Association of health literacy, COVID-19 threat, and vaccination intention among Brazilian adolescents.

Objective: investigate the influence of health literacy on the assessment of COVID-19 threat to health and the intention not to be vaccinated among Brazilian adolescents.

Method: cross-sectional study with 526 Brazilian adolescents aged 14 to 19 years. Socioeconomic aspects, health-disease profile, health literacy, health threat by COVID-19 and intention not to be vaccinated were analyzed by bivariate association and multiple linear regression with Poisson response.

Results: higher health literacy score (p=0.010), cardiovascular disease (p=0.006), lower income (p=0.000), and living in the North region (p=0.007) were factors that contributed to feeling more threatened by COVID-19. Health literacy did not influence the intention not to be vaccinated (p=0.091), whose prevalence was lower among adolescents in the Southeast region when compared to those in the North region (p=0.010), among those who attended higher education (p=0,049) and those with higher income (p=0.000).

Conclusion: health literacy influenced the perception of COVID-19 threat, but not the intention not to be vaccinated. Assessment of COVID-19 threat to health and prevalence of the intention not to be vaccinated were influenced by the region of residence, income, and education, which reinforces the importance of social determinants of health in this context.

Keypoints: (1) Average health literacy (HL) score of Brazilian adolescents: 25.3 (p-HLAT-8). (2) Adolescents in the Southeast region felt less threatened by COVID-19. (3) Higher HL score indicated adolescents felt more threatened by COVID-19. (4) Intention not to be vaccinated was observed among adolescents with higher income and education. (5) About 87% of Brazilian adolescents want to be vaccinated against COVID-19.