The Vaccination Confidence Scale: A brief measure of parents' vaccination beliefs

Melissa B. Gilkey, Brooke E. Magnus, Paul L. Reiter, Annie Laurie McRee, Amanda F. Dempsey, Noel T. Brewer

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Purpose: The success of national immunization programs depends on the public's confidence in vaccines. We sought to develop a scale for measuring confidence about adolescent vaccination in diverse populations of parents. Methods: Data came from 9623 parents who completed the 2010 National Immunization Survey-Teen, an annual, population-based telephone survey. Parents reported on a 13- to 17-year-old child in their households. We used exploratory and confirmatory factor analysis to identify latent constructs underlying parents' responses to 8 vaccination belief survey items (response scale 0-10) conceptualized using the Health Belief Model. We assessed the scale's psychometric properties overall and across demographic subgroups. Results: Parents' confidence about adolescent vaccination was generally high. Analyses provided support for three factors assessing benefits of vaccination (mean. = 8.5), harms of vaccination (mean. = 3.3), and trust in healthcare providers (mean. = 9.0). The model showed good fit both overall (comparative fit index. = 0.97) and across demographic subgroups, although internal consistency was variable for the three factors. We found lower confidence among several potentially vulnerable subpopulations, including mothers with lower levels of education and parents whose children were of Hispanic ethnicity (both p

Original languageEnglish (US)
Pages (from-to)6259-6265
Number of pages7
Issue number47
StatePublished - Oct 29 2014

Bibliographical note

Funding Information:
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 an advisory board for Merck, but has not received any research funding from this company. 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.

Funding Information:
This study was supported by an Academic Pediatric Association Young Investigator Award and the Cancer Control Education Program at UNC Lineberger Comprehensive Cancer Center ( R25 CA57726 ). The funders did not play a role in study design, data analysis, report writing, or the decision to submit the article for publication.

Publisher Copyright:
© 2014 Elsevier Ltd.


  • Adolescent health
  • Human papillomavirus vaccine
  • Immunization
  • Meningococcal vaccine
  • Tetanus vaccine
  • Vaccine hesitancy

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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