The Impact of Health Literacy on Nonvaccination Against COVID-19: The Moderating Role of Age

This study evaluated the relationship between health information literacy and nonvaccination against COVID-19, while identifying potential moderating factors. The study included 229 237 participants who reported on their COVID-19 vaccination experiences as part of the 2021 Korea Community Health Survey. Using multiple logistic regression, we analyzed the impact of health information literacy on vaccination status, adjusting for sociodemographic and personal hygiene factors, and calculated the odds ratio with 95% confidence intervals. Individuals who have difficulty understanding health information were at increased risk of being unvaccinated against COVID-19. Additionally, sociodemographic factors and hand hygiene independently influenced vaccination status. Notably, health literacy showed an age-dependent relationship with COVID-19 vaccination, with individuals below 45 and above 75 years old having a 17% and 32% higher risk of remaining unvaccinated due to difficulties in understanding health information, respectively. To reduce nonvaccination rates, health communication strategies that improve information delivery may be particularly beneficial for both younger and older age groups.