Modification and validation of a vaccine hesitancy scale for adolescent COVID-19 vaccination

Vaccine hesitancy is an urgent public health threat. While tools have been developed to monitor vaccine hesitancy among parents and the general adult population, no such tool exists for adolescents.

We modified an existing adult Vaccine Hesitancy Scale to create a teen COVID-19 Vaccine Hesitancy Scale (tVHS-COVID) for adolescents and their parents. To validate our scale, we conducted a nationally representative survey of 764 parent-teen dyads. We performed exploratory factor analysis (EFA) to determine the factor structure followed by confirmatory factor analysis (CFA) to test the factor structure validity using two random subsets. We evaluated internal consistency by Cronbach alpha values and construct validity by comparing tVHS-COVID scores to intention to receive future COVID-19 doses.

EFA suggested a three-factor structure with 13-items. CFA indicated good fit for adolescents (CFI = 1.00; RMSEA = 0.023; SRMR = 0.062; NNFI-TLI = 0.998) and for parents (CFI = 1.00, RMSEA = 0.031; SRMR = 0.028; NNFI-TLI = 1.00). Internal consistency exceeded 0.79 for adolescents and 0.78 for parents. As tVHS-COVID scores increased, the percent of adolescent and parent respondents who reported they were willing to receive a COVID-19 vaccine decreased.

The tVHS-COVID offers a unique tool that can be used to monitor COVID-19 vaccine hesitancy among adolescents and their parents. As adolescents take on more proactive roles in medical decision-making, monitoring vaccine hesitancy among this population becomes increasingly important.