Measuring infectious disease stigma in the German population: Psychometric properties of stigma scales related to COVID-19, Long Covid and non-vaccination in a representative population sample.
- 1Institute of Psychology, Department Health and Prevention, University of Greifswald, Greifswald, Germany.
- 2Institute of Psychology, Department Health and Prevention, University of Greifswald, Greifswald, Germany. [email protected].
- 3Partner site Greifswald/Rostock, German Centre for Child and Adolescent Health (DZKJ), Greifswald, Germany.
Abstract
Background
The COVID-19 pandemic was widely accompanied by stigma towards certain groups of people, which can diminish efforts of disease control and exacerbate negative impacts of the disease itself. Research on COVID-19-related stigma in the German population is scarce and, internationally, is lacking validated and standardized measurement instruments. To address this issue, this study tested the psychometric properties of a set of scales to measure COVID-19-related stigma in a representative sample of the German population.Methods
Overall, 1960 people (M(SD)age = 49.8(17.3) years, 55.8% female) participated in a nationally representative cross-sectional survey in Germany. Six scales were tested, assessing public attitudes towards people who have had COVID-19 (COVID-PSS), those who had the disease multiple times (MI-PSS), people with Long Covid (LC-PSS) and people who chose not to get vaccinated (nonVac-PSS). We further assessed internalized stigma of individuals, who have had COVID-19 at least once (COINS) and those who chose not to get vaccinated (nonVac-IS). All scales were tested for their intended factorial structure through confirmatory factor analysis, convergent and discriminant validity and reliability.Results
All scales, excepting the scale for internalized stigma of unvaccinated individuals, showed good to excellent fit indices and factor loadings, supporting their intended factorial structure. Convergent and discriminant validity were established for the public stigma scales. The COINS did not converge with a measure of quality of life, but with depressive symptoms, whereas the nonVac-IS did not show convergence with presumed related constructs. Reliability coefficients showed good internal consistency among the items.Conclusion
Five out of the six scales proved to be valid tools to measure stigmatizing attitudes related to COVID-19, Long Covid and non-vaccination in a German sample. The scales hold promises for monitoring stigma during infectious disease outbreaks and informing the development of public health interventions to counteract health-related stigma.
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BibTeX
@article{menzinger2026measuring,
title = {{Measuring infectious disease stigma in the German population: Psychometric properties of stigma scales related to COVID-19, Long Covid and non-vaccination in a representative population sample.}},
author = {Jule Menzinger and Carlotta Alpers and Thomas McLaren and Dafina Danqa and Marlene Muehlmann and Silke Schmidt and Samuel Tomczyk},
journal = {Archives of public health = Archives belges de sante publique},
year = {2026},
month = oct,
doi = {10.1186/s13690-026-02100-0},
url = {https://europepmc.org/article/MED/42968174},
note = {CC BY},
}
RIS
TY - JOUR
TI - Measuring infectious disease stigma in the German population: Psychometric properties of stigma scales related to COVID-19, Long Covid and non-vaccination in a representative population sample.
AU - Jule Menzinger
AU - Carlotta Alpers
AU - Thomas McLaren
AU - Dafina Danqa
AU - Marlene Muehlmann
AU - Silke Schmidt
AU - Samuel Tomczyk
PY - 2026
DA - 2026/10/30
JO - Archives of public health = Archives belges de sante publique
DO - 10.1186/s13690-026-02100-0
UR - https://europepmc.org/article/MED/42968174
AB - Background The COVID-19 pandemic was widely accompanied by stigma towards certain groups of people, which can diminish efforts of disease control and exacerbate negative impacts of the disease itself. Research on COVID-19-related stigma in the German population is scarce and, internationally, is lacking validated and standardized measurement instruments. To address this issue, this study tested the psychometric properties of a set of scales to measure COVID-19-related stigma in a representative sample of the German population.Methods Overall, 1960 people (M(SD)age = 49.8(17.3) years, 55.8% female) participated in a nationally representative cross-sectional survey in Germany. Six scales were tested, assessing public attitudes towards people who have had COVID-19 (COVID-PSS), those who had the disease multiple times (MI-PSS), people with Long Covid (LC-PSS) and people who chose not to get vaccinated (nonVac-PSS). We further assessed internalized stigma of individuals, who have had COVID-19 at least once (COINS) and those who chose not to get vaccinated (nonVac-IS). All scales were tested for their intended factorial structure through confirmatory factor analysis, convergent and discriminant validity and reliability.Results All scales, excepting the scale for internalized stigma of unvaccinated individuals, showed good to excellent fit indices and factor loadings, supporting their intended factorial structure. Convergent and discriminant validity were established for the public stigma scales. The COINS did not converge with a measure of quality of life, but with depressive symptoms, whereas the nonVac-IS did not show convergence with presumed related constructs. Reliability coefficients showed good internal consistency among the items.Conclusion Five out of the six scales proved to be valid tools to measure stigmatizing attitudes related to COVID-19, Long Covid and non-vaccination in a German sample. The scales hold promises for monitoring stigma during infectious disease outbreaks and informing the development of public health interventions to counteract health-related stigma.
SN - 0778-7367
SN - 2049-3258
ER -