EUROPEAN JOURNAL OF PEDIATRICS, vol.184, no.12, 2025 (SCI-Expanded, Scopus)
Children with type 1 diabetes mellitus (T1DM) are at high risk for vaccine-preventable diseases (VPDs); timely and complete vaccination, including both routine and special risk-based vaccines, is crucial. Vaccine hesitancy and refusal are increasing worldwide, and parental hesitancy poses a serious threat to children's health, especially in high-risk groups. This study aimed to evaluate vaccine acceptance among parents of children with T1DM and healthy controls using the validated Turkish version of the Vaccine Acceptance Instrument (VAI), and to identify factors associated with vaccine hesitancy as well as potential solutions. This cross-sectional primary data collection study was conducted in Turkiye with 539 parents (264 with T1DM and 275 healthy controls). Sociodemographic data, vaccination characteristics of children and parents, concerns about vaccines, and sources of vaccine information were collected via a questionnaire, and vaccine acceptance was assessed using the VAI. Being in the upper quartile (Q4) of the VAI total and subscale scores was defined as high vaccine acceptance, univariate and multivariate analyses were conducted to identify predictors. Parents of children with T1DM had significantly lower VAI total and subscale scores compared to those in the control group (p < 0.05). Vaccine acceptance was considered low in the T1DM group. Maternal participation as the survey respondent, having a higher education and higher income, being employed, receiving non-routine vaccinations, obtaining vaccine information from healthcare professionals or books/journals, and both parents being vaccinated against COVID-19 were significantly associated with higher vaccine acceptance. A history of vaccine-related side effects was associated with lower acceptance rates. Conclusion: Vaccine acceptance among parents of children with T1DM was significantly lower than healthy controls. Personalized interventions targeting low-income families, fathers, and individuals who have previously experienced vaccine-related adverse effects are needed.Trust-based, empathetic, targeted, and scientifically informed communication between healthcare professionals and vaccine-hesitant individuals is crucial. Increasing vaccine acceptance among parents of children with T1DM is important for preventing VPDs in this high-risk group.