Development of a measure to assess vaccine confidence among men who have sex with men

ABSTRACT

Background: Recent serogroup C meningococcal disease outbreaks led to meningococcal vaccine recommendations for Southern California men who have sex with men (MSM). Assessment of vaccine confidence is critical to improving vaccine coverage in the context of disease outbreaks wherein immunization(s) are recommended.

Methods: We surveyed MSM using venue-based sampling and began development of the vaccine confidence index (VCI) with 30 survey items corresponding to trust- and safety-related perceptions. We performed exploratory factor analyses and computed the Cronbach’s alpha coefficient to assess internal consistency of the VCI. We created a categorical confidence variable (low, medium, and high confidence) and conducted bivariate and multivariate analyses to evaluate associations with reported confidence and immunization uptake.

Results: Ten survey items were included in the final VCI and formed the confidence measure. Participants with low confidence had the lowest levels of reported uptake for both meningococcal vaccines. Confidence differed significantly (p ≤ 0.05) between MSM who indicated they received vaccines recommended within the context of the outbreak and those who did not.

Conclusions: Our VCI is sensitive to a number of issues that may influence vaccine confidence. It is useful for assessing MSM trust and acceptance of recommended immunizations and may be used to inform intervention development.

KEYWORDS:

• Immunization acceptance
• immunization assessment
• MSM
• vaccine confidence
• vaccine measurement

Acknowledgments

We wish to thank the participants who responded to our survey and to the staff of partner venues for their support during the implementation of this study. We also wish to thank Drs Patrick Sullivan and Kimberley Hagen (Emory University) and the Prevention Science and Development Cores at the Emory Center for AIDS Research for support of this collaboration. Special thanks to Adam Cohen, Matthew Beymer, Adrian King, and Michelle Parra for their insights and input in assisting with the development and presentation of final results of the study.

Declaration of interest

PM Frew is the PI of a cooperative agreement to Emory University from NVPO (HHS) that provided salary/travel support to the project and received collaboration/travel support funds from the Emory University Center for AIDS Research (CFAR) and the California HIV/AIDS Policy Research Center. IW Holloway is the PI of the California HIV/AIDS Policy Research Center that provided grant (salary/travel) support to this project. C Goldbeck is a graduate student/data analyst with the California HIV/AIDS Policy Research Center that provided grant/salary support to this project. D Tan is a graduate student/data analyst with the California HIV/AIDS Policy Research Center that provided grant/salary support to this project. E Wu is a project manager with the California HIV/AIDS Policy Research Center that provided grant support to this project. J Jauregui is a graduate student/data analyst with the California HIV/AIDS Policy Research Center that provided grant support to this project. V Fenimore was a staff research associate/data analyst with the California HIV/AIDS Policy Research Center that provided grant support to this project. L Randall is the project coordinator of a cooperative agreement to Emory University from NVPO (HHS) that provided salary/travel support to the project and received additional travel support the California HIV/AIDS Policy Research Center.

C Lutz is the data analyst of a cooperative agreement to Emory University from NVPO (HHS) that provided salary support to the project. J. Mendel is the project officer of a cooperative agreement to Emory University from NVPO (HHS). A. Aikin is a technical expert to a cooperative agreement to Emory University from NVPO (HHS). G. Nowak was an external expert advisor to a cooperative agreement to Emory University from NVPO (HHS). R Bednarczyk is the PI of a grant from the National Institute for Allergy and Infectious Diseases, National Institutes of Health that provided salary/travel support to the project; R Bednarczyk is a PI of a cooperative agreement to Emory University from NVPO (HHS) that provided salary/travel support to the project. All authors declare there are no known conflicts to disclose. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Disclaimer

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the U.S. Department of Health and Human Services.

Additional information

Funding

This study was supported by a grant from the California HIV/AIDS Research Program [RP15-LA-007], a grant from the US Department of Health and Human Services, National Vaccine Program Office [1VSRNV000003], and a collaboration travel grant from the Emory University Center for AIDS Research [P30 AI050409].