Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an, China.
Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Soc Sci Med. 2023 Nov;336:116270. doi: 10.1016/j.socscimed.2023.116270. Epub 2023 Sep 26.
Enhancing the public's vaccine literacy is critical for curbing vaccine hesitancy and enhancing society's pandemic preparedness, particularly in an era of infodemic. Evidence on vaccine literacy as an influencing factor of hesitancy is scarce. Lessons could be learned from COVID-19 vaccination implementation. Taking the COVID-19 vaccines as an example, the current study aimed to examine the relationship between vaccine literacy and hesitancy and the mediating role of psychological antecedents of vaccination on the relationship.
A baseline online questionnaire survey among the general public in China based on quota sampling was conducted in April 2021 to measure participants' vaccine literacy, psychological antecedents of vaccination, COVID-19 vaccination status, and vaccine hesitancy. A follow-up online survey tracked the updated COVID-19 vaccination status among those who hadn't taken COVID-19 vaccines at the baseline survey. Structural equation modeling has been applied to examine the direct and indirect effect of vaccine literacy on vaccine hesitancy. Time-to-event analysis was used to explore the effect of vaccine hesitancy on vaccination behavior.
Lower vaccine hesitancy was associated with higher vaccine literacy. The "3Cs" psychological antecedents were important mediators between vaccine literacy and vaccine hesitancy. The pathway between critical/interactive vaccine literacy and vaccine hesitancy through the "3Cs" psychological antecedents played a more important role. Time-to-event analysis showed participants with a higher vaccine hesitancy were prone to have a longer delay in vaccination.
Improving the public's ability to obtain and evaluate vaccination information can fix the public's psychological determinants of vaccination, reducing vaccine hesitancy and promoting vaccination. Governments need to put more effort into guiding and regulating the media to disseminate evidence-based information, rectifying misinformation, and improving the public's vaccine literacy through education, especially the public's capability to critically discern mixed information.
提高公众的疫苗素养对于遏制疫苗犹豫和增强社会的大流行防范能力至关重要，尤其是在信息泛滥的时代。关于疫苗素养作为犹豫的影响因素的证据很少。可以从 COVID-19 疫苗接种实施中吸取教训。以 COVID-19 疫苗为例，本研究旨在检验疫苗素养与犹豫之间的关系，以及心理接种前因对这种关系的中介作用。
2021 年 4 月，在中国采用配额抽样对公众进行了基线在线问卷调查，以测量参与者的疫苗素养、心理接种前因、COVID-19 疫苗接种状况和疫苗犹豫。对那些在基线调查时没有接种 COVID-19 疫苗的人进行了后续在线调查，以跟踪更新的 COVID-19 疫苗接种状况。结构方程模型被用于检验疫苗素养对疫苗犹豫的直接和间接影响。生存分析用于探索疫苗犹豫对接种行为的影响。
较低的疫苗犹豫与较高的疫苗素养相关。“3C”心理前因是疫苗素养与疫苗犹豫之间的重要中介。批判性/互动性疫苗素养与疫苗犹豫之间通过“3C”心理前因的途径发挥了更重要的作用。生存分析显示，疫苗犹豫较高的参与者更有可能在接种疫苗方面出现较长的延迟。
提高公众获取和评估疫苗信息的能力可以纠正公众对疫苗接种的心理决定因素，从而降低疫苗犹豫并促进接种。政府需要投入更多精力来指导和规范媒体传播基于证据的信息，纠正错误信息，并通过教育提高公众的疫苗素养，特别是公众批判性识别混合信息的能力。
