A Correlation Analysis between the Parent Attitudes about Childhood Vaccines Short Scale and the Vaccination Confidence Scale Open Access

Abstract

Background

Identifying vaccine-hesitant parents is important to deliver interventions that will boost vaccine acceptance and prevent progression to complete vaccine refusal. There is a need to identify an effective survey tool that can aid in classification of vaccine hesitancy among both parents of young children and parents of adolescents. The five-item Parental Attitudes about Childhood Vaccines (PACV) short scale is easier to administer, can be integrated into the clinical setting, and can be used for national surveillance but requires further testing and validation This analysis assessed the correlation between the PACV short scale and the Vaccination Confidence Scale.

Methods

By conducting a secondary analysis of baseline data collected for a Human Papillomavirus (HPV) vaccine uptake intervention trial, we assessed correlation using the Spearman correlation coefficient, the Cochran-Mantel-Haenszel statistic, and the Kappa coefficient. Logistic regression models were then developed to assess the associations between the PACV categories, the VCS categories and an outcome of the respondent’s intent to vaccinate their daughter against HPV.

Results

1421 participants were included in the analysis. The PACV and VCS categories were strongly correlated with each other (Spearman correlation coefficient = 0.69, p <.0001), and the Cochran-Mantel-Haenszel test of association showed a significant relationship (CMH statistic = 797.81, df = 4, p <.0001). Both tools were also found to have similar associations with an intent to vaccinate against HPV, indicating similar abilities in classifying vaccine confidence.

Conclusion

The PACV short scale and VCS tools showed similar abilities in identifying and classifying vaccine-hesitant parents, as well as estimating intent to vaccinate against HPV among parents of female young children and adolescents. The PACV short scale is an effective tool. The VCS may be used effectively to assess vaccine confidence among parents of young children as well as parents of adolescents.

Table of Contents

CHAPTER 1: REVIEW OF THE LITERATURE 1

Importance of Vaccination 1

Vaccination Recommendations and Coverage in the United States 3

Vaccine Acceptance 5

Importance of Identifying Vaccine Hesitancy 7

Existing Strategies to Classify Vaccine Hesitancy 9

Parent Attitudes About Childhood Vaccines (PACV) 11

Vaccination Confidence Scale (VCS) 12

Problem Statement 13

Purpose 13

Significance 14

CHAPTER 2: MANUSCRIPT 15

Contribution of the student 15

Abstract 15

Introduction 16

Methods 18

Results 21

Discussion 25

Conclusion 27

Tables and Figures 27

Table 1: Demographic Characteristics of Study Sample 27

Figure 1: Distribution of VCS Categories by PACV Category 29

Table 2: Summary of Correlation Analysis between the Parent Attitudes about Childhood Vaccines Short Scale and the Vaccine Confidence Scale Categories 29

Table 3: Multinomial regression: Associations between intention to vaccinate responses “No” and “Don’t Know”, as compared to “Yes”, and respondent’s PACV and VCS categories. 30

Table 4: Binary regression: Associations between no reported intention to vaccinate as compared to reported intent to vaccine and respondent’s PACV and VCS categories. 30

Supplement: Descriptive Statistics of Respondents with Matched vs. Unmatched Vaccine Confidence/Acceptance Categories 31

CHAPTER 3: CONCLUSION AND PUBLIC HEALTH IMPLICATIONS 32

REFERENCES 34

APPENDICES 38

Appendix 1: United States Immunization Schedule 38

Appendix 2: Survey Instrument 39

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Human papillomavirus vaccine adolescent vaccination vaccination vaccine confidence vaccine acceptance survey vaccine acceptance vaccine hesitancy
Committee Chair / Thesis Advisor	Omer, Saad, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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