Health Literacy as a Predictor of Vaccination Attitudes among Parents of Preschool Children

Articles in Press

Document Type : Original Article

Authors

1 Academy of Applied Studies Sabac, Dobropoljska 5, 15000 Sabac, Republic of Serbia.

2 University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, 21000 Novi Sad, Republic of Serbia

3 Ambulance of rehabilitation “Wellness Studio Laser”, Ive Lole Ribara 9c, 21460 Vrbas, Srbija.

Abstract

Background and Objectives: We are increasingly encountering parental doubts, hesitancy, or even refusal regarding vaccination. Health literacy is a key component that can contribute to reducing parental vaccine hesitancy. However, some studies suggest a more complex, and even counterintuitive, relationship between health literacy and vaccination attitudes. The aim of this study was to examine the predictive role of parental health literacy in shaping negative attitudes toward vaccination.

Material and Methods: The research was conducted as a correlational study between April and May 2025 using an online questionnaire. All kindergartens in Serbia were contacted via email. A representative sample consisted of 379 parents of children aged 1 to 7 years.

Results: Parents of preschool children in the Republic of Serbia demonstrated low levels of health literacy. Health literacy was found to be a predictor of the following criteria: Mistrust of vaccine benefits [F(1,377)=11.85; p<.01], Worries about unforeseen future effects [F(1,377)=17.57; p<.01], Concerns about commercial profiteering [F(1,377)=29.10; p<.01], Preference for natural immunity [F(1,377)=7.16; p<.01], and Overall negative attitude towards vaccination [F(1,377)=24.38; p < .01], explaining 2–8% of the variance. It was found that a higher level of parental health literacy contributed to a more negative attitude towards childhood vaccination.

Conclusion: The findings suggest that a higher level of health literacy does not necessarily correspond to more positive vaccination attitudes. This highlights the importance of considering additional factors such as institutional trust and exposure to misinformation. Future interventions should focus on improving health literacy, developing critical thinking and information appraisal skills.

Keywords

Acknowledgements: We would like to express our sincere gratitude to all individuals who contributed to the completion of this study.


Availability of Data and Materials: The data that support the findings of this study are available from the corresponding author upon reasonable request.


Conflicts of interest: The authors declare that they have no conflicts of interest.


Consent for publication: Not applicable.


Ethics Approval and Consent to Participate: This study was conducted in accordance with the Declaration of Helsinki; the study protocol and informed-consent procedures were assessed. Journalism Ethics considerations Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or fal-sification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors.


Funding: No financial support.


Authors’ Contributions: KP and RA conceptualized and designed the study. KP, DP, SBV collected the data, performed the analysis, interpreted the findings, and drafted the manuscript. GM provided supervision and critically reviewed the manuscript. All authors approved the final version for submission.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 18 November 2025

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