Abstract
Objective
To validate a brief measure of vaccination confidence using a large, nationally representative
sample of parents.
Methods
We analyzed weighted data from 9018 parents who completed the 2010 National Immunization
Survey–Teen, an annual, population-based telephone survey. Parents reported on the
immunization history of a 13- to 17-year-old child in their households for vaccines
including tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, and
human papillomavirus vaccines. For each vaccine, separate logistic regression models
assessed associations between parents' mean scores on the 8-item Vaccination Confidence
Scale and vaccine refusal, vaccine delay, and vaccination status. We repeated analyses
for the scale's 4-item short form.
Results
One quarter of parents (24%) reported refusal of any vaccine, with refusal of specific
vaccines ranging from 21% for human papillomavirus to 2% for Tdap. Using the full
8-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
(odds ratio, 2.08; 95% confidence interval, 1.75–2.47) or low (odds ratio, 4.61; 95%
confidence interval, 3.51–6.05) versus high. For the 4-item short form, scores were
also consistently associated with vaccine refusal and vaccination status. Vaccination
confidence was inconsistently associated with vaccine delay.
Conclusions
The Vaccination Confidence Scale shows promise as a tool for identifying parents at
risk for refusing adolescent vaccines. The scale's short form appears to offer comparable
performance.
Keywords
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Article info
Publication history
Published online: August 20, 2015
Accepted:
June 13,
2015
Received:
March 10,
2015
Footnotes
PR has received HPV vaccine-related grants from Merck Sharp & Dohme Corp and from Cervical Cancer–Free America via an unrestricted educational grant from GlaxoSmithKline. AD serves on advisory boards for Merck and Pfizer but has not received any research funding from these companies. NB has received HPV vaccine–related grants from or been on advisory boards for GlaxoSmithKline and Merck. MG, BM, and ALM have no disclosures to report.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
