Vaccination Literacy and Its Determinants in Hungary: Results of a Cross-Sectional Survey

Introduction/Objectives: Despite the efficacy of vaccines in preventing disease and disability and their cost-effectiveness, a proportion of the population remains reluctant to vaccination. Vaccination literacy is one of the main determinants of vaccine decision-making. The aims of this study were to assess the measurement properties of the Hungarian version of a vaccination literacy instrument and describe the level and determinants of vaccination literacy among the Hungarian adult population. Methods: A cross-sectional study was conducted on a sample of 1205 Hungarian adult respondents within the European Health Literacy Population Survey 2019–2021. The data were collected by computer-assisted telephone survey in December 2020. The questionnaire covered the following topics: sociodemographic data, self-perceived health, social support, and general and vaccination literacy. The instrument’s internal consistency was measured using Cronbach’s alpha, its reliability was assessed based on the Spearman–Brown correlation coefficient. The construct validity of the questionnaire was examined using principal component analysis based on a polychoric correlation matrix. Multivariate ordered logistic regression analyses investigated the relationship between vaccination literacy and other relevant variables. Results: The Cronbach’s alpha was 0.78, while the Spearman-Brown correlation coefficient was 0.725. The principal component analysis extracted 1 significant factor that explained 69% of the total variance. The Hungarian adult population had a good level of vaccination literacy (mean score: 82.4, 95% CI 74.9-89.8). We found that social support (OR for the moderate support: 1.93, OR for the strong support: 2.19; P < .001 for both), lack of financial deprivation (OR: 2.05, P < .001), and secondary education level (OR: 1.50, P : .024) are positively correlated with vaccination literacy. Conclusion: We recommend using the vaccination literacy instrument to identify individuals with inadequate vaccination literacy. Interventions focusing on social support and education to promote vaccine-related information would contribute to enhancing vaccination literacy.