Background and objectives
Short and valid instruments measuring vaccination attitudes across different countries are lacking. The recently developed 12-item Vaccination Attitudes Examination (VAX) scale measures vaccination hesitancy and has been translated into different languages. The aim was to validate the Danish translation of VAX.
Methods
VAX was translated from English to Danish applying Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes Measures. VAX was distributed to Danish citizens using social media and collected using the online survey system, SurveyXact. The construct, criterion, and known groups validity, as well as internal consistency reliability were examined. The factor structure was examined using confirmatory factor analysis (CFA). Internal consistency reliability was evaluated, and criterion validity was assessed using the beliefs about medicines questionnaire (BMQ). Known groups validity was tested using vaccination status.
Results
Responses from 194 participants were analysed. CFA showed an adequate four-subscale construct (GFI = 0.939, AGFI = 0.901, NFI = 0.955, TLI = 0.976, CFI = 0.982, RMSEA = 0.056, RMR = 0.087, p =0.005) and a high internal consistency reliability (Cronbach’s α 0.934). A significant correlation was with the BMQ-Total (r=-0.716, p<0.01). Significantly lower VAX item scores were in COVID-19 vaccinated (Mean (SD) = 2.36(0.83)) compared to non-vaccinated (Mean (SD) = 4.88(0.93)).
Conclusion
The Danish translation of the VAX scale showed a well-defined four-factor structure with high internal consistency, criterion validity, and known groups validity. It is a useful tool to measure vaccination hesitancy in Denmark and compare this concept with other countries.