Does Vaccine Confidence Mediate the Relationship between Vaccine Literacy and Influenza Vaccination? Exploring Determinants of Vaccination among Staff Members of Nursing Homes in Tuscany, Italy, during the COVID-19 Pandemic

Abstract

Background: Low coverage of influenza vaccination in nursing home (NH) staff may be attributed to factors such as vaccine confidence (VC) and vaccine literacy (VL). Our study aimed to evaluate the role of VL and VC in predicting the intention to get the influenza vaccine in a sample of employees of NHs in Tuscany, Italy. Methods: Data from staff members in Tuscany were collected using an online questionnaire that examined influenza vaccination history, intentions, demographic information, health status, and VL. Statistical analyses explored the relationships between VC, VL, and vaccination intentions. Results: The study included 1794 respondents, (86.3%) and assistants/aides (58.1%), with a median age of 46 years. The intention to get vaccinated was significantly higher among those with health risk conditions, and there was a positive association between VC and VL, specifically its interactive/critical component. The mediation analysis showed that VC completely mediated the relationship between VL and the intention to get vaccinated, with significant effects observed in different subgroups. Conclusions: VC is a key factor that mediates the effect of VL on vaccine intention. These results suggest that interventions aimed at improving VL alone may not be sufficient to increase vaccine uptake unless VC is also addressed.

COVID‐19 vaccine uptake, conspiracy theories, and health literacy among Black individuals in Canada: Racial discrimination, confidence in health, and COVID‐19 stress as mediators

“…In the adjusted model, we included all Due to the fact that higher levels of conspiracy beliefs are associated with lower levels of attitude/willingness to receive COVID-19 vaccination 25,26 and increased vaccine hesitancy 27 as well that given the previous studies have used this variable as an independent variable in their mediation models, [25][26][27] the current study was regarded conspiracy beliefs as the independent variable in the mediation analysis. As well, previous studies have used health literacy as an independent variable, 28,29 and due to a significant bivariate relationship between health literacy and COVID-19 vaccination, we regarded health literacy as the independent variable in the mediation analysis. The selection criteria for mediators were based on Baron and Kenny's selection procedure 30 ; we tested bivariate relationships between potential mediators (confidence and needs, COVID-19related traumatic stress, and everyday discrimination) as mediator and outcome variables as well as correlation between potential mediators and independent variables.…”

Development of Tools to Assess Vaccine Literacy: A Scoping Review and Future Perspectives

“…Theory of Planned Behavior TPB Ajzen [53], Wolff [63], Catalano [87] explains how intention to engage in a behavior is influenced by the attitude towards that behavior Protection Motivation Theory PMT Marikyan [25], Kowalski [54] explains how people respond to fear-evoking or threatening messages '3Cs' and "5Cs" McDonald [10], Betsch [12] Lu [33] explains painful" § = There are several scales to assess VH [12]; a frequently adopted measure is VCI [88,89]. The flu example [8,59]…”

Perspectives in the Development of Tools to Assess Vaccine Literacy

“…The role of the different variables as mediators between VL and outcomes was evaluated in three papers using VL tools [8,33,37]. Shon et al [37] investigated the relationship between flu VL, health beliefs, and influenza vaccination.…”

“…A recent scoping review has been published to collect, analyze, and summarize available definitions of VL, and to propose a comprehensive one [7,8]. In summary, it has been proposed that VL is the degree to which people have the ability to obtain and understand information regarding vaccination and related services.…”