AUTHOR=Wang Li , Guo Mengjie , Wang Yan , Chen Ren , Wei Xiaolin 

TITLE=The relationship between influenza vaccine hesitancy and vaccine literacy among youth and adults in China

JOURNAL=Frontiers in Immunology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1444393

DOI=10.3389/fimmu.2024.1444393

ISSN=1664-3224

ABSTRACT=<sec><title>Objectives</title><p>The present study aimed to assess influenza vaccine hesitancy and vaccine literacy levels among youth and adults in China, as well as the association between them.</p></sec><sec><title>Methods</title><p>An online cross-sectional survey was conducted in Mainland China. Participants’ total vaccine literacy and three sub-dimension vaccine literacy (knowledge literacy, competence literacy, and decision-making literacy) were assessed by a validated vaccine literacy scale. Having received influenza vaccination in the past three years or intending to accept it in next influenza season indicates less influenza vaccine hesitancy.</p></sec><sec><title>Results</title><p>Among 997 participants, a sub-optimal vaccine literacy was observed, with a mean score of 66.83 ± 10.27. Regression models 1–4 revealed that participants with middle (<italic>aOR:</italic> 1.431, <italic>P</italic>=0.039, <italic>95% CI:</italic> 1.018~2.010) or high (<italic>aOR:</italic> 1.651, <italic>P</italic>=0.006, <italic>95% CI:</italic> 1.157~2.354) total vaccine literacy, as well as those with high competence literacy (<italic>aOR:</italic> 1.533, P=0.017, <italic>95% CI:</italic> 1.079~2.180), or high decision-making literacy (<italic>aOR:</italic> 1.822, <italic>P</italic>=0.001, <italic>95% CI:</italic> 1.261~2.632) were more likely to have been vaccinated against influenza at least once in past three years. However, those with a high knowledge literacy were associated with a lower influenza vaccine rate (<italic>aOR:</italic> 0.676, <italic>P</italic>=0.046, <italic>95% CI:</italic> 0.460~0.994). Regression models 5–8 revealed that participants with middle (<italic>aOR:</italic> 1.661, <italic>P</italic>=0.008, <italic>95% CI:</italic> 1.142~2.414) or high total vaccine literacy (<italic>aOR:</italic> 2.645, <italic>P</italic>=0.000, <italic>95% CI:</italic> 1.774~3.942), as well as those with middle (<italic>aOR:</italic> 1.703, P=0.005, <italic>95% CI:</italic> 1.177~2.464) or high competence literacy (<italic>aOR:</italic> 2.346, <italic>P</italic>=0.000, <italic>95% CI:</italic> 1.159~3.461), or high decision-making literacy (<italic>aOR:</italic> 2.294, <italic>P</italic>=0.000, <italic>95% CI:</italic> 1.531~3.436) were more likely to express the willingness to receive the influenza vaccine in the next influenza season.</p></sec><sec><title>Conclusion</title><p>The participants’ influenza vaccine hesitancy was negatively associated with their total vaccine literacy levels and two of the three sub-dimensions: competence literacy and decision-making literacy. Knowledge literacy suggested a positive or no relationship with influenza vaccine hesitancy.</p></sec>