Exploring the Relationship Between Susceptibility to Health Misinformation and Vaccine Hesitancy in Poland

Background/Objectives: Vaccine hesitancy arises from multiple determinants, including individual beliefs, cognitive style, social norms, political identity and the information environment. In this context, health literacy, e-health literacy, susceptibility to health misinformation, conspiracy beliefs and trust in science may be relevant in mediatized societies. Aim: The aim of the study was to examine how susceptibility to health misinformation relates to vaccine hesitancy in Poland and how this association is influenced by health literacy, e-health literacy, trust in scientists and sociodemographic factors. Methods: Data came from a web-based survey conducted in December 2024 among 2200 adults aged 18-75 years. The questionnaire included validated scales of vaccine hesitancy, health literacy, e-health literacy, vaccine conspiracy beliefs and trust in scientists. The susceptibility to health misinformation was measured with ad hoc instrument based on the statement from fact-checking services. Items assessing digital media use, political sympathies, religious practices and sociodemographics were also applied. Multivariable linear regression was applied with continuous vaccine hesitancy as the dependent variable. Results: The model explained 57.8% of the variance in vaccine hesitancy. Susceptibility to misinformation (B = 0.11, 95% CI: 0.08-0.15) and vaccine conspiracy beliefs (B = 0.44, 95% CI: 0.41-0.46) were positive predictors, whereas trust in scientists (B = -0.20, 95% CI: -0.23--0.17) and e-health literacy (B = -0.07, 95% CI: -0.11--0.02) were protective. Older age was associated with lower hesitancy (B = -0.02, 95% CI: -0.03-0.00). Secondary education (B = -0.58) and a master's degree (B = -0.77) predicted lower hesitancy. Health literacy categories were not significantly related to vaccine hesitancy. Conclusions: Susceptibility to health misinformation and vaccine conspiracy beliefs were key predictors of vaccine hesitancy, outweighing the effects of health literacy and the protective impact of trust in scientists and e-health literacy, and indicating a need for interventions that combine prebunking and literacy-focused strategies with efforts to strengthen confidence in health institutions.