[Validation of the Vaccination Attitudes Examination (VAX) scale in Hungary]

Attitudes toward vaccination play a crucial role in shaping vaccination behavior; however, in Hungary, there is currently no validated instrument suitable for the psychometrically sound assessment of such attitudes in the general adult population.

The aim of this study was to adapt the Vaccination Attitudes Examination (VAX) scale into Hungarian and to examine its psychometric properties in a sample of the adult Hungarian population.

We analyzed data from a nationally representative cross-sectional survey of adults aged 18 years and older (n = 1000). The factor structure of the scale was examined using exploratory and confirmatory factor analyses (the former using maximum likelihood estimation with oblimin rotation, the latter using DWLS estimation appropriate for ordinal items). Internal consistency was assessed using Cronbach's alpha and CFA-based reliability indices. Convergent validity was evaluated by examining associations with theoretically relevant attitudinal and trust-related variables.

The findings supported a theoretically coherent four-factor structure. The total scale and subscales demonstrated good to excellent internal consistency (α = 0.69-0.92). VAX scores showed strong positive associations with conspiracy beliefs and moderate to strong negative associations with trust in science and institutions. Respondents who had not received a COVID-19 vaccine scored significantly higher on all subscales.

The Hungarian version of the VAX scale reliably and validly measures the multidimensional structure of vaccine-skeptical attitudes. The results are consistent with international validation studies and support the applicability of the scale in the Hungarian context.

The Hungarian version of the VAX scale is an appropriate instrument for research on vaccination attitudes and for examining the social and psychological determinants of vaccine hesitancy. Orv Hetil. 2026; 167(27): 1059-1067.