Validation of the Danish translation of the vaccination attitudes examination (VAX) scale.

Abstract

Background and objectives: Short and valid instruments measuring vaccination attitudes across countries are limited. The recently developed 12-item Vaccination Attitudes Examination (VAX) scale measures vaccination hesitancy and consists of four subscales: (1) mistrust of vaccine benefits, (2) worries over unforeseen future effects, (3) concerns about commercial profiteering, and (4) preference for natural immunity. The original English version has been translated and validated in different languages. This study aimed to validate the Danish translation of the VAX scale.

Methods: The Danish translation of the VAX scale was distributed to Danish citizens using social media via the online survey system SurveyXact. Confirmatory factor analysis (CFA) examined the factor structure. Internal consistency reliability was evaluated for the entire scale and all subscales. Known group validity was tested using vaccination status. Criterion validity was assessed using the beliefs about medicines questionnaire (BMQ).

Results: Analysis of responses from 194 participants revealed an adequate four-subscale construct (GFI = 0.939, AGFI = 0.901, NFI = 0.955, TLI = 0.976, CFI = 0.982, RMSEA = 0.056, SRMR = 0.037, p = 0.005) and a high internal consistency reliability (Cronbach's α 0.934 for the entire scale, 0.920, 0.824, 0.833, and 0.899 for the four subscales, respectively). COVID-19 vaccinated participants showed significantly lower VAX scale scores (Mean(SD) = 2.36(0.83)) compared to non-vaccinated (Mean(SD) = 4.88(0.93)). A significant correlation was found with BMQ-general (r = -0.716, p < 0.01).

Conclusion: The Danish translation of the VAX scale demonstrated a well-defined four-factor structure with high internal consistency, known group validity, and criterion validity. It is a useful tool to measure vaccination hesitancy in Denmark.