Association of parental vaccination readiness and descriptive norms with childhood vaccination status

IF 3.4 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2026-03-19 Epub Date: 2026-02-13 DOI:10.1016/j.vaccine.2026.128337

Wakana Maki , Kazue Ishitsuka , Naho Morisaki , Masaki Machida , Takahiro Tabuchi

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Abstract

Background

Maintaining high vaccination coverage requires understanding parental psychological factors, such as readiness conceptualized by the 7C model and descriptive norms, that shape decisions about childhood vaccinations. This study aimed to validate the Japanese short version of the Children-7C (C7C) scale, and examine how parental readiness and descriptive norms relate to vaccination status.

Methods

This cross-sectional study analyzed data from 5148 parents in a self-reported online survey. Structural validity and internal consistency were assessed using confirmatory factor analysis and McDonald's omega. Criterion validity was examined using structural equation modeling (SEM) for composite vaccination uptake and acceptance defined as the proportion of age-eligible vaccines received, and received or intended, respectively. Vaccine-specific SEMs were also conducted for all vaccines in the Japanese National Immunization Program—Haemophilus influenzae type b, pneumococcal conjugate vaccine, diphtheria–pertussis–tetanus, hepatitis B, rotavirus, measles–rubella, varicella, Japanese encephalitis, human papillomavirus, and diphtheria–tetanus, as well as mumps, influenza and COVID-19.

Results

The scale demonstrated acceptable structural validity (CFI = 0.97, TLI = 0.96, RMSEA = 0.092, SRMR = 0.028) and internal consistency (ω = 0.88). Factor loadings ranged from −0.51 for calculation to 0.89 for complacency. Collective responsibility, constraints, confidence, and complacency showed strong loadings, whereas compliance (λ = 0.25) and conspiracy (λ = 0.06) showed minimal loadings. Regarding criterion validity, parental readiness was positively associated with both composite uptake and acceptance. Readiness showed similar associations across routine infant vaccines, a strong association for HPV, and a weaker association for COVID-19 and seasonal influenza vaccines. Descriptive norms had a lesser overall loading but were consistently positive.

Conclusion

The Japanese short version of the C7C scale is valid for measuring parental vaccination readiness. Readiness consistently predicted children's vaccination status, underscoring the need to enhance readiness while also considering vaccine- and age-specific strategies.

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父母疫苗接种准备和描述规范与儿童疫苗接种状况的关系

维持高疫苗接种率需要了解影响儿童疫苗接种决策的父母心理因素，如7C模型和描述性规范概念化的准备程度。本研究旨在验证日本儿童7c （C7C）量表的简短版本，并检查父母准备和描述性规范与疫苗接种状况的关系。方法横断面研究分析了来自5148名家长的在线自我报告调查数据。采用验证性因子分析和麦当劳ω量表评估结构效度和内部一致性。使用结构方程模型（SEM）对复合疫苗摄取和接受度进行标准效度检验，复合疫苗摄取和接受度分别定义为接受、接受或拟接受的符合年龄的疫苗的比例。还对日本国家免疫规划中的所有疫苗——乙型流感嗜血杆菌、肺炎球菌结合疫苗、白喉-百日咳-破伤风、乙型肝炎、轮状病毒、麻疹-风疹、水痘、日本脑炎、人乳头瘤病毒、白喉-破伤风，以及腮腺炎、流感和COVID-19——进行了疫苗特异性SEMs。结果量表具有良好的结构效度（CFI = 0.97, TLI = 0.96, RMSEA = 0.092, SRMR = 0.028）和内部一致性（ω = 0.88）。因子负载范围从计算的- 0.51到自满的0.89。集体责任、约束、信心和自满表现出很强的负荷，而顺从（λ = 0.25）和共谋（λ = 0.06）表现出最小的负荷。关于标准效度，父母准备与复合摄取和接受均呈正相关。准备程度在常规婴儿疫苗中显示出类似的关联，与HPV有很强的关联，与COVID-19和季节性流感疫苗的关联较弱。描述性规范的总体负荷较小，但始终是积极的。结论日本简易C7C量表适用于父母接种疫苗准备程度的测定。准备情况一贯预测儿童的疫苗接种状况，强调有必要加强准备情况，同时也考虑针对疫苗和年龄的战略。

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.