Vaccine hesitancy and its correlates among religious personnel in Malatya, Türkiye: a cross-sectional study

Vaccines are one of the most powerful tools in modern medicine, preventing millions of deaths every year by training the body to fight off dangerous diseases. Yet, even with this proven safety and effectiveness, many people hesitate to get vaccinated. This hesitation is not always about a simple lack of information; it often stems from deep-seated concerns about safety, a distrust of authorities, or a preference for other ways of staying healthy. In many parts of the world, religious leaders hold a unique position of trust. They are the voices people turn to for guidance on life's biggest questions, and their words can shape how entire communities view health decisions. If a religious leader doubts a vaccine, their congregation may follow suit. If they support it, they can help build confidence. Understanding what influences these leaders is therefore critical for public health, especially in places where faith and daily life are closely intertwined.

In Malatya, a province in eastern Türkiye, a team of researchers set out to understand the attitudes of religious personnel toward vaccines. They focused on the imams, preachers, and teachers who serve in local mosques and Qur'an courses. The study took place in February 2026, a time when the world was still navigating the complex aftermath of the global pandemic. The researchers wanted to know if these religious figures were hesitant about vaccines themselves, what factors might be driving those feelings, and whether their personal views influenced how they spoke to their communities. They did not just ask if the leaders were vaccinated; they asked about their confidence in vaccines, where they got their information, and whether they felt comfortable discussing vaccines during religious talks or offering advice to people who asked.

The study involved 533 religious personnel who completed a detailed survey. The researchers used a standard set of questions designed to measure "vaccine hesitancy," which in this context means a lack of confidence in vaccines rather than a simple refusal. They found that the majority of these religious leaders had some level of concern. More than four out of five participants reported having worries about vaccines. A significant portion, nearly 60 percent, believed that traditional and complementary medicine—such as herbal remedies or other non-conventional treatments—was more reliable than vaccines. This preference for alternative methods was a strong indicator of lower confidence in vaccines. Furthermore, about two-thirds of the participants did not support including information about the importance of vaccination in their religious sermons, and nearly three-quarters said they did not offer advice on vaccines to the people in their communities.

The researchers discovered that a religious leader's personal confidence was the strongest predictor of their behavior, far more so than their age, gender, or education level. Those who expressed concerns about vaccines or who trusted traditional medicine more than vaccines were significantly less likely to support vaccination messages in their talks. They were also less likely to have received the COVID-19 vaccine themselves. The data showed a clear pattern: as a leader's confidence in vaccines dropped, their willingness to share positive information about them also dropped. For instance, leaders who did not support vaccination in religious talks were much more likely to have higher scores on the "lack of confidence" scale. This connection was so strong that for every small increase in a leader's lack of confidence, the likelihood of them refusing to support vaccination in their talks increased noticeably.

One of the most striking findings was how these personal attitudes translated into action, or inaction. The study found that leaders who were hesitant about vaccines were less likely to provide advice to community members, even when those members asked questions. The relationship here was not a straight line; the researchers observed that the tendency to withhold advice changed in a specific way as confidence levels shifted, suggesting that the decision to speak up or stay silent is complex. Additionally, among the leaders who had children, those with lower vaccine confidence were more likely to report that their own children had missed at least one routine childhood vaccination. This suggests that the hesitation felt by these religious figures was not just a personal opinion but something that could affect the health of their own families and, by extension, their communities.

The study also looked at where these leaders got their information. While many turned to healthcare workers, a significant number also relied on social media. The researchers found that those who used social media as a primary source of vaccine information were more likely to be hesitant and less likely to have vaccinated themselves against COVID-19. This aligns with broader concerns about how misinformation spreads online, but the study could not prove that social media caused the hesitation; it only showed that the two were linked. The researchers were careful to note that because they asked all these questions at the same time, they could not say for certain that one thing caused the other. It is possible that a leader's existing doubts made them more likely to seek out certain types of information, just as it is possible that the information they found reinforced their doubts.

Ultimately, the study paints a picture of a group where personal confidence in vaccines is the key driver of behavior. The researchers found that demographic factors like age or how long someone had been in their job did not explain the differences in attitude as well as their feelings about vaccine safety and their trust in traditional medicine did. The findings suggest that to improve vaccine acceptance, public health officials need to engage religious personnel not as messengers who simply repeat a script, but as partners who need their own concerns addressed. If these leaders are to speak confidently about vaccines, they first need to feel confident in them. The study concludes that building this trust requires honest conversations about safety, addressing specific fears, and helping religious leaders distinguish between medical questions and spiritual ones, so they know when to refer people to doctors. This approach, the authors suggest, could help turn religious personnel from potential barriers into powerful allies for community health.