HAVI: A novel tool to explore vaccine hesitancy among adults in Greece

Vaccine hesitancy remains a critical public health challenge, influenced by demographic and cultural factors. In Greece, age and gender are significant determinants. This study aimed to develop and validate a culturally adapted survey instrument, the Hellenic Attitudes towards Vaccination Index (HAVI), to assess beliefs and attitudes towards vaccination among Greek adults. Additionally, the study sought to investigate the impact of gender and age on vaccine hesitancy. By adapting an existing questionnaire, we ensured cultural and linguistic relevance to the Greek context. This novel study employed a cross-sectional design, recruiting 184 adults (92 males, mean age = 40.2 years; 92 females, mean age = 38.8 years). Participants completed the 22-item HAVI questionnaire. Data analysis included Exploratory Factor Analysis (EFA), correlation analysis, internal consistency assessment, and regression analysis. EFA revealed a four-factor structure: (1) Perceived Vaccine Safety, (2) Perceived Vaccine Effects, (3) Attitudes Towards Health Authorities, and (4) Perceived Benefit of Mandatory Vaccines. A heatmap provided an intuitive visualization of item-factor relationships. The instrument demonstrated excellent reliability (Cronbach's α = 0.92). Although explaining small to moderate amount of variance, there were key findings identified significant gender differences, with females showing higher vaccine hesitancy, and an inverse correlation between age and positive vaccination attitudes. HAVI represents a reliable and practical tool for assessing vaccine hesitancy in Greek adults, offering valuable insights to guide targeted public health strategies.