Survey vaccination

JSON Version fb2ea3648b3557221623339db478b026bbff6a37, built on 2022-03-24 17:22:19.228318

This file describes the survey design at a high level defining elements to enable data sharing and common elements. Legends are presented at the bottom of this file. Documentation is also available

Q9

single_choice 1 all
Did you receive a flu vaccine during the last autumn/winter season?
Description
  • Why are we asking this?
  • We would like to be able to work out how much protection the vaccine gives.
  • How should I answer it?
  • Report yes, if you received the vaccine this season, usually in the autumn. If you get vaccinated after filling in this questionnaire, please return to this and update your answer.
Comment
  • Note that the years will need to be changed each year.
Responses
0 Yes 1 #yes
1 No 2 #no
2 I don’t know 3 #dontknow

Q10

single_choice 2 all
Did you receive a flu vaccine this winter season?
Description
  • Why are we asking this?
  • We would like to be able to work out how much protection the vaccine gives. We would also like to find out if there is some protection from vaccines received in previous years.
  • How should I answer it?
  • Answer yes if you received the vaccine last year (during the autumn/winter of 2010-2011).
Comment
  • Note that the years will need to be changed each year.
Responses
0 Yes 1 #yes
1 No 2 #no
2 I don’t know 3 #dontknow
Rules
  • If #yes show $Q10b and $Q10c
  • If #no show $Q10d

Q10b

single_choice 3 all
When were you vaccinated against this flu season?
Responses
1 Choose date
  • DATE FIELD
 1 #date
0 I don’t know 2 #dontknow
Rules
  • Shown if $Q10 is #yes

Q10c

multiple_choice 4 all
What were your reasons for getting a seasonal influenza vaccination this year?
Responses
0 I belong to a risk group (e.g, pregnant, over 65, underlying health condition, etc) 1 #riskgroup
12 The COVID-19 context encouraged me to get influenza vaccination this year 2 #covid19
  • FR
1 Vaccination decreases my risk of getting the flu 3 #myrisk
2 Vaccination decreases the risk of spreading the flu to others 4 #spread
3 My doctor recommended it 5 #doctor
4 It was recommended in my workplace/school 6 #work
5 The vaccine was readily available and vaccine administration was convenient 7 #available
6 The vaccine was free 8 #free
7 I don’t want to miss work/school 9 #miss
8 I always get the vaccine 10 #always
9 Other reasons 11 #other
Rules
  • Shown if Q10 is #yes

Q10c_9_open

text 5
Q10c other details
Comment
  • Virtual question to represent the extra field for Q10c[9] option

Q10d

multiple_choice 6 all
What were your reasons for NOT getting a seasonal influenza vaccination this year?
Responses
0 I am planning to be vaccinated but haven’t been yet 1 #plan
1 I haven’t been offered the vaccine 2 #offer
2 I don’t belong to a risk group 3 #risk_group
3 It is better to build your own natural immunity against influenza 4 #own_immunity
4 I doubt that the influenza vaccine is effective 5 #doubt
5 Influenza is a minor illness 6 #minor_illness
17 Because of COVID-19 pandemic, I avoid seing doctors or going to the pharmacy 7 #avoid_healthseek
  • FR
18 I am afraid that influenza vaccine would increase my risk of getting COVID-19 8 #risk_covid
  • FR
19 Other reason linked with COVID-19 (open field)
  • Open field with textual response
 9 #covid_other
  • FR
6 I don’t think I am likely to get the flu 10 #likely
7 I believe that influenza vaccine can cause influenza 11 #cause_flu
8 I am worried that the vaccine is not safe or will cause illness or other adverse events 12 #safety
9 I don’t like having vaccinations 13 #vaccin
10 The vaccine is not readily available for me 14 #not_available
11 The vaccine is not free of charge 15 #free
12 No particular reason 16 #no_reason
13 Although my doctor recommended a vaccine, I did not get one 17 #doctor
14 Other reason(s) 18 #other

Q10d_14_open

text 7 optional
Virtual question holding data from extra field of $Q10d.14
Rules
  • shown if $Q10d.14

Q10d_19_open

text 8 optional
Virtual question holding data from extra field of $Q10d.19
Rules
  • shown if $Q10d.19

Q35

single_choice 9 all
Have you received a COVID-19 vaccine (since December 2020)?
Description
  • Why are we asking this?
  • We would like to be able to work out how much protection the vaccine gives.
  • How should I answer it?
  • Report yes, if you received a COVID-19 vaccine this season (since December 2020). If you get vaccinated after filling in this questionnaire, please return to this and update your answer.
Responses
1 Yes 1 #yes
0 No 2 #no
2 I don’t know 3 #dontknow
Rules
  • prefill with previous response

Q35b

single_choice 10 Inactive Removed at 2021-11-10
Which COVID-19 vaccine did you receive?
Comment
  • Removed on 2021-11, replaced by Q35i
Responses
1 Comirnaty™ vaccine, from Pfizer/BioNTech laboratories 1 #comirnaty
2 COVID-19 Vaccine Moderna™, from Moderna laboratory 2 #moderna
3 AstraZeneca COVID-19 vaccine 3 #vaxzevria
4 Jonhson & Jonhson vaccine 4 #janssen
99 I don’t know/can’t remember 5 #dontknow
Rules
  • Shown if $Q35 is #yes
  • prefill with previous response

Q35i

multiple_choice 11
Which COVID-19 vaccine did you receive?
Responses
1 Comirnaty™ vaccine, from Pfizer/BioNTech laboratories 1 #comirnaty
2 COVID-19 Vaccine Moderna™, from Moderna laboratory 2 #moderna
3 AstraZeneca COVID-19 vaccine 3 #vaxzevria
4 Jonhson & Jonhson vaccine 4 #janssen
99 I don’t know/can’t remember 5 #dontknow
Rules
  • Shown if $Q35 is #yes
  • prefill with previous response

Q35c

single_choice 12
How many doses of this vaccine did you receive?
Description
  • Why are we asking this?
  • We would like to be able to work out how much protection a complete vaccination scheme gives.
  • How should I answer it?
  • Report the number of doses you received (which corresponds to the number of time you were vaccinated against COVID-19 this season). If you get another dose after filling in this questionnaire, please return to this and update your answer.
Responses
1 One 1 #one
2 Two 2 #two
3 More than two 3 #more_2
4 Three 4 #three
5 More than three 5 #more_3
99 I don’t know/can’t remember 6 #dontknow
Rules
  • prefill with previous response
  • Shown if $Q35 is #yes

Q35j

single_choice 13 Added at 2021-11-10
When did you receive your last injection of a vaccine against COVID-19?
Description
  • Why are we asking this?
  • Knowing when people are vaccinated tells us how well the vaccination program is being carried out.
  • How should I answer it?
  • Please try and answer as accurately as possible. If you do not know the precise date, please give your best estimate. For instance, you might remember the month, then try and remember if it was at the beginning or the end of the month. Were there any significant events (e.g. a holiday or a birthday) that might help jog your memory?
Responses
1 Choose date: 1 #date
0 I don’t know/can’t remember 2 #dontknow

Q35i_1_open

date 14
Last injection date
Format
month-year
Comment
  • extra field of question Q35i not shown as an individual question
Rules
  • Show if $Q35i#date is selected

Q35d

single_choice 15 Inactive Removed at 2021-11-10
When did you receive your first injection of a vaccine against COVID-19 (since December 2020)?
Description
  • Why are we asking this?
  • Knowing when people are vaccinated tells us how well the vaccination program is being carried out.
  • How should I answer it?
  • Please try and answer as accurately as possible. If you do not know the precise date, please give your best estimate. For instance, you might remember the month, then try and remember if it was at the beginning or the end of the month. Were there any significant events (e.g. a holiday or a birthday) that might help jog your memory?
Comment
  • Replaced by Q35i from 2021-11
Responses
1 Choose date: 1 #choose_date
0 I don’t know/can’t remember 2 #dontknow
Rules
  • prefill with previous response
  • shown if $Q35 is #yes

Q35d_1_open

date 16 Inactive Removed at 2021-11-10
First injection date
Comment
  • Replaced by Q35i from 2021-11
  • extra field not shown
Rules
  • Show if $Q35d is #choose_date

Q35k

single_choice 17 Added at 2021-11-10
Do you plan to receive a second injection in the upcoming weeks?
Responses
1 Yes 1 #yes
0 No 2 #no
99 I don’t know 3 #dontknow
Rules
  • Shown if Q35c is #one

Q35l

single_choice 18
Why receiving a single injection?
Responses
1 I had COVID-19 before my first injection 1 #covidbefore
2 I had COVID-19 shortly after my first injection, and have to wait several months to receive the second injection 2 #covidafter
3 I received Janssen vaccine, which requires only one injection 3 #janssen
4 A second injection was contraindicated for me by a doctor (I had a severe allergic reaction, or a severe adverse effect after the first injection, or I have a temporary contraindication due to a treatment or a disease) 4 #contraindication
5 I changed my mind and don’t want to be vaccinated anymore 5 #changedmind
6 Other reason 6 #other
0 I don’t know 7 #dontknow
Rules
  • Shown if $Q35k is #no or #dontknow

Q35l_6_open

text 19 Added at 2021-11-10
Open field for Q35l#other
Comment
  • extra field not shown
Rules
  • Show if $Q35l is #other

Q35e

single_choice 20 Inactive Removed at 2021-11-10
When did you receive your second injection of a vaccine against COVID-19 (since December 2020)?
Description
  • Why are we asking this?
  • Knowing when people are vaccinated tells us how well the vaccination program is being carried out.
  • How should I answer it?
  • Please try and answer as accurately as possible. If you do not know the precise date, please give your best estimate. For instance, you might remember the month, then try and remember if it was at the beginning or the end of the month. Were there any significant events (e.g. a holiday or a birthday) that might help jog your memory?
Comment
  • Replaced by Q35i from 2021-11
Responses
1 Choose date: 1 #choose_date
0 I don’t know/can’t remember 2 #dontknow
Rules
  • prefill with previous response
  • Shown if $Q35c is #two or #three_more

Q35e_1_open

date 21 Inactive Removed at 2021-11-10
Second injection date
Comment
  • extra field not shown
  • Replaced by Q35i from 2021-11
Rules
  • Show if $Q35e is #choose_date

Q35g

single_choice 22 Inactive Removed at 2021-11-10
Which COVID-19 vaccine did you receive for your second dose?
Comment
  • Replaced by Q35i from 2021-11
Responses
1 Comirnaty™ vaccine, from Pfizer/BioNTech laboratories 1 #comirnaty
2 COVID-19 Vaccine Moderna™, from Moderna laboratory 2 #moderna
3 AstraZeneca COVID-19 vaccine 3 #vaxzevria
4 Jonhson & Jonhson vaccine 4 #janssen
99 I don’t know/can’t remember 5 #dontknow
Rules
  • Shown if $Q35c is #two or #three_more
  • prefill with previous response

Q35f

multiple_choice 23
What were your reasons for getting a COVID-19 vaccination? (Select all options that apply)
Description
  • Why are we asking this?
  • We would like to know why some people get the vaccine, and other don’t get it.
  • How should I answer it?
  • Please select all the answers who mattered to take your decision.
Responses
21 The vaccination is recommended by public health authorities 1 #recommended_by_pha
0 I belong to a group who is at risk of complications in case of COVID-19 (over 65, underlying health condition, obesity, etc.) 2 #belong_atrisk
20 I work in close contact with people at risk of complications in case of COVID-19 (working in a nursing home, health staff…) 3 #work_contact_atrisk
1 Vaccination decreases my risk of getting COVID-19 4 #decrease_my_risk
2 Vaccination decreases the risk of spreading COVID-19 to others 5 #decrease_spread
3 My doctor recommended it 6 #recommended_doctor
4 It was recommended in my workplace/school 7 #recommended_work
5 The vaccine was readily available and vaccine administration was convenient 8 #availability
6 The vaccine was free (no cost) 9 #free
7 I don’t want to miss work/school 10 #miss_work
8 I always get the vaccine when available 11 #always
22 I have to be vaccinated to work 12 #mandatory_work
23 To obtain a valid vaccination passport 13 #passport
9 Other reason(s) 14 #other
Rules
  • prefill with previous response
  • Shown if $Q35 is #yes

Q35f_9_open

text 24
Covid vaccination reasons other
Comment
  • extra field not shown
Rules
  • Show if $Q35f is #other

Q35m

multiple_choice 25 Added at 2021-11-10
What were your reasons for NOT getting a COVID-19 vaccination?
Description
  • Why are we asking this?
  • We would like to know why some people get the vaccine, and other don’t get it.
  • How should I answer it?
  • Please select all the answers who mattered to take your decision.
Responses
0 I am planning to be vaccinated but haven’t been yet 1 #plan
1 I haven’t been offered the vaccine 2 #notproposed
15 I have been discouraged from being vaccinated because I am pregnant 3 #pregnant_disc optional
  • FR
16 I am pregnant and I fear the vaccine could be dangerous for my baby 4 #pregnant_fear optional
  • FR
2 I don’t belong to a risk group 5 #notriskgroup
3 It is better to build your own natural immunity against COVID-19 6 #natural_immunity
4 I doubt that the COVID-19 vaccine is effective 7 #doubt_efficacy
5 COVID-19 is a minor illness 8 #benign
17 Because of COVID-19 pandemic, I avoid seeing doctors or going to the pharmacy 9 #avoid_health_facilities optional
  • FR
6 I don’t think I am likely to get the COVID-19 10 #unlikely
7 I believe that COVID-19 vaccine can cause COVID-19 11 #cause_covid
8 I am worried that the vaccine is not safe or will cause illness or other adverse events 12 #adverse_event
9 I don’t like having vaccinations 13 #dontlike
10 The vaccine is not readily available for me 14 #accessible
20 I disagree with the current vaccine policy 15 #disagree optional
  • FR
11 The vaccine is not free of charge
  • Only for country where it's applicable
 16 #not_free optional
12 I don’t know 17 #dontknow
14 Other reason(s) 18 #other
Rules
  • prefill with previous response
  • Shown if $Q35 is #no

Q35m_14_open

text 26
Covid non vaccination reasons other
Comment
  • extra field not shown
Rules
  • Show if $Q35m is #other

Legend