Moderating Effect of Education on the Impact of Vaccine Hesitancy on COVID-19 Vaccine Decision Regret

Ramazan Ayhan; Haşim Çapar

doi:10.31067/acusaglik.1853219

Moderating Effect of Education on the Impact of Vaccine Hesitancy on COVID-19 Vaccine Decision Regret

Abstract

Purpose: During the Covid-19 pandemic, herd immunity was accepted as an important strategy in the fight against the epidemic. However, vaccine decision regret emerged for various reasons. The aim of this research is to reveal the factors affecting vaccine decision regret in those who received the COVI-19 vaccine. Methods: This research is a cross-sectional study conducted in Türkiye with 748 people who received at least three doses of Covid-19 vaccine. The study was conducted between 13.12.2024 and 3.3.2025 online with an analytical research model and a convenience sampling method was used. Demographic and health-related discrete variables and a decision regret scale were used as data collection tools. T-test, ANOVA and and moderator effect analysis was performed with Jamovi. Results: The findings show that demographic variables such as age, gender, marital status, education, employment status, and income level have significant effects on decision regret. It was found that education has a significant moderator role in the effect of vaccine hesitancy on vaccine regret. Conclusion: It has been revealed that both demographic characteristics and attitudes towards Covid-19 affect vaccine decision regret at various levels, vaccine hesitancy increases vaccine regret, but this effect decreases with education.

Keywords

References

1. Alilio M, Hariharan N, Lugten E, Garrison K, Bright R, Owembabazi W, et al. Strategies to Promote Health System Strengthening and Global Health Security at the Subnational Level in a World Changed by COVID-19. Glob Health Sci Pract [Internet]. 2022 Apr 28 [cited 2026 Jan 23];10(2):e2100478. Available from: https://pmc.ncbi.nlm. nih.gov/articles/PMC9053150/
2. Palmer A, Gorman S. Misinformation, trust, and health: The case for information environment as a major independent social determinant of health. Soc Sci Med [Internet]. 2025 Sept 1 [cited 2026 Jan 23];381:118272. Available from: https://www.sciencedirect. com/science/article/pii/S0277953625006033
3. Altman JD, Miner DS, Lee AA, Asay AE, Nielson BU, Rose AM, et al. Factors Affecting Vaccine Attitudes Influenced by the COVID-19 Pandemic. Vaccines [Internet]. 2023 Feb 23 [cited 2026 Jan 23];11(3):516. Available from: https://pmc.ncbi.nlm.nih.gov/articles/ PMC10057947/
4. Azizoğlu F, Terzi B, Topçu Tarakçi N. The attitudes of healthcare professionals in Turkey toward the coronavirus vaccine. Int Nurs Rev. 2022 Dec;69(4):566–74.
5. Porat T, Nyrup R, Calvo RA, Paudyal P, Ford E. Public Health and Risk Communication During COVID-19-Enhancing Psychological Needs to Promote Sustainable Behavior Change. Front Public Health. 2020;8:573397.
6. Alper S, Bayrak F, Yilmaz O. Psychological correlates of COVID-19 conspiracy beliefs and preventive measures: Evidence from Turkey. Curr Psychol. 2021;40(11):5708–17.
7. Benham JL, Atabati O, Oxoby RJ, Mourali M, Shaffer B, Sheikh H, et al. COVID-19 Vaccine-Related Attitudes and Beliefs in Canada: National Cross-sectional Survey and Cluster Analysis. JMIR Public Health Surveill. 2021 Dec 23;7(12):e30424.
8. Kalil I, Silveira SC, Pinheiro W, Kalil Á, Pereira JV, Azarias W, et al. Politics of fear in Brazil: Far-right conspiracy theories on COVID-19. Glob Discourse [Internet]. 2021 May 1 [cited 2026 Jan 23];11(3):409– 25. Available from: https://bristoluniversitypressdigital.com/view/ journals/gd/11/3/article-p409.xml

9. Eren H. The Relationship Between COVID-19 Awareness and Vaccine Hesitancy among University Students. J Basic Clin Health Sci [Internet]. 2022 May 31 [cited 2026 Jan 23];6(2):550–9. Available from: https://dergipark.org.tr/en/pub/jbachs/article/1066123
10. Paakkari L, Okan O. COVID-19: health literacy is an underestimated problem. Lancet Public Health [Internet]. 2020 May 1 [cited 2026 Jan 23];5(5):e249–50. Available from: https://www.thelancet.com/ journals/lanpub/article/PIIS2468-26672030086-4/fulltext
11. Durmuş A, Akbolat M, Amarat M. COVID-19 Aşı Okuryazarlığı Ölçeği’nin Türkçe geçerlilik ve güvenirliliği. Cukurova Med J [İnternet]. 2021 June 30 [cited 2026 Jan 23];46(2):732–41. Available from: http://dergipark.org.tr/tr/doi/10.17826/cumj.870432
12. Budiyanti RT, Ganggi RIP, Murni M. Barrier Factors Related to COVID-19 Vaccine Literacy in Developing Countries: A Traditional Literature Review. E3S Web Conf [Internet]. 2021 [cited 2026 Jan 23];317:03018. Available from: https://www.e3s-conferences.org/ articles/e3sconf/abs/2021/93/e3sconf_icenis2021_03018/e3sconf_ icenis2021_03018.html
13. World Health Organization. Vaccines and immunization [Internet]. 2023 [cited 2026 Jan 23]. Available from: https://www.who.int/ health-topics/vaccines-and-immunization
14. Keaveney SM, Huber F, Herrmann A. A model of buyer regret: Selected prepurchase and postpurchase antecedents with consequences for the brand and the channel. J Bus Res [Internet]. 2007 Dec 1 [cited 2026 Jan 23];60(12):1207–15. Available from: https://www. sciencedirect.com/science/article/pii/S0148296307001282
15. Luo C, Jiang W, Chen HX, Tung TH. Post-vaccination adverse reactions, decision regret, and willingness to pay for the booster dose of COVID-19 vaccine among healthcare workers: A mediation analysis. Hum Vaccines Immunother. 2022 Nov 30;18(6):2146964.
16. Çapar H, Çinar F. Vaccine Hesitancy Scale in Pandemics: Turkish Validity and Reliability Study. Gevher Nesibe J IESDR [İnternet]. 2021 May 25 [cited 2026 Jan 23];6(12):40–5. Available from: https:// gevhernesibedergisi.com/index.php/gnj/article/view/106
17. Türkiye Cumhuriyeti Sağlık Bakanlığı. Covid-19 Aşısı Bilgilendirme Platformu [Internet]. 2026. Available from: https://covid19asi.saglik. gov.tr/.
18. R Core Team. R: A Language and environment for statistical computing. [Internet]. 2022. Available from: https://cran.r-project. org.
19. The Jamovi Project. jamovi [Internet]. 2023. Available from: https:// www.jamovi.org.
20. Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine. 2014 Apr 17;32(19):2150–9.
21. Brehaut JC, O’Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, et al. Validation of a decision regret scale. Med Decis Mak Int J Soc Med Decis Mak. 2003;23(4):281–92.
22. Telatar TG, Ozel CS, Turgut A, Kınlı Ö. Turkish version methodological validation study of the Decision Regret Scale. Ethiop J Health Dev [Internet]. 2021 Nov 25 [cited 2026 Jan 23];35(4). Available from: https://ejhd.org/index.php/ejhd/article/view/5313
23. Galluci M. jAMM: jamovi Advanced Mediation Models. [jamovi module]. [Internet]. 2020. Available from: https://jamovi-amm. github.io/.
24. Adawi M, Bragazzi NL, Argumosa-Villar L, Boada-Grau J, Vigil-Colet A, Yildirim C, et al. Translation and Validation of the Nomophobia Questionnaire in the Italian Language: Exploratory Factor Analysis. JMIR MHealth UHealth. 2018 Jan 22;6(1):e24.
25. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Pearson; 2009.
26. Diener E, Biswas-Diener R. Will Money Increase Subjective Well- Being?: A Literature Review and Guide to Needed Research. Soc Indic Res [Internet]. 2002 [cited 2026 Jan 23];57(2):119–69. Available from: https://www.jstor.org/stable/27526987
27. Tayhan A, Bozhan Tayhan E, Şahin Büyük D. Nursing and Midwifery Students’ COVID-19 Vaccine Regrets and Future Vaccination Intentions: A Mixed Methods Study. Nurs Health Sci. 2025 Mar;27(1):e70039.
28. Göl İ, Açıkgöz S. Does Health Literacy Affect Vaccine Hesitation? Turk J Fam Med Prim Care [Internet]. 2025 Mar 7 [cited 2026 Jan 23];19(1):23–31. Available from: https://dergipark.org.tr/en/pub/ tjfmpc/article/1474170
29. Wong JC, Yang JZ. Misinformation, Anticipated Regret, and Vaccine- Related Behaviors. J Health Commun. 2022 Sept 2;27(9):644–53.
30. Brera A, Arrigoni C, Belloni S, Conte G, Magon A, Arcidiacono MA, et al. Decision Regret and Vaccine Hesitancy among Nursing Students and Registered Nurses in Italy: Insights from Structural Equation Modeling. Vaccines. 2024 Sept 14;12:1054.

Details

Primary Language

English

Subjects

Public Health (Other)

Journal Section

Research Article

Authors

Ramazan Ayhan
0009-0005-2215-3563
Türkiye

Haşim Çapar ^*
0000-0001-7056-7879
Türkiye

Publication Date

April 27, 2026

Submission Date

January 1, 2026

Acceptance Date

January 29, 2026

Published in Issue

Year 2026 Volume: 17 Number: April, May, June 2026

DOI

https://doi.org/10.31067/acusaglik.1853219

IZ

https://izlik.org/JA57ZN25AA

Cite

RIS / Bibtex

EndNote

Ayhan R, Çapar H (April 1, 2026) Moderating Effect of Education on the Impact of Vaccine Hesitancy on COVID-19 Vaccine Decision Regret. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 April, May, June 2026