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

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.

Automated summary

This study investigates the impact of health literacy and trust in health information on COVID-19 vaccine hesitancy among Chinese Hong Kong adults. A cross-sectional study was conducted in August 2022, with 401 participants completing the study. The findings demonstrate that inadequate functional health literacy, adequate critical health literacy, and low-level trust in government health information are associated with delaying the first dose of the COVID-19 vaccine. In addition, individuals with adequate interactive health literacy and inadequate critical health literacy are more likely to delay the booster dose, while trust in government health information suppresses the negative association between critical health literacy and vaccination.