The mediating role of health literacy on the relationship between health care system distrust and vaccine hesitancy during COVID-19 pandemic

Abstract

This study explores the mediating role of health literacy on the association between health care system distrust and vaccine hesitancy. An online survey including Personal Information Form, Health Care System Distrust Scale, Vaccine Hesitancy Scale, and Health Literacy Scale were applied to 620 participants. The degree of applying mask-wearing, hygiene rule and physical distance, and the level of COVID-19 vaccine literacy were modeled with hierarchical multiple regression analysis to have a deeper analysis of participants' actions towards COVID-19 vaccine hesitancy. It was found that health care system distrust and health literacy were the most important variables that had an impact on vaccine hesitancy. Based on the mediation analysis, the total effect of health care system distrust on vaccine hesitancy was statistically significant. Participants who held a low level of health literacy and a high perception of the health care system distrust experienced more vaccine hesitancy. The findings suggested the health literacy mediated the relationship between health care system distrust and vaccine hesitancy. Health authorities need to consider the dynamic and complex factors around the health care system distrust and health literacy to reduce vaccine hesitancy during COVID-19.

Influenza Vaccination Uptake in the General Italian Population during the 2020–2021 Flu Season: Data from the EPICOVID-19 Online Web-Based Survey

“…On the contrary, data from Ireland, Italy and Spain showed that education above primary level was associated with lower chances of flu vaccination uptake [38]. The inverted trend toward vaccine uptake in Italy according to education level observed in our study could be explained, on the one hand, by the evolving and dynamic nature of vaccine hesitancy [39] and, on the other, by the potential advantage of more highly educated respondents when it comes to interpreting information regarding vaccines within the context of a pandemic [35,40]. Although digital health literacy and different information seeking behaviours [41] have not been explored in our questionnaire, it could be speculated that changes in digital health literacy during the last decade might have resulted in-in highly educated individuals-better knowledge about influenza vaccination and therefore led to a higher uptake.…”

Worldwide Vaccination Willingness for COVID-19: A Systematic Review and Meta-Analysis

“…Healthcare system distrust as well as vaccine hesitancy are suggested to be closely related to health literacy [67]. Heidari et al [68] emphasized the need for an intersectional gender approach to vaccine development and deployment.…”

Vaccines alone will not prevent COVID-19 outbreaks among migrant workers—the example of meat processing plants

“…Lack of translated culturally tailored health information from reputable sources combined with misinformation exposure through social networks and social media may further erode trust in health systems, employers, or public institutions. Mistrust can then lead to poor compliance with public health and occupational health guidance such as proper workplace personal protective equipment (PPE) use and further increasing infection risk (50,51).…”