Abstract. Although vaccines are among the most effective interventions used in fighting diseases, vaccination readiness varies substantially among individuals. Vaccination readiness is defined as a set of components that increase or decrease AN individual’s likelihood of getting vaccinated. Building on earlier work that distinguished five components of vaccination readiness (confidence, complacency, constraints, calculation, and collective responsibility), we revised the questionnaire used to measure these components to improve its psychometric properties, specifically criterion validity. In doing so, we also developed two new components of vaccination readiness: compliance and conspiracy. Compliance is the tendency to support monitoring to control adherence to regulations; conspiracy is the tendency to endorse conspiratorial beliefs about vaccination. The newly introduced 7C scale was initially piloted in a cascade of serial cross-sectional studies and then validated with N = 681 participants from the COVID-19 Snapshot Monitoring in Denmark. We report a bifactor measurement model, convergent validity with other questionnaires, and an explanation of 85% variance in the willingness to vaccinate against COVID-19. We also present a 7-item short version of the scale. The instrument is publicly available in several languages ( www.vaccination-readiness.com ), and we seek collaboration to provide translations of our instrument into other languages.

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To reach high vaccination rates against COVID-19, children and adolescents should be also vaccinated. To improve childhood vaccination rates and vaccination readiness, parents need to be addressed since they decide about the vaccination of their children. We adapted the 7C of vaccination readiness scale to measure parents’ readiness to vaccinate their children and evaluated the scale in a long and a short version in two studies. The study was first evaluated with a sample of N = 244 parents from the German COVID-19 Snapshot Monitoring (COSMO) and validated with N = 464 parents from the Danish COSMO. The childhood 7C scale showed acceptable to good psychometric properties in both samples and explained more than 80% of the variance in vaccination intentions. Additionally, differences in parents’ readiness to vaccinate their children against COVID-19 were strongly determined by their readiness to vaccinate themselves, explaining 64% of the variance. Vaccination readiness and intentions for children changed as a function of the children’s age explaining 93% of differences between parents in their vaccination intentions for their children. Finally, we found differences in correlations of components with self- versus childhood vaccination, as well as between the children’s age groups in the prediction of vaccination intentions. Thus, parents need to be targeted in specifically tailored ways, based on the age of their child, to reach high vaccination rates in children. The scale is publicly available in several languages (www.vaccination-readiness.com).

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BackgroundRecent studies reported an increase in colorectal cancer incidence for adults below 50 years. There is a lack of studies distinguishing between histological subgroups, especially from Europe.MethodsUsing data from the Bavarian Cancer Registry, we analyzed incidence trends in colorectal cancer by age (20–29, 30–39, 40–49, and 50 years and above), anatomic site (colon without appendix, appendix, and rectum), and histological subgroup (adenocarcinoma and neuroendocrine neoplasm) from 2005 to 2019. 3-year average annual age-standardized incidence rates (ASIR) per 100,000 persons for the beginning (2005–2007) and the end (2017–2019) of the study period and estimated average annual percentage change.ResultsData from 137,469 persons diagnosed with colorectal cancer were included. From 139,420 cases in total, 109,825 (78.8%) were adenocarcinomas (ACs), 2,800 (2.0%) were neuroendocrine neoplasms (NENs), and 26,795 (19.2%) had other histologies. This analysis showed a significant increase in the 3-year average annual ASIR of colorectal NENs in all age groups between 2005–2007 and 2017–2019 with the highest increase in the age groups 30–39 years (0.47 to 1.53 cases per 100,000 persons; +226%; p < 0.05) and 20–29 years (0.52 to 1.38 cases per 100,000 persons; +165%; p < 0.05). The increase was driven by appendiceal and rectal NENs but not by colonic NENs. The 3-year average annual ASIR of colorectal ACs did not change significantly for the age groups below 50 years. For those aged 50 years and above, the 3-year average annual ASIR of colorectal ACs decreased significantly (132.55 to 105.95 cases per 100,000 persons; −20%; p < 0.05]). The proportion of NENs increased across all age groups, especially in the younger age groups.ConclusionFuture studies that analyze trends in early-onset colorectal cancer need to distinguish between anatomic sites as well as histological subgroups and may, thus, provide useful information regarding the organization of colorectal cancer screening, which primarily helps to detect adenomas and adenocarcinomas."