TABLE.

5C^a Scale Vaccine Hesitancy Short-Form Questions and Possible Questions for Contraceptive Hesitancy-Acceptability

	Short-Form Questions^b
	Original Vaccine Hesitancy	Adapted Contraceptive Hesitancy-Acceptability
Confidence	I am completely confident that vaccines are safe. Vaccinations are effective. Regarding vaccines, I am confident that public authorities decide in the best interest of the community.	I am confident that contraceptives are safe. Contraceptives are effective. Regarding contraceptives, I am confident that health providers prioritize my best interest.
Constraints	Everyday stress prevents me from getting vaccinated. For me, it is inconvenient to be vaccinated. Visiting the doctor makes me feel uncomfortable; this keeps me from being vaccinated.	Circumstances in my life prevent me from using contraceptives. For me, it is difficult to access contraceptives. Visiting health providers makes me feel uncomfortable; this keeps me from using contraception.
Complacency	Vaccination is unnecessary because vaccine-preventable diseases are not common anymore. My immune system is so strong; it also protects me against diseases. Vaccine-preventable diseases are not so severe that I should be vaccinated.	Contraception is unnecessary because I am unlikely to have an unplanned pregnancy. My body is unlikely to be fertile; I do not need to worry about unplanned pregnancy. Contraception is unnecessary because an unplanned pregnancy would not be a problem for me.
Calculation	When I think about getting vaccinated, I weigh benefits and risks to make the best decision possible. For each and every vaccination, I closely consider whether it is useful for me. It is important for me to fully understand the topic of vaccination before I get vaccinated.	When I think about using contraceptives, I weigh benefits and risks to make the best decision possible. For each and every form of contraception, I closely consider whether it will be suitable for me. It is important for me to fully understand the topic of contraception before I use contraception.
Collective responsibility	When everyone is vaccinated, I don’t have to get vaccinated, too. I get vaccinated because I can also protect people with a weaker immune system. Vaccination is a collective action to prevent the spread of diseases.	It is my partner’s responsibility to contracept, so I don’t have to.^c I use contraception so I can take better care of my family. Contraception is an action that can improve the well-being of individuals, families, and communities.

^a Instructions for the 5C are: “Please evaluate how much you disagree or agree with the following statements.” (1=strongly disagree, 2=moderately disagree, 3=slightly disagree, 4=neutral, 5=slightly agree, 6=moderately agree, 7=strongly agree). The items used for the short scale are in bold font.
^b Items related to each of the short-form questions are bulleted beneath each short-form question. Adapted questions are provided for illustrative purposes only; they must be tested and validated.
^c Partner responsibility and collective responsibility do not involve equivalent actors but have in common a perception of shared responsibility for others’ health (e.g., the degree to which an individual perceives vaccination or contraception as part of their responsibility to others).