The still unexplored mediating role of vaccine literacy

The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.

Objectives: Vaccine literacy (VL) is an essential component of health literacy and is regarded as the promising technique for eliminating vaccine hesitancy. This review summarizes the relationship between VL and vaccination, including vaccine hesitancy, vaccination attitude, vaccination intention, and vaccination uptake. Methods: A systematic search was conducted in the PubMed, Embase, Web of Science, CINAHL, PsycINFO, and Cochrane Library databases. Studies that explored the relationship between VL and vaccination were included, and the PRISMA recommendations were followed. Results: 1523 studies were found, and 21 articles were selected. The earliest article was published in 2015 and focused on the HPV vaccination and VL of female college students. Three studies surveyed parents’ VL about childhood vaccinations, and the remaining 17 focused on COVID-19 VL in different groups. Conclusion: Although VL plays a role in determining the level of vaccine hesitancy across various populations, the association remains unclear. In the future, additional assessment methods could be developed and used to conduct prospective cohort and longitudinal studies to determine the causal relationship between VL and vaccination.

ABSTRACT To address vaccine hesitancy, specific self-rated tools have been developed to assess vaccine literacy (VL) related to COVID-19, including additional variables, such as beliefs, behavior, and willingness to be vaccinated. To explore the recent literature a search was performed selecting articles published between January 2020 and October 2022: 26 papers were identified using these tools in the context of COVID-19. Descriptive analysis showed that the levels of VL observed in the studies were generally in agreement, with functional VL score often lower than the interactive-critical dimension, as if the latter was stimulated by the COVID-19-related infodemic. Factors associated with VL included vaccination status, age, educational level, and, possibly, gender. Effective communication based on VL when promoting vaccination is critical to sustaining immunization against COVID-19 and other communicable diseases. The VL scales developed to date have shown good consistency. However, further research is needed to improve these tools and develop new ones.