Assessing Parental Intention to Vaccinate their Children Against COVID-19: Validation of the Modified Japanese 7C Vaccination Readiness Scale

Parental willingness is a prerequisite for childhood immunization. This study evaluated whether parental vaccination readiness and willingness, measured using the modified Japanese 7C Vaccination Readiness Scale, predicted vaccination behavior. In December 2021, 2 months before the approval of COVID-19 vaccination for children aged 5–11 years in Japan, we asked 1,190 parents of children in this age groups about their intention regarding vaccinating their children against COVID-19 using an online modified 7C Vaccination Readiness Scale, consisting of seven components, namely, Confidence, Complacency, Constraints, Calculation, Collective responsibility, Compliance, and Conspiracy. The modified 7C components were analyzed for model fit and association with parental intention using structural equation modeling. The model fit of the modified 7C scale was good (goodness-of-fit index: 0.98), and the factor loadings and model fit for parental readiness were high (standardized factor loadings: 0.84). In January 2024, we asked the same parents about their children's COVID-19 vaccination status (valid responses: 536). The components of the modified 7C scale were compared with actual vaccination behavior. Parents with a low readiness to vaccinate their children against COVID-19 had a high actual non-vaccination rate. The use of the modified 7C scale may assist in the development of childhood vaccination interventions.