# Factors Influencing the Intention of Chinese Adults to Recommend COVID-19 Vaccination for Specific or Non-Specific Groups

## TL;DR

This study explores what influences Chinese adults to recommend COVID-19 vaccination for specific or general groups, highlighting the role of health information literacy and vaccine hesitancy.

## Contribution

The study identifies health information literacy as a key factor influencing vaccination recommendation intentions through mediation by vaccine hesitancy and information perception.

## Key findings

- Health information literacy directly and indirectly affects intentions to recommend vaccination for specific groups.
- Vaccine hesitancy and perceived information usefulness mediate the link between health literacy and recommendation intentions.
- Special attention is needed to address safety hesitancy in specific groups for effective vaccination promotion.

## Abstract

The widespread availability of vaccines has profound implications for sustainable public health. Positive recommendation on vaccination is one of the most effective ways to increase the willingness to vaccinate against COVID-19. This study aims to investigate the factors influencing the intentions to recommend COVID-19 vaccination for specific groups (IRCVSG) and the intentions to recommend COVID-19 vaccination for non-specific groups (IRCVNSG) in China and explore the mediating role of vaccine hesitancy and perception of vaccination information. This study conducted a cross-sectional anonymous online survey of adults (N = 903) in 28 provincial-level administrative regions in China in May 2022. The prevalence of IRCVSG and IRCVNSG was 60.5% and 93.0%, respectively. Health information literacy has a significant direct and indirect impact on IRCVSG through safety hesitancy and the perceived adequacy and usefulness of vaccination information. The relationship between health information literacy and IRCVNSG is entirely mediated via hesitation about the effectiveness and perceived usefulness of vaccination information. Special attention should be paid to the safety hesitation of COVID-19 vaccination for specific groups. This study tests these effects from both theoretical and practical perspectives, helping to address barriers to promoting the vaccination of specific groups for COVID-19 in clinical practice, improving health and sustainability.