Association between adults' vaccine literacy and their intention to recommend older family members for influenza vaccine.

Objective: Seasonal influenza vaccine is effective to reduce the risk of hospitalization and death in vulnerable older persons, but the coverage of influenza vaccine remains low in these population in China. This study thus aimed to investigate how adults' vaccine literacy affects their intention to recommend influenza vaccination to older family members in China.

Methods: A cross-sectional survey was performed in China during October 7 to 16, 2023 through a web-based questionnaire. The participants' influenza vaccine literacy (IVL) was quantitatively assessed using an adapted scale, and bivariate analyses were undertaken to evaluate variable associations among the participants. Multivariable logistic regression and mediation effect model were used to analyze the target factors.

Results: 3027 valid respondents were included in our survey, 89.6 % of them were willing to recommend their older family members for influenza vaccine. Participants with higher IVL scores were more likely to recommend influenza vaccination (OR = 1.553, P < 0.01). In addition, participants who were living with their older family members, received annual influenza vaccinations, or whose older family members had infected influenza within the past six months, were also more likely to do so. Of note, despite of a higher level of vaccine literacy, healthcare works were more reluctant to recommend vaccination for older family members (OR = 0.496, P < 0.05).

Conclusion: High level of vaccine literacy is positively correlated to adults' intention to recommend influenza vaccination for older family members. We should take educational interventions of vaccine literacy among adults, and thus promoting influenza vaccination coverage among the older population.