Psychometric validation of the COVID-19 vaccine hesitancy scale for primary and booster doses among university students: A cross-sectional study

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-06-07 DOI:10.1016/j.vaccine.2025.127368

Bara’ Abdallah AlShurman , Shannon E. Majowicz , Kelly Grindrod , Joslin Goh , Zahid Ahmad Butt

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引用次数: 0

Abstract

Background

Vaccine hesitancy (VH) continues to impede COVID-19 vaccine coverage. Booster dose uptake lags behind primary dose uptake, especially among younger adults. Unlike most studies that focus on initial stages of VH, the aim of this study was to validate the COVID-19 Vaccine Hesitancy Scale (CVHS) for both primary and booster doses among University of Waterloo (UW) students.

Methods

An online survey was conducted among UW students in Ontario, Canada, between March and May 2024. The CVHS items were adapted for primary and booster doses. Exploratory (EFA) and confirmatory factor analyses (CFA) assessed the factor structure and model fit. Reliability was evaluated using Cronbach's alpha and composite reliability (CR). Convergent and discriminant validity were assessed through average variance extracted (AVE). Significant differences between primary and booster dose hesitancy were determined via 95 % Confidence Interval.

Results

A total of 4453 students participated. Respondents were predominantly female (57.2 %), aged 18–22 years (84.0 %), and undergraduates (94.8 %). EFA and CFA confirmed a three-factor structure for both primary and booster dose scales. Both scales had high reliability (Cronbach's alpha >0.60, CR >0.7). CFA results indicated a good model fit (Comparative Fit Index = 0.94; Root Mean Square Error of Approximation = 0.07), and demonstrated adequate convergent, discriminant, and criterion validity. Known-group validity was supported by significant differences in VH scores across gender and academic level, with men and undergraduate students reporting higher hesitancy than women and graduate students (p < 0.001). VH was higher for booster doses (33.4 %) than primary doses (19.3 %) with more students delaying (32.1 %) or refusing boosters (29.3 %) than delaying (11.5 %) or refusing (6.2 %) primary doses.

Conclusion

Our adapted scales performed well psychometrically to measure VH across different COVID-19 vaccine phases. These scales can help in identifying key barriers of VH to understand shifting trajectories over time, thereby informing targeted interventions to promote vaccination uptake among younger adults.

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大学生COVID-19疫苗初次和加强剂量犹豫量表的心理测量学验证：一项横断面研究

疫苗犹豫（VH）继续阻碍COVID-19疫苗的覆盖。加强剂量摄取滞后于初级剂量摄取，特别是在年轻人中。与大多数关注VH初始阶段的研究不同，本研究的目的是验证滑铁卢大学（UW）学生中初级和加强剂量的COVID-19疫苗犹豫量表（CVHS）。方法于2024年3月至5月在加拿大安大略省的华盛顿大学学生中进行了一项在线调查。CVHS项目适用于初级和加强剂量。探索性因子分析（EFA）和验证性因子分析（CFA）评估了因子结构和模型拟合。采用Cronbach’s alpha和复合信度（composite Reliability， CR）评估信度。通过平均方差提取（AVE）评估收敛效度和判别效度。初次和加强剂量犹豫之间的显著差异通过95%置信区间确定。结果共4453名学生参与。受访者以女性（57.2%）、18-22岁（84.0%）和大学生（94.8%）为主。EFA和CFA确认了初级和加强剂量量表的三因素结构。两种量表均具有高信度（Cronbach's alpha >0.60, CR >0.7）。CFA结果显示模型拟合良好(比较拟合指数= 0.94；近似的均方根误差= 0.07)，并证明了足够的收敛性，判别性和标准有效性。已知组效度得到了不同性别和学术水平的VH分数显著差异的支持，男性和本科生比女性和研究生报告更高的犹豫(p <；0.001)。加强剂量的VH（33.4%）高于初次剂量（19.3%），延迟（32.1%）或拒绝（29.3%）的学生多于延迟（11.5%）或拒绝（6.2%）初次剂量的学生。结论本量表在不同疫苗期的VH测量中具有良好的心理测量效果。这些量表有助于确定VH的主要障碍，了解随时间变化的轨迹，从而为有针对性的干预措施提供信息，以促进年轻人接种疫苗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.