Association between vaccination readiness and COVID-19 health literacy in German school leaders

Abstract Background Health literacy has revealed to be a personal resource for managing health information and navigating the information ecosphere during the COVID-19 pandemic. A tremendous amount of information about COVID-19 vaccines were available and changed quickly during the process of implementing vaccination strategies in Germany, which might have left people confused and overwhelmed. The international COVID-HL school principal study investigated COVID-19 health literacy in relation to vaccination attitude and readiness. Methods An online survey of school leaders was conducted in Germany during the third infection wave of the pandemic in four federal states. COVID-19 health literacy, COVID-19 information confusion, COVID-19 vaccination readiness and general vaccination attitude were assessed using self-report tools. Descriptive statistics and variance analyses were conducted. The Bielefeld University Ethics Board approved the study. Results A total of 2186 school leaders took part in the survey. 65.4% felt well informed about the coronavirus or the COVID-19 pandemic. Welch's ANOVA indicated that school leaders with higher COVID-19 health literacy levels were less confused about COVID-19 information (F(2, 456.253) = 149.78, p < 0.001; η2 = 0.14), were more likely to get vaccinated if they were offered a COVID-19 vaccination (F(2, 424.02) = 16.56, p < 0.001; η2 = 0.02) and had a more positive attitude towards vaccination in general (F(2, 425.801) = 54.32, p < 0.001; η2 = 0.06) than those with lower COVID-19 health literacy levels. Conclusions Overall, the sample had a positive attitude towards vaccination in general and stated to likely get the COVID-19 vaccine when offered. However, only two-thirds felt well enough informed about COVID-19 information. School leaders with a low COVID-19 health literacy level were a bit more hesitant towards vaccines, emphasizing the role of health literacy for school leaders’ own health and the health of the whole school environment.