Adolescents, Young Adults, and Vaccine Hesitancy: Who and What Drives the Decision to Vaccinate?

The Impact of COVID-19 and Non-COVID-19 Vaccinations in Special Populations

Vaccination to prevent human infection is a key driver for reducing morbidity and mortality [...].

Vaccination Attitudes Examination (VAX) Scale: a Bifactor-ESEM approach in a youth sample (15-24 years)

BACKGROUND

The Vaccination Attitudes Examination (VAX) Scale is a widely used scale designed to measure general attitudes toward vaccinations. However, evidence for the VAX's structural, convergent, and discriminant validity is still limited, especially in youth samples.

METHODS

The present study examined the psychometric multidimensionality and evidence of convergent and discriminant validity of the VAX using the bifactor-exploratory structural equation modeling approach (bifactor-ESEM). Using a sample of 803 Serbian adolescents and young adults (Mage = 18.23, SDage = 2.66, age range = 15-24 years, 59.2% female), we contrasted the original four-factor model of the VAX with alternative solutions (ESEM, bifactor-CFA, and bifactor-ESEM), and investigated associations between vaccination attitudes and a variety of external criteria.

RESULTS

The results supported the bifactor-ESEM solution with one general factor of vaccination attitudes and four specific factors (Mistrust of vaccine benefit, Worries about unforeseen future effects, Concerns about commercial profiteering, and Preference for natural immunity) as the best representation of the data. The general factor was well-defined, and three specific factors showed good validity and specificity after the general factor was taken into account. The results of convergent validity analyses showed that the general factor of vaccine attitudes and one specific factor (Mistrust of vaccine benefit) were good predictors of vaccine conspiracy beliefs, attitudes towards COVID-19 vaccination, intention to get vaccinated against COVID-19, and trust in healthcare. The remaining three specific factors' contributions to external criteria were generally weak and nonsignificant. Evidence of the discriminant validity of the VAX scores was supported by weak positive associations of the general factor with medical fears and paranoid worry.

CONCLUSIONS

The present findings indicate that distinguishing general and specific components of vaccination attitudes offers a more nuanced assessment and understanding of vaccination attitudes.

Who chooses alternative sources of information about childhood vaccinations? A cross-sectional study

Introduction

Vaccine hesitancy can lead to problematic outcomes in terms of public health. A factor playing a fundamental role in this dynamic is the source of information considered by parents in the decision-making progress that leads to the acceptance or refusal of childhood vaccinations. This study aims to investigate the sources of information considered by the parents of children attending primary and secondary schools in two large Italian cities and to identify predictors that led to choosing alternative sources of information.

Methods

An online questionnaire was administered to the parents of students attending elementary, middle, and high schools in Rome and Turin. Two validated tools were used: the Parent Attitudes about Childhood Vaccines Survey and the Vaccine Health Literacy of adults in Italian. Sources of information about vaccinations, trust toward the healthcare system, hesitancy and attitudes about COVID-19 vaccinations, were also investigated. A multivariable logistic regression model was built to identify predictors of the preferred sources of information on the topic.

Results

Totally, 2,301 answers to the survey were collected from June to October 2021. Of these, 1,127 came from parents in Rome (49%) and 1,174 from parents based in Turin (51%) with a mean age of 47.7 years (±6.4). The majority of the respondents were mothers (81%), married (73%), with two or more children (70.5%). The multivariable logistic regression model results showed that fathers were more inclined than mothers to use alternative sources of information (OR 1.48, 95% CI 1.29-2.00). Moreover, a higher level of vaccine hesitancy was a strong predictor for choosing alternative sources of information (OR 2.45, 95% CI 1.73-3.46). The HLVa-it scores show that parents with a lower Vaccine Literacy (VL) were more inclined to use alternative sources of information.

Discussion

Addressing health literacy issues and changing the official forms of communication could help improving vaccine acceptance. This study shows the importance of rebuilding a trusting relationship between patients and health care providers, which is fundamental in the fight against vaccine hesitancy.