Abstract

Background

     More than 130 million individuals in the United States have now received at least one dose of a COVID-19 vaccine. Currently, all adults in the Unites States now have access to one of three COVID-19 vaccines. As part of the vaccination procedure, Emergency Use Authorization (EUA) fact sheets, which contain information regarding the vaccine, are provided. The purpose of this study was to analyze the ease of reading (i.e., readability) of the EUA-approved fact sheets for the vaccines currently available in the United States, the V-Safe adverse event survey script, and the Centers for Disease Control and Prevention (CDC) website information on COVID-19 vaccines designed for the general public in the United States.

Methods

     We acquired the Pfizer, Moderna, and Janssen EUA fact sheets, as well as the V-Safe survey script and the CDC website information regarding COVID-19 vaccines. These documents were analyzed for their complexity regarding the following readability factors: average length of paragraphs, sentences, and words; font size and style; use of passive voice; the Gunning-Fog index; the Flesch Reading Ease index; and the Flesch-Kincaid Grade Level index.

Results

     Only the V-Safe adverse-event survey script met readability standards for adequate comprehension. The mean readability scores of the EUA fact sheets and the CDC website were as follows: Flesch Reading Ease score (44.35 avg); Flesch-Kincaid Grade Level (10.48 avg); and Gunning-Fog index (11.8 avg). These scores indicate that at least a 10th-grade level education would be required to understand these reading materials.

Conclusion

     The average person in the United States would have difficulty understanding the information provided in the EUA fact sheets and CDC COVID-19 vaccine website documents; however, the V-Safe survey was written at an adequate reading level. To ensure that the general public fully understands information regarding COVID-19 vaccines, greater care and effort should be given to the development of simplified information material.

Introduction

     The 2019 coronavirus disease (COVID-19) has resulted in a global pandemic and the subsequent development of vaccines. Vaccine recipients are encouraged to read several vaccine information documents before they receive a vaccine, including reviewing the Centers for Disease Control and Prevention (CDC) website on COVID-19 vaccines and the vaccine-specific emergency-use authorization (EUA) fact sheet for the Pfizer, Moderna, or Janssen vaccine they are receiving. Subjects are also encouraged to sign up for an adverse-event tracking survey called V-Safe after they receive their vaccination. In addition, the CDC website on COVID-19 and the EUA fact sheets contain basic vaccine information for the general public, including potential benefits, risks, side effects, and necessary precautions. The purpose of this study was to analyze the readability of the EUA fact sheets, the CDC website on COVID-19 vaccine questions, and the V-Safe adverse-event survey script for vaccines in the United States to determine if they meet the guidelines for adequate public readability.

Results

     We reviewed the COVID-19 vaccine fact sheets for the Pfizer, Moderna, and Janssen vaccines available under EUA in the US, the complete V-Safe adverse event survey script, and the CDC general public website on information about COVID-19 vaccines. No significant differences were detected in the Microsoft scoring metrics between the two independent study authors who analyzed readability.

     Document length ranged from 5 to 18 pages (8.25 avg). The number of words (including headers) ranged from 1,662 to 5,564 (3,086.8 avg). Average words per page ranged from 175.9 to 334.2 (294.8 avg), and average words per paragraph ranged from 7.0 to 25.1 (17.76 avg). Font size ranged from 11 to 16 points. All documents used sans serif fonts. The average word length ranged from 4.9 to 5.4 characters (5.18 avg). Average sentence length ranged from 9.8 to 18.7 words (14.4 avg). See Table 2.