Factors Associated with Recommendation of Non-Routine Childhood Vaccines Among Healthcare Workers in Türkiye
TL;DR
Positive attitudes toward non-routine childhood vaccines among healthcare workers do not necessarily translate into consistent recommendation behaviors across all vaccine types, including rotavirus, meningococcal, human papillomavirus (HPV) and influenza vaccines.
Abstract
Background: Healthcare workers play a critical role in parental vaccine decision-making and the uptake of non-routine childhood vaccines. This study aimed to evaluate healthcare workers’ knowledge, attitudes and behaviors regarding non-routine childhood vaccines, including rotavirus, meningococcal, human papillomavirus (HPV) and influenza vaccines. Methods: This cross-sectional study was conducted between October 2025 and March 2026 among healthcare workers in Türkiye. Data were collected using a structured questionnaire and the Attitudes Towards Vaccine Scale (ATVS), distributed through convenience and snowball sampling methods. Results: A total of 345 healthcare workers participated in the study. Recommendation behaviors differed significantly according to vaccine type (p < 0.001). Rotavirus and meningococcal vaccines were more frequently recommended than HPV and influenza vaccines. Although influenza vaccine had the highest awareness rate, it demonstrated the lowest recommendation rate and the lowest support for inclusion in the national immunization schedule. Physicians had significantly higher knowledge levels and vaccination attitude scores than non-physician healthcare workers (p < 0.001). ATVS scores were positively correlated with recommendation behaviors (ρ = 0.35, p < 0.001) and self-vaccination tendency (ρ = 0.34, p < 0.001). In multivariable analyses, higher vaccination attitude scores independently predicted greater self-vaccination tendency (OR = 1.07, 95% CI: 1.04–1.11, p < 0.001). Cost was the most commonly reported barrier to vaccine implementation. Conclusions: Positive attitudes toward non-routine childhood vaccines among healthcare workers do not necessarily translate into consistent recommendation behaviors across all vaccine types. Strategies targeting healthcare worker education, equitable vaccine access and standardized vaccine counseling practices may improve uptake and recommendation of optional childhood vaccines in Türkiye.