Modification and validation of a vaccine hesitancy scale for adolescent COVID-19 vaccination

Annette K Regan; Marie-Claude Couture; Timothy Callaghan; Brianna Agnew; Jillian Baker; Onyebuchi A Arah

doi:10.1016/j.vaccine.2024.126495

Modification and validation of a vaccine hesitancy scale for adolescent COVID-19 vaccination

Vaccine. 2025 Jan 1;43(Pt 1):126495. doi: 10.1016/j.vaccine.2024.126495. Epub 2024 Nov 10.

Authors

Annette K Regan¹, Marie-Claude Couture², Timothy Callaghan³, Brianna Agnew², Jillian Baker⁴, Onyebuchi A Arah⁵

Affiliations

¹ Division of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Practical Causal Inference Lab, University of California Los Angeles, Los Angeles, CA, USA; School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
² School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
³ Boston University School of Public Health, Boston, MA, USA.
⁴ Center for Parent and Teen Communication, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
⁵ Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA; Practical Causal Inference Lab, University of California Los Angeles, Los Angeles, CA, USA; Department of Statistics & Data Science, University of California Los Angeles, Los Angeles, CA, USA.

PMID: 39527888
DOI: 10.1016/j.vaccine.2024.126495

Abstract

Background: Vaccine hesitancy is an urgent public health threat. While tools have been developed to monitor vaccine hesitancy among parents and the general adult population, no such tool exists for adolescents.

Methods: We modified an existing adult Vaccine Hesitancy Scale to create a teen COVID-19 Vaccine Hesitancy Scale (tVHS-COVID) for adolescents and their parents. To validate our scale, we conducted a nationally representative survey of 764 parent-teen dyads. We performed exploratory factor analysis (EFA) to determine the factor structure followed by confirmatory factor analysis (CFA) to test the factor structure validity using two random subsets. We evaluated internal consistency by Cronbach alpha values and construct validity by comparing tVHS-COVID scores to intention to receive future COVID-19 doses.

Results: EFA suggested a three-factor structure with 13-items. CFA indicated good fit for adolescents (CFI = 1.00; RMSEA = 0.023; SRMR = 0.062; NNFI-TLI = 0.998) and for parents (CFI = 1.00, RMSEA = 0.031; SRMR = 0.028; NNFI-TLI = 1.00). Internal consistency exceeded 0.79 for adolescents and 0.78 for parents. As tVHS-COVID scores increased, the percent of adolescent and parent respondents who reported they were willing to receive a COVID-19 vaccine decreased.

Discussion: The tVHS-COVID offers a unique tool that can be used to monitor COVID-19 vaccine hesitancy among adolescents and their parents. As adolescents take on more proactive roles in medical decision-making, monitoring vaccine hesitancy among this population becomes increasingly important.

Keywords: Adolescent health; COVID-19; COVID-19 vaccines; Vaccine hesitancy.

Publication types

Validation Study

MeSH terms

Adolescent
Adult
COVID-19 Vaccines* / administration & dosage
COVID-19* / prevention & control
Factor Analysis, Statistical
Female
Humans
Male
Middle Aged
Parents* / psychology
SARS-CoV-2
Surveys and Questionnaires
Vaccination / psychology
Vaccination Hesitancy* / psychology
Vaccination Hesitancy* / statistics & numerical data

Substances

COVID-19 Vaccines

Grants and funding

R21 HD109536/HD/NICHD NIH HHS/United States