Development and validation of the COVID-19 vaccine beliefs scale for the Chinese population

At present, there is no culturally appropriate scale designed to measure Chinese people's attitudes and beliefs about COVID-19 vaccines. Understanding people's attitudes and beliefs about vaccines can help policy makers and health care professionals better evaluate local beliefs to increase vaccine coverage and minimize COVID-19 vaccine hesitancy.

We developed a COVID-19 vaccine attitudes and beliefs scale comprising items based on qualitative research data. We then conducted an explorative and confirmatory factor analysis using data from two online sources.

The 26-item vaccine belief scale includes a five-factor model: vaccine benefit (VB), vaccine concern (VC), observing others' reactions to vaccination (VR), the influence of authority and others toward vaccination (VI), and common sense about vaccination (VS). The multivariate analysis results showed that VB (OR = 1.065, 95% CI 1.035-1.097), VR (OR = 0.878, 95% CI 0.832-0.927), and VS (OR = 1.076, 95% CI 1.032-1.122) were associated with the intention to receive the vaccine. These results implied that VC (OR = 0.957, 95% CI 0.928-0.987) could predict the choice not to be vaccinated. A correlation between beliefs about vaccines and conspiracy theories and fear of COVID-19 was also found and discussed.

These findings suggest that the locally designed and culturally sensitive scale has good reliability and validity. The questionnaire provides researchers with a standardized assessment tool to measure Chinese people's beliefs about the COVID-19 vaccine.