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.