Adaptation and validation of a French version of the Vaccination Attitudes Examination (VAX) scale

Over the past decades, vaccination has proven to be largely beneficial to global health. Despite vaccine efficacy, the French population has been recently affected by more anti-vaccination attitudes and vaccine refusal, and it is therefore necessary to develop and validate tools to study this health issue. The Vaccination Attitudes Examination scale is a brief 12-item questionnaire targeting adults, that assesses general attitudes towards vaccination. The aims of the study were (1) to translate and adapt the original English version of the scale into French and (2) to test the psychometric properties of the scale in a French population-based sample of adults. We included 450 French speaking adults that completed the French Vaccination Attitudes Examination scale and other questionnaires in order to assess convergent and divergent validities. Exploratory and confirmatory factor analyses showed that the French version of the Vaccination Attitudes Examination scale replicated the factorial structure of the original scale. Moreover, it demonstrated high internal consistency, good convergent and divergent validities, and excellent temporal stability. Also, scores on the scale differentiated vaccinators from non-vaccinator respondents. Results on the scale provides us with insight into factors involved in vaccine hesitancy in France, therefore allowing French authorities and policy makers to address these specific concerns and by consequence improve vaccine acceptance rates in this country.