Dear Editor.We read with interest the longitudinal qualitative study by Yıldırım et al., which examined the reasons for individuals' COVID-19 vaccine hesitations and decisions that have changed over time in Turkey. The authors demonstrated that vaccine hesitancy is influenced by negative information and news on social media, conspiracy theories about biological or economic warfare, the belief that vaccines are not protective, and the fear of side effects. On the other hand, it was shown that the fear of being infected with SARS-CoV-2 led to the acceptance of the vaccine for some individuals. The findings of Yıldırım et al. are intriguing, and they reflect the current challenges of health education in controlling vaccine-preventable diseases. Vaccine delays or refusals have emerged as critical barriers to achieving optimal vaccination rates in recent decades. In 2019, the World Health Organization (WHO) listed vaccine hesitancy as one of the top ten threats to global health alongside air pollution and climate change. Uptake and confidence in vaccines can vary over time, even within the same population, and are strongly influenced by sex, educational level, sources of trust, and information-seeking behavior. Furthermore, political ideology,
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reticence among minorities, and resource limitations in low- and middle-income settings are key factors that should be analyzed in implementing public health strategies to improve vaccination coverage and control of vaccine-preventable diseases. Social networks have a powerful influence on health decisions. Unfortunately, disinformation and the massive dissemination of misinformation are one of the biggest challenges in the digital era, and recent evidence shows a substantive effect of disinformation and misinformation campaigns on declining vaccination coverage worldwide. A global effort is needed to effectively implement best-practice recommendations for debunking misinformation, increase trust in science and evidence-based decision making, and improve the prevention and control of vaccine-preventable diseases.Conflict of interest: None.Funding: None.
Conflict of interest statement
The authors declare that there are no conflicts of interest regarding the publication of this paper.