The vaccine hesitancy scale: Psychometric properties and validation

Vaccine. 2018 Jan 29;36(5):660-667. doi: 10.1016/j.vaccine.2017.12.043. Epub 2017 Dec 27.

Abstract

Introduction: The SAGE Working Group on Vaccine Hesitancy developed a vaccine hesitancy measure, the Vaccine Hesitancy Scale (VHS). This scale has the potential to aid in the advancement of research and immunization policy but has not yet been psychometrically evaluated.

Methods: Using a cross-sectional design, we collected self-reported survey data from a large national sample of Canadian parents from August to September 2016. An online questionnaire was completed in English or French. We used exploratory and confirmatory factor analysis to identify latent constructs underlying parents' responses to 10 VHS items (response scale 1-5, with higher scores indicating greater hesitancy). In addition to the VHS, measures included socio-demographics items, vaccine attitudes, parents' human papillomavirus (HPV) vaccine decision-making stage, and vaccine refusal.

Results: A total of 3779 Canadian parents completed the survey in English (74.1%) or French (25.9%). Exploratory and confirmatory factor analysis revealed a two-factor structure best explained the data, consisting of 'lack of confidence' (M = 1.98, SD = 0.72) and 'risks' (M = 3.07, SD = 0.95). Significant Pearson correlations were found between the scales and related vaccine attitudes. ANOVA analyses found significant differences in the VHS sub-scales by parents' vaccine decision-making stages (p < .001). Independent samples t-tests found that the VHS sub-scales were associated with HPV vaccine refusal and refusing another vaccine (p < .001). Socio-demographic differences in the VHS were found; however, effect sizes were small (η2 < 0.02).

Conclusions: The VHS was found to have two factors that have construct and criterion validity in identifying vaccine hesitant parents. A limitation of the VHS was few items that loaded on the 'risks' component and a lack of positively and negatively worded items for both components. Based on these results, we suggest modifying the wording of some items and adding items on risk perceptions.

Keywords: Attitudes; Health decision-making; Immunization; Scale validation; Vaccine hesitancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Canada / epidemiology
  • Cross-Sectional Studies
  • Decision Making
  • Female
  • Humans
  • Immunization
  • Male
  • Middle Aged
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Vaccines / immunology
  • Psychometrics* / methods
  • Surveys and Questionnaires
  • Vaccination*
  • Vaccines*
  • Young Adult

Substances

  • Papillomavirus Vaccines
  • Vaccines

Grants and funding