September 3, 2015

In the United States, there is a sizable minority of parents who have concerns that lead them to refuse or delay certain vaccines for their children. The most common concerns include fears about long-term adverse effects, believing the vaccine is not truly needed and uncertainty about effectiveness.

Assessing parents’ vaccination beliefs is critical to surveillance and intervention efforts, but the field currently lacks a holistic measure that characterizes vaccination beliefs regarding adolescents.

To develop such a tool, a team of researchers sought to validate the Vaccination Confidence Scale, an eight-item, three-factor measure of vaccination beliefs that prior research has shown to be highly reliable across diverse populations.

Dr. Noel Brewer

Dr. Noel Brewer

Noel T. Brewer, PhD, associate professor of health behavior at the UNC Chapel-Hill Gillings School of Global Public Health and member of the Lineberger Comprehensive Cancer Center, is the study’s senior author. Lead author Melissa B. Gilkey, PhD, is a former postdoctoral research associate at the Lineberger Cancer Center; she is now assistant professor of population medicine at Harvard Medical School.

Using a nationally representative sample of parents of adolescents, the study analyzed associations between Vaccination Confidence Scale scores and vaccine refusal, vaccine delay and vaccination status.

Using the full eight-item scale, vaccination confidence was negatively associated with measures of vaccine refusal and positively associated with measures of vaccination status. For example, refusal of any vaccine was more common among parents whose scale scores were medium or low versus high. A four-item, short form of the scale yielded similar results.

This study concludes that the Vaccination Confidence Scale shows promise as a tool for identifying parents at risk for refusing adolescent vaccines. By validating this brief measure of vaccination beliefs, the researchers aim to provide a practical tool for understanding and intervening on forgone vaccination among parents of adolescents.

The full article on these findings, titled “Validation of the Vaccination Confidence Scale: A Brief Measure to Identify Parents at Risk for Refusing Adolescent Vaccines,” was published online August 20 by Academic Pediatrics.


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Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu
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