Department of Family Science, University of Maryland, College Park, MD, USA; Center for Health Equity, University of Maryland, College Park, MD, USA.
Center for Health Equity, University of Maryland, College Park, MD, USA.
Vaccine. 2019 Feb 21;37(9):1168-1173. doi: 10.1016/j.vaccine.2019.01.033. Epub 2019 Jan 29.
Vaccine hesitancy (VH) has emerged as a factor in vaccine delay and refusal yet the measurement of the constructs within vaccine hesitancy remains a challenge. Outstanding questions include; should VH be measured as an attitude or a behavior? What is the role of key constructs including confidence, complacency, and convenience? What is the role of trust? Should measures be general or vaccine specific? Furthermore, much of the research has centered on parental acceptance of vaccines for their children.
In March of 2015, we contracted with the GfK Group to conduct a nationally representative survey with 819 African American and 838 White, US born adults. Measures include general vaccine hesitancy and confidence, trust, and influenza vaccine specific measures of hesitancy, confidence and trust.
Factor analysis yielded a bi-factor structure for both general vaccine hesitancy and flu vaccine specific hesitancy. Greater hesitancy, both in general and specific to the flu vaccine, was associated with lower vaccine uptake. In the flu vaccine specific model, greater confidence was associated with higher vaccine uptake. Trust remained distinct from vaccine confidence in both the general and flu vaccine specific models.
Clearly, there is value in the utilization of general vaccine hesitancy and confidence measures, as well as vaccine specific measures. Trust continues to provide additional insights apart of vaccine confidence and remains an important factor for inclusion in future research. Our set of measures can be tested and validated with other populations and applied to other vaccines for adults and children.
疫苗犹豫（VH）已成为疫苗延迟和拒绝接种的一个因素，但疫苗犹豫的结构测量仍然是一个挑战。悬而未决的问题包括：VH 是否应作为态度或行为来衡量？信心、自满和便利等关键结构的作用是什么？信任的作用是什么？测量方法应该是一般性的还是针对疫苗的？此外，许多研究都集中在父母对子女疫苗的接受程度上。
2015 年 3 月，我们与 GfK 集团合作，对 819 名非裔美国人和 838 名美国出生的白种人进行了一项全国代表性调查。测量方法包括一般疫苗犹豫和信心、信任以及流感疫苗特定的犹豫、信心和信任措施。
因子分析得出了一般疫苗犹豫和流感疫苗特定犹豫的双因素结构。更大的犹豫，无论是一般的还是针对流感疫苗的，都与较低的疫苗接种率有关。在流感疫苗特定模型中，更大的信心与更高的疫苗接种率相关。在一般和流感疫苗特定模型中，信任与疫苗信心不同。
显然，使用一般疫苗犹豫和信心测量方法以及疫苗特定测量方法是有价值的。除了疫苗信心之外，信任仍然提供了额外的见解，并且仍然是未来研究中纳入的一个重要因素。我们的一整套措施可以用其他人群进行测试和验证，并应用于成人和儿童的其他疫苗。
