Vaccination Knowledge, Attitudes and Practices Among Healthcare Students in Spain: Development and Psychometric Validation of a Life-Course Immunization Questionnaire

Abstract

[EN] Vaccine hesitancy represents a threat to immunization programs and herd immunity. Our objective was to validate a Spanish-language questionnaire to assess knowledge, attitudes, and practices (KAP) of students in the healthcare field regarding vaccination and the immunization schedule. Methods: An online questionnaire was developed and distributed via RedCap v.13.7.1 to healthcare students undertaking clinical placements at the University Hospital of Santiago de Compostela during the 2024–2025 academic year. The questionnaire assessed nine dimensions through thirty-four items. Validation was carried out in two phases: (1) translation and expert content validation, and (2) reliability testing using Cronbach’s alpha and validity assessment through principal component analysis (PCA). Results: A total of 398 students completed the questionnaire. The mean age was 23.78 ± 3.77 years. Of these, 19.60% were men (n = 80) and 77.50% were women (n = 316). Validation of the questionnaire was carried out with a random sample of 294 students. The final 30-item questionnaire demonstrated high internal consistency (Cronbach’s alpha = 0.83) and construct validity, confirmed by PCA, supporting the presence of nine dimensions that explained 60.93% of the total variance. Overall, 74.70% of students reported that scientific evidence was the main influence on their opinion about vaccines. Regarding practices, 76.10% believed that certain vaccines should be mandatory for healthcare personnel. Conclusions: The questionnaire demonstrated reliability and validity for evaluating KAP on vaccination among future healthcare professionals. Having this instrument available will help guide future educational interventions and strengthen their role as trusted agents in immunization.