I am not an authority in this area and I don't think what I have to say is particularly deep. Just a few thoughts I had upon reading your question.
In all that follows I'll be referring to free fields.
The real scalar field has a unique spatial representation because there is only one polarization and one charge, which can be seen by realizing $|\vec{p}\rangle$ uniquely labels one-particle states (Fourier-transforming gives $|\vec{x}\rangle$ with a phase-factor).
The complex scalar field does not have a unique spatial representation because, although there is only one polarization, there are two charges (which we distinguish in canonical quantization by introducing separate creation and annihilation operators $\hat{a}/\hat{a}^{\dagger}$ and $\hat{b}/\hat{b}^{\dagger}$). This can be seen doubly by again realizing that the correct one-particle states need to also have a species label, say $|\vec{p},\pm\rangle$. The spatial representation must then also carry such a label, i.e. $|\vec{x},\pm\rangle$.
You can see how this logic will carry over to the spinor case. A Dirac field has two charges and, for each charge, two polarization states.
So when you ask:
"what does it mean to multiply a ket vector by a 4-component spinor?"
it means that you will get a four-component object out in the end, namely:
$$\begin{align}
\psi(x)|0\rangle&=\sum_{s=1}^2 \int \frac{d^3p}{(2\pi)^3}\bigg[\require{cancel}\cancel{(b^s_p|0\rangle)}u^s(p)e^{-ip\cdot x}+(c_p^{s \dagger}|0\rangle)v^s(p)e^{-ip\cdot x} \bigg]\\
&=\sum_{s=1}^2 \int \frac{d^3p}{(2\pi)^3}\bigg[v^s(p)e^{-ip\cdot x} \bigg]|\vec{p},s,+\rangle \\
\end{align}$$
and now you can ask for its projection onto $|\vec{x},s,+\rangle$, or also less usefully but more straightforwardly $|\vec{x},i\rangle$ where $i$ is one of the components of the Dirac field, etc.. How these states and their projections along $|\vec{p},s,\pm\rangle$ are actually defined, I don't know, but I'm sure somebody here does. Nevertheless, you can see that we need to incorporate the different polarizations and charges $(s,\pm)$ in our definitions of state-projections, in contrast with the real scalar field where we simply had:
$$<\vec{x}|\vec{k}>=e^{-i\vec{k}\cdot\vec{x}}$$
If I had to guess a consistent way to define $\langle \vec{x},s',r'|\vec{p},s,r\rangle$, it would be simply:
$$\langle \vec{x},s',r'|\vec{p},s,r\rangle=\delta_{s,s'}\delta_{r,r'} e^{-i\vec{k}\cdot\vec{x}}$$