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Thank you for agreeing to take part in our Community Vaccination Survey! Your participation will really help us to understand more about our community so we can provide better services - and you could win a cash prize! We will ask some questions about you and what you think about vaccination, and if you want to learn more about it, we'll signpost you to further information. All questions are optional - if you don't want to answer a particular question, please move on to the next one - you will still be able to submit the survey at the end. |
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| 1|1|About you|1|1 Please tell us your age group Please tell us your age group | |
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| 2|1|About you|2|2 How would you describe your gender? How would you describe your gender? | |
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| 3|1|About you|3|3 Do you live in one of the following areas of Birmingham? Do you live in one of the following areas of Birmingham? | |
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| 4|1|About you|4|4 Please tell us your postcode Please tell us your postcode | |
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| 5|1|About you|5|5 Which of the following best describes your ethnic group? Which of the following best describes your ethnic group? | |
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| 6|1|About you|6|6 Please describe your ethnic group Please describe your ethnic group | |
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| 7|1|About you|7|7 Is English your first language?
(There are language translation options at the top-right of this survey page - entitled Display options.) Is English your first language?
(There are language translation options at the top-right of this survey page - entitled Display options.) | |
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| 8|1|About you|8|8 Do you identify with any of the following religions? Do you identify with any of the following religions? | |
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Assuming they had been told to get vaccinated by their doctor... |
| 9|1|Your family|9|14 How likely are you to recommend getting vaccinated to a friend or family member who was worried about it? How likely are you to recommend getting vaccinated to a friend or family member who was worried about it? | |
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| 10|1|Your family|10|15 Please tell us why you gave this answer Please tell us why you gave this answer | |
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Do you have children of the following ages in your care? |
| 11|1|Your family|11|16 Please select all that apply Please select all that apply | |
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Have the members of your family had all the vaccines recommended by the NHS? |
| 12|1|Your family|12|17 Please select all that apply Please select all that apply | |
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When it comes to vaccines, which of the following statements apply to you? |
| 13|1|Opinion on Vaccination|13|18 There are 27 statements. For each one, please select from 1 (not at all) to 5 (very much so). There are 27 statements. For each one, please select from 1 (not at all) to 5 (very much so). | |
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| 14|1|Opinion on Vaccination|14|19 Why do you think some people are worried about vaccinations? Why do you think some people are worried about vaccinations? | |
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| 15|1|Child Vaccine Awareness|15|20 You haven't told us there are children in your care. If you would still like to view questions and information about childhood vaccinations, please select. You haven't told us there are children in your care. If you would still like to view questions and information about childhood vaccinations, please select. | |
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Before today, had you heard of the following recommended vaccinations for babies? |
| 16|1|Child Vaccine Awareness|16|21 Vaccinations due at between age 8 weeks to 1 year old Vaccinations due at between age 8 weeks to 1 year old | |
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Before today, had you heard of the following recommended vaccinations for young children? |
| 17|1|Child Vaccine Awareness|17|22 Vaccinations due at age 3 years 4 months old Vaccinations due at age 3 years 4 months old | |
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Before today, had you heard of the following recommended vaccinations for older children? |
| 18|1|Child Vaccine Awareness|18|23 Vaccinations due at age 12 to 13 years old Vaccinations due at age 12 to 13 years old | |
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Before today, had you heard of the following recommended vaccinations for young teenagers? |
| 19|1|Child Vaccine Awareness|19|24 Vaccinations due at age 14 years old Vaccinations due at age 14 years old | |
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Before today, had you heard of the following recommended vaccinations for older teenagers? |
| 20|1|Child Vaccine Awareness|20|25 Vaccinations due at age 16+ years old Vaccinations due at age 16+ years old | |
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Before today, had you heard of the following recommended vaccinations for all adults? |
| 21|1|Adult Vaccine Awareness|21|26 Recommended adult vaccinations Recommended adult vaccinations | |
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Before today, had you heard of the following recommended vaccinations for older adults (60+)? |
| 22|1|Adult Vaccine Awareness|22|27 Recommended older adult vaccinations Recommended older adult vaccinations | |
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| 23|1|Adult Vaccine Awareness|23|28 Is there anything in particular that you would like to know more about, with regards to vaccination?
If you are hesitant about getting any vaccination for you or your family, please mention what would help you to decide to do so? Is there anything in particular that you would like to know more about, with regards to vaccination?
If you are hesitant about getting any vaccination for you or your family, please mention what would help you to decide to do so? | |
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| 24|1|A bit more about you|24|29 Are your daily activities limited by an ongoing disability or health condition? Are your daily activities limited by an ongoing disability or health condition? | |
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| 25|1|A bit more about you|25|30 How would you describe your sexuality? How would you describe your sexuality? | |
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| 26|1|A bit more about you|26|31 Where do you usually get your information about vaccines? Where do you usually get your information about vaccines? | |
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| 27|1|A bit more about you|27|32 What level of education do you have?
Please select the most applicable option. What level of education do you have?
Please select the most applicable option. | |
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| 28|1|A bit more about you|28|33 Where did you hear about this survey? Where did you hear about this survey? | |
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| 29|1|A bit more about you|29|34 Please specify Please specify | |
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| 30|1|Prize Draw|30|35 To say thank you for your time today, we are giving away 5 prizes of a £50 Amazon voucher. To be entered in our prize draw, please leave your email address here. This will not be stored with your other responses to the survey and will never be shared. You will only be contacted if you are one of our lucky winners! To say thank you for your time today, we are giving away 5 prizes of a £50 Amazon voucher. To be entered in our prize draw, please leave your email address here. This will not be stored with your other responses to the survey and will never be shared. You will only be contacted if you are one of our lucky winners! | |
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| 31|1|Hidden|31|36 [EVENTDESCRIPTION] [EVENTDESCRIPTION] | |
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