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. 2023 Mar 1;11(3):562.
doi: 10.3390/vaccines11030562.

Associations between Health Literacy, Trust, and COVID-19 Vaccine Hesitancy: The Case of Hong Kong

Cindy Yue Tian  1 , Phoenix Kit-Han Mo  1   2 , Dong Dong  1   2 , Hong Qiu  1   2 , Annie Wai-Ling Cheung  1   2 , Eliza Lai-Yi Wong  1   2
Affiliations

Associations between Health Literacy, Trust, and COVID-19 Vaccine Hesitancy: The Case of Hong Kong

Cindy Yue Tian et al. Vaccines (Basel). .

Abstract

This study investigates how health literacy (HL) and trust in health information affected COVID-19 vaccine hesitancy among Chinese Hong Kong adults. A cross-sectional study was conducted in August 2022. A total of 401 participants completed the study. Participants completed a newly developed Hong Kong HL scale and self-reported their trust levels in health information from different resources. The proportions of early uptake of the first dose and booster dose of COVID-19 vaccine were 69.1% and 71.8%, respectively. The risk of delaying the first dose was higher among participants with inadequate functional HL (OR = 0.58, p = 0.015), adequate levels of two subdomains of critical HL (OR = 1.82, p = 0.013; OR = 1.91, p < 0.01), and low-level trust in health information from the government (OR = 0.57, p = 0.019). Respondents with adequate interactive HL (OR = 0.52, p = 0.014) and inadequate level of one subdomain of critical HL (OR =1.71, p = 0.039) were more likely to delay the booster dose. This negative association between critical HL and vaccination was suppressed by trust in health information from the government. This study shows that HL and trust in health information from the government are associated with COVID-19 vaccine hesitancy. Efforts should be directed at providing tailored communication strategies with regard to people's HL and increasing public confidence in health authorities to decrease vaccine hesitancy.

Keywords: COVID-19; health literacy; mediation analysis; vaccine hesitancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Theoretical framework of HLS-HK. (Note: Abbreviations: HL: health literacy; FHL: functional health literacy; IHL: interactive health literacy; CHL-1: the first subdomain of critical health literacy; CHL-2: the second subdomain of critical health literacy; CHL-3: the third subdomain of critical health literacy; HLS-HK: Hong Kong Health Literacy Scale).
See this image and copyright information in PMC

References

    1. Kwan R. How Hong Kong’s vaccination missteps led to the world’s highest COVID-19 death rate. BMJ. 2022;377:1127. doi: 10.1136/bmj.o1127. - DOI - PubMed
    1. Cheung P.-H.H., Chan C.-P., Jin D.-Y. Lessons learned from the fifth wave of COVID-19 in Hong Kong in early 2022. Emerg. Microbes Infect. 2022;11:1072–1078. doi: 10.1080/22221751.2022.2060137. - DOI - PMC - PubMed
    1. Chow W., Chow C., Cheng C. Estimation of the Total Number of Infected Cases in the 5th Wave of COVID-19 in Hong Kong. medRxiv. 2022 doi: 10.1101/2022.08.12.22278708. - DOI
    1. Region TGotHKSA Hong Kong Vaccination Dashboard. [(accessed on 8 November 2022)]; Available online: https://www.covidvaccine.gov.hk/en/dashboard.
    1. Nutbeam D. Health promotion glossary. Health Promot. Int. 1998;13:349–364. doi: 10.1093/heapro/13.4.349. - DOI

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