研究背景： 台灣在後疫情時代，面臨COVID-19與季節性流感可能交替或共同流行的挑戰，提升整體疫苗覆蓋率是降低併發重症與死亡風險並保全醫療量能的重要策略。然而，在政府同時推動COVID-19疫苗與流感疫苗之接種政策下，兩種疫苗接種率卻存在明顯差異。有鍳於現有研究多以單一疫苗為分析對象，缺乏在同一樣本下比較影響跨疫苗心理機制之研究，因此，本研究聚焦於影響民眾接種決策的心理因素，以7C心理前因模型與疾病陰謀信念為理論框架，探討台灣成年人在不同疫苗情境下心理構念差異與其對接種意願之影響。
研究目的：本研究旨在發展並驗證繁體中文版COVID-19疫苗/流感疫苗接種準備度量表(CVRS/IVRS)與 COVID-19/流感陰謀信念量表(CCBS/ICBS)，評估量表在不同疫苗情境中的心理計量特性及跨疫苗適用性。此外，本研究進一步探討疫苗接種準備度、疾病陰謀信念與相關人口學因素對疫苗接種意願之影響，並比較同一受測者在COVID-19疫苗與流感疫苗情境下之心理構念差異，以理解跨疫苗心理決策機制作為提升疫苗覆蓋率之策略建議。
研究方法： 本研究於2024年10月至11月期間，以線上便利取樣結合滾雪球招募方式，針對台灣18歲以上成年人進行橫斷式調查，共納入914份有效樣本。首先，針對四份量表分別進行驗證性因素分析(CFA)，以評估量表之結構效度、模型適配度，並進行內部一致性分析，以檢驗中文版量表之心理計量特性。在人口學背景分析中，以卡方檢定檢視人口學特徵及接種相關行為變項與接種意願之關聯；進一步以羅吉斯迴歸模型評估人口學特徵、接種史、接種準備度與陰謀信念對接種意願之影響，並以Pseudo-R²與曲線下面積(AUC)評估模型解釋力與預測能力。最後，使用重複量測變異數分析(Repeated-Measures ANOVA)與配對樣本t檢定，比較同一受測者在COVID-19疫苗與流感疫苗情境下之心理構念差異。
結果： 四份量表皆表現出良好適配度(CFI/TLI＞0.90；RMSEA/SRMR＜0.08)與內部一致性(Cronbach’s α＞0.8；McDonald’s ω＞0.8)，並支持其於台灣成年樣本中的適用性與跨疫苗之比較性。卡方檢定顯示，多數人口學特徵及接種相關行為對COVID-19疫苗與流感疫苗的接種意願均具有顯著影響，其中以過去接種史與接種意願之關聯最強(COVID-19疫苗: χ²＝184.25，p＜.001，Cramér’s V＝0.451；流感疫苗: χ²＝180.44，p＜.001，Cramér’s V＝0.447)。在羅吉斯迴歸中，接種準備度每增加1單位，願意接種COVID-19疫苗與流感疫苗之勝算分別提高7.45倍(OR=7.45, 95% C.I.=5.44-11.30)與11.59 倍(OR=11.59, 95% C.I.=7.43-18.75)，且模型具中度以上解釋力與良好辨別能力(COVID-19疫苗: pseudo-R²=0.34, AUC=0.79；流感疫苗: pseudo-R²=0.42, AUC=0.85)；相較之下，陰謀信念單獨解釋力與辨別能力有限(pseudo-R²＜.01；AUC=0.55-0.57)，但與接種準備度之間存在中度負相關(COVID-19疫苗: r＝−0.417，p＜.001；流感疫苗: r＝−0.354，p＜.001)，可能透過降低準備度間接影響意願。在心理構念層面，「限制」構念是影響兩種疫苗接種意願之共同且最關鍵的心理因素(COVID-19疫苗:OR=2.16, 95% C.I.=1.66-2.83；流感疫苗:OR=2.19, 95% C.I.=1.52-3.18)，但在COVID-19 疫苗中，「計算」構念的影響力居次(OR=1.59, 95% C.I.=1.29-1.97)；而在流感疫苗中則是「自滿」構念(OR=1.93, 95% C.I.=1.42-2.64)。民眾對跨疫苗心理構念之配對比較(差值定義為COVID疫苗相較於流感疫苗)則顯示，民眾傾向對COVID-19疫苗表現出較低的「信心」(t= -16.78, p < 0.001, Cohen’s d = -0.53)；而對流感疫苗則較容易出現「自滿」態度(t= 11.98, p < 0.001, Cohen’s d = 0.40)。
結論： 本研究驗證繁體中文版CVRS/IVRS與CCBS/ICBS具良好心理計量特性，及在台灣成年族群與跨疫苗情境中的適用性，可作為衡量跨疫苗之心理構念與評估接種意願之可靠工具。接種準備度能有效解釋並區辨接種意願，其中「限制」為影響COVID-19疫苗與流感疫苗接種決策的共同關鍵因素，顯示降低結構性或情境性障礙改善接種便利性，可能有助於提升整體接種意願；其次，在COVID-19疫苗應聚焦於加強安全性與效益之風險溝通，增強對COVID-19疫苗的「信心」；流感疫苗則需強化疾病嚴重度認知，減少低估疾病風險的「自滿」心態。在共同宣導與提供便利性的基礎上，依疫苗特性調整溝通焦點，設計更具差異化的宣導策略，將有助於增進整體疫苗準備度並提升民眾接種意願。

In the post-pandemic era, Taiwan faces alternating or co-circulating epidemics of COVID-19 and seasonal influenza, making the enhancement of vaccine coverage a critical public health priority. Despite concurrent government efforts to promote both vaccinations, substantial disparities in vaccination rates persist. This study aimed to develop and validate the Traditional Chinese versions of the COVID-19 and Influenza Vaccine Readiness Scales (CVRS/IVRS) and the COVID-19 and Influenza Conspiracy Beliefs Scales (CCBS/ICBS), and to examine how vaccination readiness, disease-related conspiracy beliefs, and sociodemographic factors influence vaccination willingness across vaccine contexts. A cross-sectional online survey was conducted among 914 Taiwanese adults. Psychometric properties were evaluated using confirmatory factor analysis and internal consistency measures. Associations between psychological constructs and vaccination willingness were examined using chi-square tests, logistic regression models, and repeated-measures analyses. The results demonstrated satisfactory model fit and reliability for all scales. Vaccination readiness showed strong explanatory and predictive power for willingness in both the COVID-19 and influenza vaccine contexts, whereas conspiracy beliefs alone had limited direct predictive value but were negatively correlated with vaccination readiness. Structural barriers (“Constraints”) emerged as the most critical determinant for both vaccines, while vaccine-specific differences were observed in other psychological constructs. These findings support the applicability of the validated scales and highlight the importance of addressing both common and vaccine-specific psychological factors to improve vaccination coverage.

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