Italian version of the Vaccination Fear Scale (VFS-6): internal and external validation

Mirko Duradoni, Marta Villen Veloso, Martina La Gamma, Anna Maria Monciatti, Andrea Guazzini


Background: COVID-19 is one of the biggest threats in our current society in terms of mental and public health. Vaccination represents the most cost-efficient way to avoid disease, mental health negative outcomes, and an overload of the healthcare system, however, many people expressed fears and concerns related to COVID-19 vaccines.  This paper presents the Italian validation of the Vaccination Fear Scale (VFS-6) originally developed in Spanish to complement clinical efforts in the prevention of vaccine hesitancy.

Methods: The sample was composed of 1111 Italian participants (14.2% not vaccinated) recruited by means of on-line anonymous voluntary census. The items of the VFS-6 were firstly adapted to the Italian language by means of a translation and back-translation standard procedure, and subsequently administered together with convergent and divergent concurrent measures to ascertain their reliability and validity (i.e., internal and external) properties. Finally, confirmatory factor analysis has been carried out to validate the internal structure of the test and investigate its psychometric properties.

Results: Confirmatory factor analysis supported a bifactorial model (cognitive and physical factors) also for the Italian version of the test, with very robust goodness of fit indicators, reliability, and internal consistency. Our data indicated that fear of vaccination is greater for females and highly correlated with vaccine anxiety and hesitancy. In particular, vaccine fear appeared strongly related to vaccination.

Conclusion: The Italian version of the VFS-6 appears valid and reliable to assess the fear of vaccination among the Italian population, as well as to support the research for the design of public campaigns devoted to decreasing vaccine hesitancy.


Vaccination Fear Scale; Vaccines; Hesitance; Covid-19; Validity and Reliability.

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