The effect of Health Literacy on COVID-19 Vaccine Hesitancy: The Moderating Role of Stress

Abstract

Background The COVID-19 vaccine is an essential means to establish group immunity and prevent the spread of the pandemic. However, the public's hesitation has created major difficulties to the promotion of the vaccine. By investigating the relationship between health literacy and COVID-19 vaccine hesitancy, as well as the potential moderating role of stress, the present study would provide critical insights for tailoring vaccine-promotion strategies. Objective The two-fold research purpose is: i) address the effect of health literacy on people's attitude toward COVID-19 vaccine, ii) clarify the role of stress in this effect. Method With structured questionnaires, an online survey was conducted to evaluate general public's COVID-19 vaccine hesitancy, health literacy, and perceived stress. In total, 560 responses were collected, and moderated regression analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of stress. Results A total of 560 participants aged over 18 years were included in this study. About 39.8% of the respondents reported vaccine hesitancy, and this rate is higher among those aged 20-30 years old (83%) and female (71.3%). The results showed people with higher level of health literacy are less likely to have vaccine hesitancy . However, this effect was only among those with lower to moderate level of stress , among the people with high stress, no significant effect of health literacy was found . Conclusions By focusing on the effect of health literacy on COVID-19 vaccine hesitancy, the findings showed education program increasing individual's health literacy may also effectively reduce the public's vaccine hesitancy and promote accepting attitude. However, for people with high level of stress, other health programs need to be developed to enhance their positive attitude toward the COVID-19 vaccine. In conclusion, promotion strategies should be tailored for different populations, with considering individual factors such as health literacy and stress. Keywords vaccine hesitancy; health literacy; stress; moderation

COVID-19 Vaccine Literacy, Attitudes, and Vaccination Intention Against COVID-19 Among Thai Older Adults

“…24 Older adults with a high level of vaccine literacy were less likely to have COVID-19 vaccine hesitancy. 22 Conversely, inadequate vaccine literacy was associated with a reluctance to get COVID-19 vaccination. 15 This cross-sectional study had some limitations.…”

“… 15 In addition, vaccine literacy has been shown to be a significant factor that influences vaccination intention 20 and reduces vaccine hesitancy. 21 , 22 Recently, a COVID-19 vaccine literacy scale was developed to measure and assess a person’s ability to understand, appraise, and apply existing information about the COVID-19 vaccine to make an appropriate decision about vaccination. 23 , 24 This highlighted that vaccine literacy is an essential factor affecting vaccination intention.…”

Assessment of attitude towards COVID-19 vaccine and associated factors among clinical practitioners in Ethiopia: A cross-sectional study

“…Personal attitudes, subjective norms, and perceived vulnerability have also been linked to behavioral intention with regards to vaccine uptake [ 24 , 25 , 27 , 29 , 30 ]. When compared to contextual factors (availability) and vaccine characteristics, individual factors such as health literacy have been found to be more likely altered in health promotion strategies [ 28 ]. Clinical practitioners’ attitudes toward vaccines are frequently misunderstood as positive because they have substantial health literacy through extensive scientific and medical knowledge and training [ 19 , 28 ].…”

“…When compared to contextual factors (availability) and vaccine characteristics, individual factors such as health literacy have been found to be more likely altered in health promotion strategies [ 28 ]. Clinical practitioners’ attitudes toward vaccines are frequently misunderstood as positive because they have substantial health literacy through extensive scientific and medical knowledge and training [ 19 , 28 ]. However, clinical practitioners are not uniformly homogeneous in their level of expertise, and thus the majority are not experts in immunology and vaccination [ 19 , 28 ].…”

“…Clinical practitioners’ attitudes toward vaccines are frequently misunderstood as positive because they have substantial health literacy through extensive scientific and medical knowledge and training [ 19 , 28 ]. However, clinical practitioners are not uniformly homogeneous in their level of expertise, and thus the majority are not experts in immunology and vaccination [ 19 , 28 ]. Numerous studies have indicated that vaccine hesitancy exists among clinical practitioners at the varying prevalence and intensity levels that are inversely related to their level of immunology training [ 19 , 21 , 22 ].…”