Vaccine conspiracy beliefs are the main determinant of adult vaccine hesitancy

Abstract Background Many factors influence the level of vaccine hesitancy. The COVID-19 pandemic demonstrated that conspiracy beliefs are an important element of overwhelming misinformation. The main aim of the study was to assess the relationship between vaccine hesitancy (VH) and vaccine conspiracy beliefs (VCB) in Polish society. Methods The analysis was conducted using data from an online survey of 2189 Internet users conducted in November 2021. Uni- (ULRM) and multivariable linear regression (MLRM) models were developed for vaccine hesitancy as a dependent variable. The independent variables included VCB score (VCBS), health (HL) and e-health literacy (eHL), Internet (IU) and social media use (SMU), political views (PV), and sociodemographic variables. Results The VCBS, eHL, HL, age, income, vocational and marital status, place of residence, PV, IU, and SMU were significant predictors of VH in ULRMs. A significant relationship with VH was maintained in MLRM for all independent variables enlisted earlier, apart from age, income, and vocational status. Respondents with higher VCBS were more likely to have higher VH (B, 95%CI: 0.38, 0.37-0.40). Those with undetermined HL had higher VH than persons with sufficient HL (B, 95%CI: 0.13, 0.06-0.20). A higher level of eHL predicted a lower level of VH (B, 95%CI: -0.01, -0.012 - -0.03). Lower IU and higher SMU were associated with higher VH (B, 95%CI: 0.16, 0.02-0.30, and 0.10, 0.03-0.17, respectively). Supporters of far right-wing party showed higher HV than supporters of the governmental party (B, 95%CI: 0.16, 0.07-0.27). Finally, singles showed higher HV than married (B, 95%CI: 0.07, 0.01-0.13), and residents of small cities had higher HV than residents of rural areas (B, 95%CI: 0.08, 0.004-0.15). Conclusions The vaccine conspiracy beliefs play a major role in the development of VH. The interventions aimed at the change of antivaccination attitudes should address the problem of widespread conspiracy beliefs. Key messages • Conspiracy beliefs are an important determinant of attitudes toward vaccination. • The development of adequate digital health literacy may be a protective factor against vaccine hesitancy.