Heidi Sze Lok Fan , Edmond Pui Hang Choi , Elizabeth Keys , Rishma Chooniedass , Stephanie Masina , Alex Halonen , Kalysse Mantai , Marie Tarrant
{"title":"COVID-19疫苗犹豫量表：孕妇和哺乳者及父母的心理测量特性和验证","authors":"Heidi Sze Lok Fan , Edmond Pui Hang Choi , Elizabeth Keys , Rishma Chooniedass , Stephanie Masina , Alex Halonen , Kalysse Mantai , Marie Tarrant","doi":"10.1016/j.jvacx.2025.100720","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>The Vaccine Hesitancy Scale (VHS) was developed by the World Health Organization's Strategic Advisory Group of Experts on Immunization (SAGE) to examine parents' vaccine hesitancy toward childhood vaccines. The VHS has been validated and modified to assess vaccine hesitancy toward specific vaccines, including influenza and human papillomavirus vaccines, but not the COVID-19 vaccine. The objective of this study is to validate a modified VHS for the COVID-19 vaccine among pregnant and breastfeeding persons, and parents of children under 12 years of age.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in British Columbia, Canada from October to December 2021. A total of 1510 participants including pregnant and breastfeeding persons, and parents of children <12 years of age were included in the analysis. Participants completed questionnaires tailored to their respective groups based on self-identification. Confirmatory factor analysis was conducted to assess the original VHS structure. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Factor structure, internal construct validity, internal consistency, and known-group validity were evaluated.</div></div><div><h3>Results</h3><div>The original VHS model showed a poor fit. Exploratory factor analysis identified a revised one-factor model (VHS-COVID19), which showed satisfactory fit in the validation sample for pregnant participants (comparative fit index [CFI] = 0.999; root mean square error of approximation [RMSEA] = 0.041; standardized root mean squared residual [SRMR] = 0.008; Tucker-Lewis Index [TLI] = 0.997), breastfeeding participants (CFI = 0.995; RMAEA = 0.089; SRMR = 0.006; TLI = 0.990) and parent participants (CFI = 0.995; RMAEA = 0.080; SRMR = 0.004; TLI = 0.992). The revised scale comprised five items for pregnant and breastfeeding participants and six for parent participants<em>.</em> VHS-COVID19 showed high internal construct validity and reliability.</div></div><div><h3>Conclusions</h3><div>The VHS-COVID19 shows adequate psychometric performance for assessing COVID-19 vaccine hesitancy among pregnant, breastfeeding persons, and parents. It is easy to administer and can be used by healthcare providers to rapidly assess vaccine hesitancy of the targeted population in clinical settings.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100720"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COVID-19 Vaccine Hesitancy Scale: Psychometric properties and validation among pregnant and breastfeeding persons and parents\",\"authors\":\"Heidi Sze Lok Fan , Edmond Pui Hang Choi , Elizabeth Keys , Rishma Chooniedass , Stephanie Masina , Alex Halonen , Kalysse Mantai , Marie Tarrant\",\"doi\":\"10.1016/j.jvacx.2025.100720\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>The Vaccine Hesitancy Scale (VHS) was developed by the World Health Organization's Strategic Advisory Group of Experts on Immunization (SAGE) to examine parents' vaccine hesitancy toward childhood vaccines. The VHS has been validated and modified to assess vaccine hesitancy toward specific vaccines, including influenza and human papillomavirus vaccines, but not the COVID-19 vaccine. The objective of this study is to validate a modified VHS for the COVID-19 vaccine among pregnant and breastfeeding persons, and parents of children under 12 years of age.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in British Columbia, Canada from October to December 2021. A total of 1510 participants including pregnant and breastfeeding persons, and parents of children <12 years of age were included in the analysis. Participants completed questionnaires tailored to their respective groups based on self-identification. Confirmatory factor analysis was conducted to assess the original VHS structure. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Factor structure, internal construct validity, internal consistency, and known-group validity were evaluated.</div></div><div><h3>Results</h3><div>The original VHS model showed a poor fit. Exploratory factor analysis identified a revised one-factor model (VHS-COVID19), which showed satisfactory fit in the validation sample for pregnant participants (comparative fit index [CFI] = 0.999; root mean square error of approximation [RMSEA] = 0.041; standardized root mean squared residual [SRMR] = 0.008; Tucker-Lewis Index [TLI] = 0.997), breastfeeding participants (CFI = 0.995; RMAEA = 0.089; SRMR = 0.006; TLI = 0.990) and parent participants (CFI = 0.995; RMAEA = 0.080; SRMR = 0.004; TLI = 0.992). The revised scale comprised five items for pregnant and breastfeeding participants and six for parent participants<em>.</em> VHS-COVID19 showed high internal construct validity and reliability.</div></div><div><h3>Conclusions</h3><div>The VHS-COVID19 shows adequate psychometric performance for assessing COVID-19 vaccine hesitancy among pregnant, breastfeeding persons, and parents. It is easy to administer and can be used by healthcare providers to rapidly assess vaccine hesitancy of the targeted population in clinical settings.</div></div>\",\"PeriodicalId\":43021,\"journal\":{\"name\":\"Vaccine: X\",\"volume\":\"27 \",\"pages\":\"Article 100720\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vaccine: X\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590136225001147\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vaccine: X","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590136225001147","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
COVID-19 Vaccine Hesitancy Scale: Psychometric properties and validation among pregnant and breastfeeding persons and parents
Introduction
The Vaccine Hesitancy Scale (VHS) was developed by the World Health Organization's Strategic Advisory Group of Experts on Immunization (SAGE) to examine parents' vaccine hesitancy toward childhood vaccines. The VHS has been validated and modified to assess vaccine hesitancy toward specific vaccines, including influenza and human papillomavirus vaccines, but not the COVID-19 vaccine. The objective of this study is to validate a modified VHS for the COVID-19 vaccine among pregnant and breastfeeding persons, and parents of children under 12 years of age.
Methods
A cross-sectional survey was conducted in British Columbia, Canada from October to December 2021. A total of 1510 participants including pregnant and breastfeeding persons, and parents of children <12 years of age were included in the analysis. Participants completed questionnaires tailored to their respective groups based on self-identification. Confirmatory factor analysis was conducted to assess the original VHS structure. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Factor structure, internal construct validity, internal consistency, and known-group validity were evaluated.
Results
The original VHS model showed a poor fit. Exploratory factor analysis identified a revised one-factor model (VHS-COVID19), which showed satisfactory fit in the validation sample for pregnant participants (comparative fit index [CFI] = 0.999; root mean square error of approximation [RMSEA] = 0.041; standardized root mean squared residual [SRMR] = 0.008; Tucker-Lewis Index [TLI] = 0.997), breastfeeding participants (CFI = 0.995; RMAEA = 0.089; SRMR = 0.006; TLI = 0.990) and parent participants (CFI = 0.995; RMAEA = 0.080; SRMR = 0.004; TLI = 0.992). The revised scale comprised five items for pregnant and breastfeeding participants and six for parent participants. VHS-COVID19 showed high internal construct validity and reliability.
Conclusions
The VHS-COVID19 shows adequate psychometric performance for assessing COVID-19 vaccine hesitancy among pregnant, breastfeeding persons, and parents. It is easy to administer and can be used by healthcare providers to rapidly assess vaccine hesitancy of the targeted population in clinical settings.
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