Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, CDMX, Mexico.
Department of Rheumatology, Hospital General de México Dr. Eduardo Liceaga, CDMX, México.
Hum Vaccin Immunother. 2021 Dec 2;17(12):5038-5047. doi: 10.1080/21645515.2021.2003649.
Vaccine hesitancy (VH) has emerged as a recognized threaten to contain the COVID-19 pandemic. Historically, low vaccine acceptance rates had been described among patients with rheumatic diseases (RMDs). The study objective was to determine COVID-19 VH among Mexican outpatients with RMDs and validate the COVID-19 VH questionnaire. This cross-sectional study was developed in three steps. Step 1 consisted of translation/cultural adaptation of the Oxford-COVID-19-VH questionnaire. Step 2 consisted of pilot testing and questionnaire feasibility, content, construct and criterion validity, reliability (internal consistency and temporal stability) and questionnaire sensitivity to change. Step 3 consisted of VH phenomenon quantification in patients from two metropolitan tertiary-care-level centers. Step 1 followed ISPOR-task-force recommendations. Patients who participated in step 2 (n = 50 for pilot testing/feasibility and n = 208 for questionnaire validation [91 in test-retest and 70 in questionnaire-sensitivity to change]) and step 3 (n = 600) were representative outpatients with RMDs. The seven-item COVID-19 VH questionnaire was found feasible, valid (experts' agreement ≥80%; a 1-factor structure accounted for 60.73% of the total variance; rho = 0.156, = .025 between COVID-19 VH questionnaire and score from the Spanish version of the Vaccine Hesitancy Scale; and lower questionnaire scores in patients who reported 5 years-previous influenza vaccination), reliable (Cronbach's ɑ = 0.889, intra-class correlation coefficient = 0.933 and 95% confidence interval = 0.898-0.956) and sensitive to change (effect size = 1.17 and 0.86, respectively, in patients who decreased [n = 34] and increased [n = 31] questionnaire-score after intervention). VH phenomenon was 35.5%. VH phenomenon was present in a substantial number of Mexican patients with RMDs. The COVID-19 VH questionnaire showed good psychometric properties to assess COVID-19 VH in our population.
疫苗犹豫（VH）已成为控制 COVID-19 大流行的公认威胁。历史上，风湿性疾病（RMDs）患者的疫苗接种率一直较低。本研究的目的是确定墨西哥门诊 RMD 患者的 COVID-19 VH，并验证 COVID-19 VH 问卷。这项横断面研究分三步进行。步骤 1 包括翻译/文化适应牛津 COVID-19-VH 问卷。第 2 步包括试点测试和问卷可行性、内容、结构和标准效度、可靠性（内部一致性和时间稳定性）以及问卷对变化的敏感性。第 3 步是在两个大都市三级保健中心的患者中量化 VH 现象。步骤 1 遵循 ISPOR 工作组的建议。参加第 2 步（n=50 用于试点测试/可行性，n=208 用于问卷验证[91 用于测试-再测试，70 用于问卷对变化的敏感性]）和第 3 步（n=600）的患者具有代表性门诊 RMD 患者。发现七项 COVID-19 VH 问卷具有可行性、有效性（专家意见≥80%；一个因素结构占总方差的 60.73%；rho=0.156，=0.025，COVID-19 VH 问卷与西班牙版疫苗犹豫量表的得分之间；以及报告 5 年前流感疫苗接种的患者问卷得分较低）、可靠性（Cronbach's α=0.889，组内相关系数=0.933 和 95%置信区间=0.898-0.956）和对变化敏感（在干预后降低[n=34]和增加[n=31]问卷评分的患者中，效应量分别为 1.17 和 0.86）。VH 现象为 35.5%。在大量患有 RMD 的墨西哥患者中存在 VH 现象。COVID-19 VH 问卷具有良好的心理测量特性，可用于评估我们人群中的 COVID-19 VH。
