Ethical analysis of childhood vaccination information processes among Turkish parents in the United States

Introduction Highly educated, established immigrant populations remain understudied in vaccine-hesitancy research, which has focused primarily on refugee and low-literacy samples. This study examines how foreign-born Muslim Turkish parents in the US experience informed consent for childhood vaccination within a legal context that treats vaccination as a mandatory condition of school enrollment. Methods A qualitative descriptive design was employed using semi-structured in-depth interviews with 13 foreign-born Turkish Muslim parents recruited via snowball sampling across five U. S. states. Data were analyzed using codebook thematic analysis within Braun and Clarke’s six-step framework. After two coders performed manual coding independently, Google NotebookLM was integrated for preliminary code extraction. A third author participated in the comparative evaluation and code book consensus, and the findings were organized into themes. Results Participant-reported experiences yielded four main themes: (1) Technical language and understandability barriers in the information process; (2) Ethical competence and barrier management in clinical communication; (3) Vaccine mandates in education and enrollment processes and their impact on the informed consent process; (4) Information verification mechanisms. Discussion Participants described mandatory school immunization requirements as shifting clinical consent encounters toward procedural compliance. Independent of the mandate, clinical encounters did not equip parents to discuss vaccine ingredients, and unaddressed religious inquiries prompted digital and community-based verification. Formal religious guidance on these concerns exists in the US but appeared unfamiliar to participants, unlike in some Muslim-majority contexts with coordinated religious-regulatory guidance. These findings, from a small qualitative sample, suggest that clinical communication alone may not resolve parents’ difficulties, pointing to possible value in broader coordination among healthcare systems, manufacturers, and religious authorities.