Assessing COVID-19 vaccine literacy: a preliminary online survey

Figures & data

Table 1. Principal Component Analysis (PCA): correlations between questions and components (factors) after Varimax rotation. VL functional questions^1–4 and interactive-critical questions⁵–¹² loading on two different components (Factor 1 and Factor 2): values in bold correspond for each variable to the factor for which the correlation was the greatest

Questions	Component (Factor) 1	Component (Factor) 2
1	0.0590	0.7664
2	0.1049	0.8583
3	0.0436	0.8677
4	0.0768	0.8240
5	0.6405	−0.0387
6	0.5955	0.2506
7	0.6838	0.1113
8	0.5775	−0.0136
9	0.5086	−0.0301
10	0.5397	0.0162
11	0.6735	0.1515
12	0.6831	0.1529

Figure 1. Principal Component Analysis (PCA): correlation circle between questions and components after Varimax rotation. Projection of the functional VL questions (Q1–Q4) and the interactive-critical VL questions (Q5–Q12) on two components (Factor 1 and Factor 2), representing 49.49% of the total variability. Variables close to each other were significantly positively correlated

Table 2. Main demographic characteristics of the participants

	Respondents (%)
Total population	885
Males (%)	442 (49.9%)
Females (%)	443 (50.1%)
Age class
18–30 (%)	206 (23.3%)
31–50	327 (36.9%)
51–65	270 (30.5%)
> 65	82 (9.3%)
Residence Area
Northern Italy	260 (30.4%)
Central Italy	455 (53.2%)
Southern Italy & Islands	140 (16.4%)
Education
Primary	37 (4.2%)
Secondary	356 (40.2%)
Tertiary	478 (54.0%)
Other	14 (1.6%)
Occupational status
Employed	532 (60.1%)
Non-employed	54 (6.1%)
Retired	99 (11.2%)
Students	125 (14.1%)
Housewives	17 (1.9%)
Other	58 (6.6%)

Table 3. VL functional and interactive-critical scores of the total, male, and female populations

	Functional mean score (SD) [95% CI]	Interactive-critical mean score (SD) [95% CI]	Functional Median (25–75 P)	Interactive-critical Median (25–75 P)
Total (N = 885)	2.92 (0.70) [2.87–2.97]	3.27 (0.54) [3.23–3.30]	3.00 (2.50–3.50)	3.38 (3.00–3.66)
Male (N = 442)	2.99 (0.68) [2.92–3.05]	3.26 (0.52) [3.21–3.31]	3.00 (2.50–3.50)*	3.38 (3.00–3.63)
Female (N = 443)	2.85 (0.72) [2.77–2.92]	3.28 (0.55) [3.22–3.38]	3.00 (2.25–3.25)*	3.38 (3.0 –3.75)

*P <.05, Mann–Whitney.

Figure 2. Observed functional Vaccine Literacy (VL) scores, visualized as mean and 95% C.I. (error bars), according to age groups

Figure 3. Observed interactive-critical Vaccine Literacy (VL) scores, visualized as mean and 95% C.I. (error bars), according to age groups

Table 4. Positive and negative attitudes/perceptions about future COVID-19 vaccines and behavior toward current vaccines, and significance level of their association with vaccine literacy (VL) scores, age, and gender (significant values in bold)

			VL functional score		VL interactive-critical score		Age groups	Sex
Questions about COVID-19 vaccines	Answers	N (%)	Mean (SD)	P, Kruskal-Wallis	Mean (SD)	P, Kruskal-Wallis	P, chi-squared	P, chi-squared
1 – Will it be possible to produce safe and efficacious vaccines?	Yes	792 (89%)	2.93 (0.70)	=.354	3.28 (0.54)	=.014	=.180	=.100
	No	95 (11%)	2.84 (0.76)		3.15 (0.53)
2 – Will you get vaccinated, if possible?	Yes	816 (92%)	2.93 (0.70)	=.491	3.30 (0.52)	<.001	=.165	=.103
	No	69 (8%)	2.86 (0.70)		2.98 (0.63)
3 – Will Authorities succeed in vaccinating the entire population?	Yes	584 (66%)	2.97 (0.68)	=.003	3.34 (0.50)	<.001	=.030 (1)	<.001 (3)
	No	301 (34%)	2.82 (0.73)		3.13 (0.57)
4 – Would you pay a fee to be vaccinated?	Yes	739 (84%)	2.92 (0.70)	=.823	3.31 (0.52)	<.001	=.940	=.856
	No	146 (16%)	2.90 (0.73)		3.05 (0.57)
5 – Should children be vaccinated too?	Yes	768 (87%)	2.93 (0.70)	=.485	3.29 (0.53)	<.001	=.037 (1)	=.023 (3)
	No	117 (13%)	2.88 (0.71)		3.10 (0.56)
Questions about current vaccines
1 – Have you been vaccinated against flu last season?	Yes	366 (41%)	3.05 (0.70)	<.001	3.38 (0.49)	<.001	<.001 (2)	=.785
	No	519 (59%)	2.83 (0.69)		3.19 (0.56)
2 – Will you get vaccinated against flu this year?	Yes	588 (66%)	2,98 (0.71)	<.001	3.36 (0.49)	<.001	<.001 (2)	=.176
	No	297 (34%)	2.80 (0.68)		3.09 (0.57)
3 – Do you plan to be vaccinated against other infectious diseases?	Yes	649 (73%)	2.97 (0.70)	=.007	3.33 (0.51)	<.001	=.644	=.543
	No	236 (27%)	2.82 (0.70)		3.11 (0.57)

(1) = less positive answers in age group >65 y with respect to the other groups.

(2) = positive answers progressively increasing with age (chi-squared for trend: P <.001).

(3) = more positive answers among males.

Table 5. Spearman rank correlation coefficients (r) and significance levels between ordinal and ordinal/numerical variables observed in the survey (significant P values in bold)

		Educational level	Age group	Belief 1st statement	Belief 2nd statement
FUNCTIONAL Vaccine Literacy	Correlation coefficient Significance Level P N	0.120 <.001 871	0.011 =.741 885	0.196 <.001 885	0.140 <.001 885
INTERACTIVE-CRITICAL Vaccine Literacy	Correlation coefficient Significance Level P N	0.159 <.001 871	0.089 =.008 885	0.234 <.001 885	0.196 <.001 885
EDUCATIONAL LEVEL	Correlation coefficient Significance Level P N		0.129 <.001 871	0.110 =.001 871	0.103 =.002 871
AGE GROUP	Correlation coefficient Significance Level P N			−0.042 =.216 885	0.033 =.331 885

Belief 1st statement: ‘I am not favorable to vaccines because they are unsafe.’

Belief 2nd statement: ‘There is no need to vaccinate because natural immunity exists.’

Table

Variable	Measure and Items	Assessment (score)
VL functional skills	When reading or listening to information about future COVID-19 vaccines or current vaccines: Did you find words you didn’t know? Did you find that the texts were difficult to understand? Did you need much time to understand them? Did you or would you need someone to help you understand them?	Numerical – 4 points Likert scale Often (1) Sometimes (2) Rarely (3) Never (4)
VL interactive/critical skills	When looking for information about future COVID-19 vaccines or current vaccines: Have you consulted more than one source of information? Did you find the information you were looking for? Have you had the opportunity to use the information? Did you discuss what you understood about vaccinations with your doctor or other people? Did you consider whether the information collected was about your condition? Have you considered the credibility of the sources? Did you check whether the information was correct? Did you find any useful information to make a decision on whether or not to get vaccinated?	Numerical – 4 points Likert scale Often (4) Sometimes (3) Rarely (2) Never (1)
COVID-19 vaccines perceptions and attitudes	About future COVID-19 vaccines: Will be possible to produce safe and efficacious vaccines? Will you get vaccinated, if possible? Will Health Authorities succeed in vaccinating the entire population? Would you pay a fee to be vaccinated? Should children be vaccinated too?	Categorical YES/NO
Current vaccines behavior	About current vaccines: Have you been vaccinated against flu last season? Will you get vaccinated against flu this year? Do you plan to be vaccinated against other infectious diseases?	Categorical YES/NO
Beliefs about vaccination	How much do you agree with the following statements: ‘I am not favorable to vaccines because they are unsafe’ ‘There is no need to vaccinate because natural immunity exists’	Ordinal 4 points Likert scale Totally (1) A little (2) Partially (3) Not at all (4)

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