Trust and education, not illness, shape vaccine doubt in Türkiye

Analysis of 1,600 adults finds vaccine scepticism is most strongly associated with education, religion, region and confidence in scientists, rather than health status alone.

A new analysis of adults in Türkiye suggests that vaccine doubt is shaped far more by education, trust and social background than by health status alone, adding fresh evidence to a debate that has become central to public health after the pandemic. Writing in BMC Public Health, Ömer Faruk Sönmez of Kırıkkale University and Université Paris-Saclay used data from the 2024 Turkish General Social Survey to examine who was most likely to agree with the statement that vaccines generally do more harm than good.

The study drew on valid responses from 1,600 adults and treated hesitancy as a spectrum rather than a simple yes-or-no choice. That approach allowed Sönmez to measure both mild and strong scepticism, and to test how it related to age, schooling, region, religion, trust and health-related characteristics. The analysis found that the most resistant attitudes were concentrated among people aged 35 to 44, those with only primary education, residents of the Aegean region and respondents who described themselves as more religious.

By contrast, higher levels of education were linked to less hesitation, with university and master’s qualifications each associated with lower odds of vaccine doubt. Confidence in scientists emerged as one of the strongest protective factors in the model. The findings fit with broader evidence from Türkiye, where other research has already shown the value of measuring hesitancy with validated survey tools and of looking beyond COVID-19-specific attitudes to understand vaccination behaviour more generally.

That wider literature also suggests the problem does not stop at one vaccine or one group. Studies indexed on PubMed have examined parental hesitancy around childhood immunisation in Turkey, while separate work has looked at hesitancy and acceptance among haemodialysis patients, who face particular health risks and may still hold misconceptions about vaccines. Research on Turkish academics has likewise shown that hesitancy can persist even among highly educated groups, underscoring that schooling alone does not eliminate scepticism.

Another recent study focused on Syrian refugees in Turkey found that trust in health workers and concerns about vaccine safety were central to acceptance, pointing to the importance of culturally sensitive messaging. Research on Turkish health worker parents has reached a similar conclusion, suggesting that attitudes within medical households are not automatically aligned with official guidance. Taken together, these studies support the broader pattern seen in Sönmez’s analysis: vaccine confidence is shaped by trust networks, social identity and local context as much as by medical knowledge.

The new paper also found that most health conditions were not independently tied to vaccine hesitancy once other factors were taken into account, with arthritis or rheumatism standing out as one exception. The study did not find a significant link between general hesitancy and uptake of the COVID-19 vaccine, suggesting that people may accept one vaccine while remaining broadly doubtful about immunisation. That distinction matters for public health planners, because it means the people most likely to resist vaccines cannot be identified from medical history alone.

The study has limits. It is cross-sectional, so it can show association but not cause and effect. It was also unweighted, meaning the results describe the survey sample rather than serving as a precise national estimate. Even so, the findings add to a consistent picture emerging from Turkish research: vaccine hesitancy is not driven primarily by illness, but by education, trust, belief and the social settings in which people form their views.