Abstract

Abstract Background The COVID-19 pandemic showed that health denialism and conspiracy beliefs may influence adherence to preventive measures. Many variables have been considered as determinants of conspiracist attitudes. This study aims to assess the determinants of conspiracy beliefs related to vaccination (Vaccine Conspiracy Beliefs Score, VCBS) in Polish society during the COVID-19 pandemic. Methods The analysis was based on data from the online survey conducted in November 2021 in a representative sample of adult Internet users. Uni- (ULR) and multivariable linear regression (MLR) models were developed for VCBS. The relationships of health literacy (HL), e-health literacy (eHL), future anxiety (FA), Internet (IU) and social media use (SMU), self-assessed health status (SAHS), and prevalence of chronic disease (CD) with VCBS were assessed after adjusting for sociodemographic variables and political sympathies. B coefficient (B) and 95% confidential intervals (95%CI) are reported here for MLR. Results The study sample of 2189 comprised 51.2% of women and 26.1% of persons with a University education. The mean age (standard deviation, SD) of respondents was 44.1 (15.25) years; VCBS - 3.77 (1.52), eHL score - 28.91 (10.63), and FA score 4.75 (1.27). MLR revealed that VCBS was significantly associated with HL but not eHL. VCBS was higher in persons with inadequate HL than those with sufficient HL (B; 95%CI: 0.66; 0.36 - 0.95). Greater FA was also associated with higher VCBS (0.08; 0.03 - 0.13). Interestingly, less duration of IU (the lowest vs. the highest use: 0.47; 0.08 - 0.85) but more intense SMU (frequent vs. infrequent use: 0.31; 0.11 - 0.51) predicted higher levels of VCBS. Finally, SAHS and CD were not significant predictors. Conclusions Health literacy remains a key modifiable determinant of the prevalence of conspiracy beliefs related to vaccination. Effective measures counteracting conspiracy beliefs should be considered in future public health challenges. Key messages • Developing adequate health literacy may be an efficient measure counteracting unfavorable impact of conspiracist thinking on the acceptance of vaccinations. • Health denialism manifesting with conspiracy beliefs should be treated as a target for public health interventions during pandemics.

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