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ABSTRACTNo validated measures of vaccine hesitancy (VH) for youth vaccination currently exist. We adapted the Parent Attitudes about Childhood Vaccines survey (PACV-15) for use in youth to create the version Youth Attitudes about Vaccines survey (YAV-14 and YAV-5), then translated it into three languages (German, French, and Italian). We administered the YAV-14 to 1,003 youth aged 15–26 years in Switzerland. We used exploratory factor analysis and Mokken scale analysis to explore the psychometric properties, Cronbach’s alpha to investigate the reliability for the YAV-14 and the YAV-5, but we only report results of the YAV-5 analysis here. We determined construct validity by logistic regression of the association between youth VH as measured by the YAV-5 and non-receipt of the first human papillomavirus (HPV) vaccine dose. EFA produced a single scale in German and French while two factors were obtained in Italian. All language versions fit the Mokken scale models with medium-scale strength. There was a significant association between VH and HPV vaccine non-receipt for the full sample (odds ratio (OR); 1.93, 95% confidence interval (CI); 1.31–2.85). Language-stratified analyses found a significant association between VH and non-immunization in the German-language sample. Our results demonstrate that the German version of YAV-5 is a valid and reliable scale for identifying vaccine hesitant youth regardless of sex, and the French version is a valid and reliable scale for identifying vaccine hesitant female youth. Further validation is needed for Italian and French-speaking male youth.

ABSTRACTVaccine hesitancy (VH) is a complex and context-specific phenomenon that is linked to under-immunization and poses challenges to immunization programs. The Parent Attitudes about Childhood Vaccines (PACV) is an instrument developed to measure VH. We translated the PACV into three languages (German, French and Italian) and administered it to 1388 Swiss parents. We used exploratory factor analysis (EFA) to confirm the scale sub-domains, Cronbach’s alpha to assess internal consistency reliability, and Mokken scale analysis (MSA), to explore unidimensionality of each language version. We determined to construct validity by linking parental PACV score to children’s immunization status for the first dose of measles vaccine. For the 15-item PACV, EFA extracted three sub-domains in German and French and four sub-domains in Italian. Cronbach’s alpha was >0.8 across the three languages, and MSA produced a 13-item German, 14-item French, and 11-item Italian PACV. EFA and MSA of the short version PACV extracted a single factor and scale with Cronbach’s alpha >0.7 in all three language versions. VH was significantly associated with non-timely receipt of the first dose of measles in all languages (odds ratio of 20.7, 21.3, and 8.3 for German, French, and Italian languages, respectively). The translated and revised PACV-15 versions are valid and reliable instruments for VH measurement. The structure and reliability of the short version of the PACV was as good as the long version. Our results suggest that the PACV can be used to measure parental VH outside the US in the validated languages.