pediatric vaccine hesitancy of parents: a cross- sectional study in Turkey. Human Vaccines & Immunotherapeutics. 2021;17(11):4505-11.
20. Özceylan G, Toprak D, Esen ES. Vaccine rejection and hesitation in Turkey. Human vaccines & immunotherapeutics. 2020;16(5):1034-9.
21. Motta M, Callaghan T, Sylvester S. Knowing less but presuming more: Dunning-Kruger effects and the endorsement of anti-vaccine policy attitudes. Social Science & Medicine. 2018;211:274-81.
22. Al-Regaiey KA, Alshamry WS, Alqarni RA, Albarrak MK, Alghoraiby RM, Alkadi DY, et al. Influence of social media on parents’ attitudes towards vaccine administration. Human vaccines & immunotherapeutics. 2022;18(1):1872340.
23. Hornsey MJ, Harris EA, Fielding KS. The psychological roots of anti-vaccination attitudes: A 24-nation investigation. Health psychology. 2018;37(4):307.
24. Lamot M, Kirbiš A. Understanding vaccine hesitancy: a comparison of sociodemographic and socioeconomic predictors with health literacy dimensions. Vaccines. 2024;12(10):1141.
25. Novilla MLB, Goates MC, Redelfs AH, Quenzer M, Novilla LKB, Leffler T, et al. Why parents say no to having their children vaccinated against measles: a systematic review of the social determinants of parental perceptions on MMR vaccine hesitancy. Vaccines. 2023;11(5):926.
26. Gu J, Dor A, Li K, Broniatowski DA, Hatheway M, Fritz L, et al. The impact of Facebook’s vaccine misinformation policy on user endorsements of vaccine content: An interrupted time series analysis. Vaccine. 2022;40(14):2209-14.
27. Rodrigues F, Ziade N, Jatuworapruk K, Caballero-Uribe CV, Khursheed T, Gupta L. The impact of social media on vaccination: a narrative review. Journal of Korean medical science. 2023;38(40).
28. Kuatewo M, Ebelin W, Doegah PT, Aberese-Ako M, Lissah S, Kpordorlor AG, et al. Fake news, misinformation, vaccine hesitancy and the role of community engagement in COVID-19 vaccine acceptance in Southern Ghana. PloS one. 2025;20(6):e0316969.
29. Corben P, Leask J. Vaccination hesitancy in the antenatal period: a cross-sectional survey. BMC public health. 2018;18:1-13.
30. Kun E, Benedek A, Mészner Z. Vaccine hesitancy among primary healthcare professionals in Hungary. Orvosi hetilap. 2019;160(48):1904-14.
31. Aguolu OG, Willebrand K, Elharake JA, Qureshi HM, Kiti MC, Liu CY, et al. Factors influencing the decision to receive seasonal influenza vaccination among US corporate non-healthcare workers. Human vaccines & immunotherapeutics. 2022;18(6):2122379.
32. Sheeran P, Bosch JA, Crombez G, Hall PA, Harris JL, Papies EK, et al. Implicit processes in health psychology: Diversity and promise. Health Psychology. 2016;35(8):761.