COVID-19 vaccination uptake is associated with susceptibility to misinformation and vaccine hesitancy, but not with health literacy
1
Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
Popul. Med. 2026;8(Supplement Supplement 1):A3949
ABSTRACT
ABSTRACT:
Background. COVID-19 vaccination uptake reflects access and cognitive/attitudinal determinants in an infodemic environment¹. Vaccine hesitancy (VH) can reduce acceptance through safety concerns, low perceived necessity, and limited trust in institutions². Susceptibility to health misinformation (SHM) may impair rejection of false claims and reinforce hesitant attitudes³. Health literacy (HL) is often viewed as protective because it supports obtaining and understanding health information⁴. We examined whether SHM and VH predict COVID-19 vaccination uptake after adjustment for HL, trust in scientists (TRS), and sociodemographic variables. Methods. We conducted a nationwide online survey of Polish adults (18–75 years; N=2,200) using a quota-matched sample by sex, age band, education, place of residence, and NUTS1 region. Participants were recruited via an online panel. The outcome was self-reported COVID-19 vaccination uptake (vaccinated vs not vaccinated). The main predictors were SHM and VH⁵. HL was entered as a categorical variable. Covariates included TRS⁶ and sociodemographic variables. Associations with uptake were tested using multivariable logistic regression. Results. Overall, 1,438 respondents (65.4%) were vaccinated and 762 (34.6%) were unvaccinated. Model explanatory power was moderate (Nagelkerke R²=0.351). VH emerged as the strongest independent correlate of uptake: each 1-point increase was associated with lower odds of being vaccinated (OR=0.86, 95%CI 0.85 - 0.88). Higher SHM was also linked to lower uptake (OR=0.98, 95%CI 0.96 - 0.99). HL was not independently associated with uptake (overall Wald p=0.148). TRS was not significant (OR=0.99, 95%CI 0.98 - 1.01). Older age predicted higher uptake (OR=1.02 per year, 95%CI 1.01 - 1.03). Place of residence and income showed smaller associations, while gender and education were not significant. Conclusions. COVID-19 vaccination uptake was primarily determined by VH and SHM, whereas HL showed no independent association. Interventions should prioritize reducing hesitancy drivers and strengthening resistance to misinformation, alongside equity-sensitive outreach for groups with lower uptake.
Background. COVID-19 vaccination uptake reflects access and cognitive/attitudinal determinants in an infodemic environment¹. Vaccine hesitancy (VH) can reduce acceptance through safety concerns, low perceived necessity, and limited trust in institutions². Susceptibility to health misinformation (SHM) may impair rejection of false claims and reinforce hesitant attitudes³. Health literacy (HL) is often viewed as protective because it supports obtaining and understanding health information⁴. We examined whether SHM and VH predict COVID-19 vaccination uptake after adjustment for HL, trust in scientists (TRS), and sociodemographic variables. Methods. We conducted a nationwide online survey of Polish adults (18–75 years; N=2,200) using a quota-matched sample by sex, age band, education, place of residence, and NUTS1 region. Participants were recruited via an online panel. The outcome was self-reported COVID-19 vaccination uptake (vaccinated vs not vaccinated). The main predictors were SHM and VH⁵. HL was entered as a categorical variable. Covariates included TRS⁶ and sociodemographic variables. Associations with uptake were tested using multivariable logistic regression. Results. Overall, 1,438 respondents (65.4%) were vaccinated and 762 (34.6%) were unvaccinated. Model explanatory power was moderate (Nagelkerke R²=0.351). VH emerged as the strongest independent correlate of uptake: each 1-point increase was associated with lower odds of being vaccinated (OR=0.86, 95%CI 0.85 - 0.88). Higher SHM was also linked to lower uptake (OR=0.98, 95%CI 0.96 - 0.99). HL was not independently associated with uptake (overall Wald p=0.148). TRS was not significant (OR=0.99, 95%CI 0.98 - 1.01). Older age predicted higher uptake (OR=1.02 per year, 95%CI 1.01 - 1.03). Place of residence and income showed smaller associations, while gender and education were not significant. Conclusions. COVID-19 vaccination uptake was primarily determined by VH and SHM, whereas HL showed no independent association. Interventions should prioritize reducing hesitancy drivers and strengthening resistance to misinformation, alongside equity-sensitive outreach for groups with lower uptake.
| eISSN: | 2654-1459 |
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