A Validation and Feasibility of a Questionnaire to Assess Literacy, Fear, Hesitancy, and Acceptance of COVID-19 Vaccine in Thailand

Pallop Siewchaisakul1, Sirinya Nanthanangkul2, Jirapat Longkul3, Pongdech Sarakarn4, 5, Jukkrit Wungrath1, *
1 Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
2 Research Publishing and Academic Support Department, Udonthani Cancer Hospital, Department of Medical Services, Ministry of Public Health, Nong Phai, Thailand
3 Faculty of Public health, Thammasat University, Bangkok, Thailand
4 Epidemiology and Biostatistics Department, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
5 ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen, Thailand

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© 2022 Siewchaisakul et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand. Tel: +66-81-595-9638; E-mail:



Few studies have developed tools to evaluate COVID-19 vaccine literacy (VL), especially in Asia. In this study, an online tool was utilized to assess COVID-19 VL, vaccine fear (VF), vaccine hesitancy (VH), and vaccine acceptance (VA) among village health volunteers (VHVs) in Thailand.


A cross-sectional online questionnaire was distributed to 210 VHVs between 10th to 14th September, 2021 to assess their VL, VF, VH, and VA levels. Item objective congruence (IOC) and Cronbach’s alpha were used to estimate the validity and reliability of the questionnaire. The two-independent sample t-test, Wilcoxon rank-sum test, ANOVA, and the Kruskal-Wallis test were employed to compare differences between the scores. Pearson correlation and Spearman’s rank correlation were used to estimate the correlation of the scores.


The online questionnaire showed high validity, with IOC values over 0.70 and reliability over 0.87 for all items. Median scores of VL, VF, and VH for the 210 participants were high (VL 2.92 and VF 2.5 out of a maximum of 4, and VH 2.43 out of a maximum of 5). The mean VA score was low (0.21 out of a maximum of 1) and significantly different between demographic variables. A significant correlation was found between VL and VH and VF and VA.


The online questionnaire showed high values of validity and reliability. This tool proved to be beneficial for evaluating VL, VF, VH, and VA in Thailand. Further studies using a larger population are required to verify these results.

Keywords: Literacy, Fear, Hesitancy, Acceptance, COVID-19 vaccine, Validation, Feasibility.