Understanding vaccine hesitancy in Slovakia: mapping Slovak population through latent class analysis

Background: Vaccine hesitancy and public adherence to health measures remain critical challenges in Slovakia, where coverage of COVID-19 vaccination has been low, and parents' decisions regarding vaccination of their children further illustrate variability in immunization uptake. Methods: = 505) differ in their perceptions of vaccination, compliance with restrictions, and health literacy. Using Latent Class Analysis, we identified three distinct population segments that reflect both internationally recognized typologies and the unique sociocultural context of Slovakia. Results: Our findings indicate that health literacy is an important characteristic distinguishing population segments with different vaccine-related beliefs and behaviours. Individuals with higher health literacy demonstrated greater confidence in vaccination and more autonomous, informed decision-making, whereas those with lower literacy relied more on external authority and restrictive measures. Conclusions: These results highlight the importance of tailored public health communication strategies that prioritize clarity, accessibility, and credibility, alongside interventions that combine education and community engagement. By targeting health literacy, policymakers can potentially reduce vaccine hesitancy and foster sustainable trust in health systems. Future research should explore longitudinal and mixed-method approaches to examine causal mechanisms and the dynamic interplay of literacy, trust, and social influence over time.