Abstract
We sought to analyze the relationship between health literacy, confidence in COVID-19 vaccines, and self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. We recruited (N = 271) English- and Spanish-speaking adults in Boston and Chicago from September 2018 to September 2021. We performed a probit mediation analysis to determine if confidence in COVID-19 vaccines and health literacy predicted self-reported vaccination. We hypothesized that the relationship between health literacy and vaccination would be mediated by vaccine confidence. Participants were on average 50 years old, 65% female, 40% non-Hispanic Black, 25% Hispanic, and 30% non-Hispanic White; 231 (85%) reported at least one COVID-19 vaccination. A higher mean vaccine confidence score (t = −7.9, p < 0.001) and higher health literacy (t = −2.2, p = 0.03) were associated with vaccination, but only vaccine confidence predicted vaccination in a multivariate model. Vaccine confidence mediated the relationship between health literacy and COVID-19 vaccination (mediated effects: 0.04; 95% CI [0.02, 0.08]). We found that using a simple tool to measure vaccine confidence identified people who declined or delayed COVID-19 vaccination in a diverse sample of adults with varying levels of health literacy. Simple short survey tools can be useful to identify people who may benefit from vaccine promotion efforts and evidence-based communication strategies.
Original language | English (US) |
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Article number | 1848 |
Journal | Vaccines |
Volume | 11 |
Issue number | 12 |
DOIs | |
State | Published - Dec 2023 |
Funding
The research was funded by the National Institute of Health’s National Institute on Minority Health and Health Disparities (NIMHD), grant number 5R01MD010440-05.
Keywords
- COVID-19
- health literacy
- vaccine confidence
- vaccine hesitancy
ASJC Scopus subject areas
- Immunology
- Pharmacology
- Drug Discovery
- Infectious Diseases
- Pharmacology (medical)