Understanding the Dimensions of Anti-Vaccination Attitudes: the Vaccination Attitudes Examination (VAX) Scale
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ORIGINAL ARTICLE
Understanding the Dimensions of Anti-Vaccination Attitudes: the Vaccination Attitudes Examination (VAX) Scale Leslie R. Martin, PhD 1 & Keith J. Petrie, PhD 2
# The Society of Behavioral Medicine 2017
Abstract Background Anti-vaccination attitudes are important predictors of vaccination behavior. Existing measures of vaccination attitudes focus on specific age groups and/or particular vaccines; a more comprehensive measure would facilitate comparisons across studies. Purpose The aim of this study was to develop a short measure of general vaccination attitudes and establish its reliability and validity. Methods Two studies were conducted using the VAX scale. For Study 1, participants were 409 individuals (53% female), with a mean age of 34.5 years. For Study 2, participants were 92 individuals (67% female) with a mean age of 28.6. Participants answered paper-and-pencil questions about their attitudes toward vaccines, prior and expected-future vaccination behaviors, perceived sensitivity to medicines, online behavior, and basic demographic information. Exploratory and confirmatory factor analyses were conducted with correlations and t tests then used to assess the scale’s reliability and validity. Results Four distinct but correlated vaccine attitudes were identified: (1) mistrust of vaccine benefit, (2) worries about unforeseen future effects, (3) concerns about commercial profiteering, and (4) preference for natural immunity. These factors were significantly related to prior vaccination behavior, future intentions to obtain recommended vaccinations,
* Leslie R. Martin [email protected]
1
Department of Psychology, La Sierra University, 4500 Riverwalk Parkway, Riverside, CA 92515, USA
2
Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
perceived sensitivity to medicines, and the tendency to obtain health information online. Conclusions The VAX scale provides an efficient method for identifying those with vaccination resistance, and the four subscales enable a more nuanced understanding of the nature of those views. It should be noted, however, that the strong correlations amongst the four subscales suggest that interventions should target all four attitude areas, and it remains to be seen whether differential emphasis across the four areas is warranted. Keywords Vaccination behavior . Vaccination attitudes . Scale development . Vaccine . Intentions
Despite the demonstrated effectiveness of vaccines for reducing the mortality and morbidity of communicable diseases, vaccination rates are on the decline in many areas of the world [1, 2]. This has led to a commensurate resurgence of diseases thought to be largely controlled or eradicated [3, 4]. Recently, refusal to vaccinate has been related to outbreaks of whooping cough, measles, and other vaccine preventable illnesses [5, 6]. Failure to vaccinate is an important health behavior, but it is important to recognize that individuals may have arrived at this decision through quite different pathways. In certai
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