Exploring Anti-vaccination Beliefs among the Youth Population: A Comprehensive Validation of the Arabic VAX Scale for In-depth Attitude Analysis

Background The rise of anti-vaccination sentiments among the youth has become a significant public health concern, highlighting the need for effective tools to understand and address these beliefs. Aims This research introduces the Arabic VAX Scale, designed to assess and analyze the complex attitudes towards vaccinations within Arabic-speaking populations. Methods A cross-sectional study was conducted among undergraduate students from different disciplines in governmental universities in Riyadh, Saudi Arabia, between November 2020 and August 2021. Results The translated questionnaire was piloted among 39 Arabic-speaking participants. Subsequently, it was electronically sent to 2000 undergraduate university students attaining 319 complete responses. Majority were females (69.3%; n=221), averaging 21.6±2.7 years. The factor analysis of VAX-AR questionnaire loaded fittingly on the four subdomains previously defined in the original VAX questionnaire. The reliability analysis revealed a Cronbach's α score of 0.70 – 0.88 for all subdomains. Higher VAX-AR scores reliably correlated with negative behaviors and attitudes towards Flu, COVID-19, and mandatory vaccinations (p<.001). Anti-vaccination ideas stemming from religious beliefs were associated with ideas pertaining to the commercial profiting. Conclusion VAX-AR scale has good validity and reliability scores and can be used to assess the prevalence of anti-vaccination beliefs and ideas in Arabic-speaking populations.