ASPA
COVID-19 PUBLIC EDUCATION CAMPAIGN A
campaign to increase vaccine acceptance and reinforce basic
prevention measures
CET – Annotated Questionnaire
Note: The questions below are the proposed questions for the first iteration of the Weekly Current Events Tracker. Questions highlighted in yellow will be asked every week; questions highlighted in blue will be rotated into the survey on a monthly basis; and questions highlighted in green are meant to be asked in Wave 1 only. Other potential topics that will be included in subsequent Waves include: misperceptions about COVID-19 and the vaccines, reactions to the COVID-19 vaccine rollout, sources of information about the COVID-19 vaccine, exposure to messages about COVID-19 vaccines, the impact of key events and milestones on attitudes toward COVID-19 and the vaccine, and experiences with and reactions to getting a COVID-19 vaccine.ASPA will provide OMB with updates to the questionnaire for subsequent Waves. |
Standard Questions
Modular Questions
One-Time Questions
For the next section we would like to talk about current events.
// Page Break //
Item #: Q1
Question type: Single punch
// Soft Prompt: “We would like your response to this question.” //
hhs_fam: How familiar are you with the U.S. Department of Health and Human Services (HHS)?
Variable Label: hhs_fam: Familiarity with HHS
Value |
Value Label |
1 |
Not at all familiar |
2 |
Slightly familiar |
3 |
Moderately familiar |
4 |
Very familiar |
-99 |
Refused |
//PROGRAMMING NOTE: IF Q1 = 1, SKIP TO Q6//
// Page Break //
Item #: Q2
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
hhs_op. How favorable is your opinion of the U.S. Department of Health and Human Services (HHS)?
Variable Label: hhs_op: Opinion of HHS
Value |
Value Label |
1 |
Very unfavorable |
2 |
Mostly unfavorable |
3 |
Mostly favorable |
4 |
Very favorable |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
Item #: Q3
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
hhs_op_change. In the past few weeks, how has your opinion of the U.S. Department of Health and Human Services (HHS) changed, if at all?
Variable Label: hhs_op_change: Change in Opinion of HHS
Value |
Value Label |
1 |
Much more negative |
2 |
Slightly more negative |
3 |
Stayed the same |
4 |
Slightly more positive |
5 |
Much more positive |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
Item #: Q4
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
hhs_job. How would you rate the job currently being done on the COVID-19 pandemic by the U.S. Department of Health and Human Services (HHS)?
Variable Label: hhs_job: Job Done by HHS
Value |
Value Label |
1 |
Very poor |
2 |
Poor |
3 |
Good |
4 |
Very good |
5 |
I don’t know |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
Item #: Q5
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
hhs_trust. How much trust do you have in the U.S. Department of Health and Human Services (HHS) to provide you with accurate information about the coronavirus or COVID-19?
Variable Label: hhs_trust: Trust in HHS
Value |
Value Label |
1 |
None at all |
2 |
Not very much |
3 |
A fair amount |
4 |
A great deal |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
Item #: Q6/Q7
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
ATT8_CET. Do you think COVID-19 is transmitted in the following ways? Select yes or no for each item.
//PROGRAMMING NOTE: RANDOMIZE ATT8_1_CET-ATT8_6
//INTERNAL NOTE: Counts as two questions.//
Variable Name |
Variable Text |
Variable Label |
ATT8_1_CET |
Close contact with an infected person who has symptoms |
ATT8_1_CET: Close contact with symptomatic, infected person |
ATT8_2_CET |
Close contact with an infected person even if they are not showing symptoms of infection |
ATT8_2_CET: Close contact with asymptomatic, infected person |
ATT8_3_CET |
Contact with surfaces that an infected person has touched |
ATT8_3_CET: Contact with surfaces infected person has touched |
ATT8_4_CET |
Contact with someone who previously had COVID-19 |
ATT8_4_CET: Contact with someone who had COVID-19 |
ATT8_5_CET |
Through the air while outdoors and in close contact with an infected person |
ATT8_5_CET: Through the air outdoors |
ATT8_6_CET |
Through the air while indoors and in close contact with an infected person |
ATT8_6_CET: Through the air indoors |
Value |
Value Label |
0 |
No |
1 |
Yes |
-99 |
Refused |
// Page Break //
Item #: Q8
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
ATT_CET. How much do you agree or disagree with the following statements?
//PROGRAMMING NOTE: RANDOMIZE ATT2_3_CET-ATT4_3_CET
ATT2_3_CET |
Wearing a face mask helps reduce the spread of COVID-19. |
ATT2_3_CET: Wearing mask helps reduce COVID-19 |
ATT3_3_CET |
Maintaining a social distance helps reduce the spread of COVID-19. |
ATT3_3_CET: Social distancing helps reduce COVID-19 |
ATT1_3_CET |
Getting all of the recommended vaccines helps reduce the spread of COVID-19. |
ATT1_3_CET: Getting all recommended vaccines helps reduce COVID-19 |
ATT4_3_CET |
Washing hands with soap and water for 20 seconds helps reduce the spread of COVID-19. |
ATT4_3_CET: Washing hands helps reduce COVID-19 |
Value |
Value Label |
1 |
Strongly disagree |
2 |
Disagree |
3 |
Neither agree nor disagree |
4 |
Agree |
5 |
Strongly agree |
-99 |
// Page Break //
Item #: Q9
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
hhs_confid. How much confidence do you have in the U.S. Department of Health and Human Services (HHS) to continue to confirm the effectiveness and safety of current and future COVID-19 vaccines prior to releasing them to the public?
Variable Label: hhs_confid: Confidence in HHS
Value |
Value Label |
1 |
None at all |
2 |
Not very much |
3 |
A fair amount |
4 |
A great deal |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
Item #: Q10
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
BEH1_CET. A Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 is now available at no cost. Have you received a COVID-19 vaccine?
Variable Label: BEH1: Vaccination behavior
Value |
Value Label |
0 |
No, I have not received a COVID-19 vaccine |
1 |
Yes, but I have only received one shot out of the two required shots |
2 |
Yes, I have received all of the required shots |
-99 |
Refused |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q10=0 OR -99//
Item #: Q11
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
BEH2a_CET. What is the likelihood that you will get a COVID-19 vaccine?
Variable Label: BEH2a: Intention to get vaccinated
Value |
Value Label |
1 |
Very unlikely |
2 |
Somewhat unlikely |
3 |
Neither likely nor unlikely |
4 |
Somewhat likely |
5 |
Very likely |
-99 |
Refused |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q10=1//
Item #: Q12
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
BEH2b_CET. What is the likelihood that you will complete COVID-19 vaccination?
Variable Label: BEH2b_CET: Intention to complete vaccination
Value |
Value Label |
1 |
Very unlikely |
2 |
Somewhat unlikely |
3 |
Neither likely nor unlikely |
4 |
Somewhat likely |
5 |
Very likely |
-99 |
Refused |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q10=0 OR -99//
Item #: Q13
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
BEH3a_CET. A Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 is now available at no cost. How soon will you get vaccinated? For this question, assume there is enough vaccine so that everyone who wants it can get it.
Variable Label: BEH3a_CET: Wait to get vaccinated
Value |
Value Label |
1 |
I will get a vaccine as soon as I can |
2 |
I will wait to get a vaccine for one or more reasons |
3 |
I will never get a COVID-19 vaccine |
-99 |
Refused |
-100 |
Valid Skip |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q10=1//
Item #: Q14
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
BEH3b_CET. A Food and Drug Administration (FDA)-authorized vaccine to prevent COVID-19 is now available at no cost. How soon will you get the second required dose? For this question, assume there is enough vaccine so that everyone who wants it can get it.
Variable Label: BEH3b_CET: Wait to complete vaccination
Value |
Value Label |
1 |
I will get the second required dose as soon as I can |
2 |
I will wait to get the second required dose for one or more reasons |
3 |
I will never get the second required COVID-19 dose |
-99 |
Refused |
-100 |
Valid Skip |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q13=2//
Item #: Q15
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
BEH4_CET. You responded that you will wait to get a COVID-19 vaccine. For each of the following statements, is this a reason why you would wait to get a COVID-19 vaccine? Select yes or no for each item.
Variable Label: BEH4_CET: Reasons: Waiting to get vaccinated
//PROGRAMMING NOTE: RANDOMIZE BEH3_1_CET-BEH3_10_CET
Variable Name |
Variable Text |
Variable Label |
BEH4_1_CET |
I will because of my age. |
BEH4_1_CET: Age |
BEH4_2_CET |
I will because of my health status, allergies, or medical history. |
BEH4_2_CET: Health |
BEH4_3_CET |
I want to know if the vaccine is effective first. |
BEH4_3_CET: Confirm effectiveness |
BEH4_4_CET |
I am pregnant or expect to become pregnant. |
BEH4_4_CET: Pregnant |
BEH4_5_CET |
I want to talk to my doctor first. |
BEH4_5_CET: Talk to doctor first |
BEH4_6_CET |
I want to compare the effectiveness of the different vaccines. |
BEH4_6_CET: Compare vaccines |
BEH4_7_CET |
I want to see if my friends and family get the vaccine. |
BEH4_7_CET: Friends/family |
BEH4_8_CET |
I want to see if others who get the vaccine first develop any problems. |
BEH4_8_CET: Side effects |
BEH4_9_CET |
I want to make sure it is safe for people like me first. |
BEH4_9_CET: Confirm safety |
BEH4_10_CET |
I want to hear from leaders in my community about the vaccine first. |
BEH4_10_CET: Hear from leaders |
BEH4_11_CET |
Other |
BEH4_11_CET: Other |
Value |
Value Label |
0 |
No |
1 |
Yes |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
Item #: Q16/Q17
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
message_frames. Please indicate to what extent you agree or disagree with the following statements:
Variable Label: message_frames: Vaccine Readiness Message Frames
//PROGRAMMING NOTE: RANDOMIZE message_frame1-message_frame7.//
//INTERNAL NOTE: Counts as two questions.//
Variable Name |
Variable Text |
Variable Label |
message_frame1 |
By getting the COVID-19 vaccine, I am helping keep myself healthy. |
message_frame1: Benefit to Self |
message_frame2 |
By getting the COVID-19 vaccine, I am helping keep my loved ones and my community healthy. |
message_frame2: Benefit to Loved Ones |
message_frame3 |
Getting the vaccine is important because it will help ensure my family can continue our culture and traditions. |
message_frame3: Protecting Culture |
message_frame4 |
Getting the COVID-19 vaccine will help get us one step closer to normal. |
message_frame4: Hope for Normalcy |
message_frame5 |
Getting a COVID-19 vaccine will help keep me healthy so I can provide for my loved ones. |
message_frame5: Economic Benefits |
message_frame6 |
The COVID-19 vaccine is authorized to make sure the vaccine’s benefits outweigh any possible risks. |
message_frame6: Benefits Outweigh Risks |
message_frame7 |
I trust a COVID-19 vaccine will only be approved if it is safe and effective. |
message_frame7: Safety/Testing Process |
message_frame8 |
A few days of feeling flu-like symptoms is worth the benefit of being protected against COVID-19. |
message_frame8: Side Effects |
Value |
Value Label |
1 |
Strongly disagree |
2 |
Disagree |
3 |
Neither agree nor disagree |
4 |
Agree |
5 |
Strongly agree |
-99 |
Refused |
// Page Break //
Item #: Q18
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
vacc_trust. How much trust do you have that an FDA-authorized COVID-19 vaccine may be safe and effective for you to get?
Variable Label: vacc_trust: Trust in Safety of Vaccine
Value |
Value Label |
1 |
None at all |
2 |
Not very much |
3 |
A fair amount |
4 |
A great deal |
-99 |
Refused |
// Page Break //
Item #: Q19
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
vacc_off. How much do you trust U.S. federal public health officials to provide reliable information on COVID-19?
Variable Label: vacc_off: Confidence in U.S. public health officials
Value |
Value Label |
1 |
None at all |
2 |
Not very much |
3 |
A fair amount |
4 |
A great deal |
-99 |
Refused |
// Page Break //
Item #: Q20/Q21
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
vacc_source. How likely would you be to get the COVID-19 vaccine if each of the following recommended it?
//PROGRAMMING NOTE: RANDOMIZE vacc_source1-vacc_source11.//
//INTERNAL NOTE: Counts as two questions.//
Variable Name |
Variable Text |
Variable Label |
vacc_source1 |
Your State Government |
vacc_source1: Source of Vaccine: Your State Government |
vacc_source2 |
The U.S. Department of Health and Human Services (HHS) |
vacc_source2: Source of Vaccine: HHS |
vacc_source3 |
The Centers for Disease Control and Prevention (CDC) |
vacc_source3: Source of Vaccine: CDC |
vacc_source4 |
U.S. Federal public health officials |
vacc_source4: Source of Vaccine: Federal public health officials |
vacc_source5 |
White House officials |
vacc_source5: Source of Vaccine: White House officials |
vacc_source7 |
The U.S. Food and Drug Administration (FDA) |
vacc_source7: Source of Vaccine: FDA |
vacc_source8 |
Pharmaceutical companies |
vacc_source8: Source of Vaccine: Pharmaceutical companies |
vacc_source9 |
Local public health officials (e.g. state, county, city, or town) |
vacc_source9: Source of Vaccine: Local public health officials |
vacc_source10 |
The American Medical Association |
vacc_source10: Source of Vaccine: The American Medical Association |
vacc_source11 |
Medical websites, like WebMD or the Mayo Clinic |
Vacc_source11: Source of Vaccine: Medical websites like WebMD or the Mayo Clinic |
Value |
Value Label |
1 |
Not at all likely |
2 |
Not very likely |
3 |
Somewhat likely |
4 |
Very likely |
-99 |
Refused |
// Page Break //
Item #: Q22/Q23
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
vacc_source. How likely would you be to get the COVID-19 vaccine if each of the following recommended it?
//PROGRAMMING NOTE: RANDOMIZE vacc_source1-vacc_source9.//
//INTERNAL NOTE: Counts as two questions.//
Variable Name |
Variable Text |
Variable Label |
fam_vacc_source1 |
My family physician |
fam_vacc_source1: Source of Vaccine: My family physician |
fam_vacc_source2 |
Friends |
fam_vacc_source2: Source of Vaccine: Friends |
fam_vacc_source3 |
Immediate family members |
fam_vacc_source3: Source of Vaccine: Immediate family members |
fam_vacc_source4 |
Extended family members |
fam_vacc_source4: Source of Vaccine: Extended family members |
fam_vacc_source5 |
Neighbors in my community |
fam_vacc_source5: Source of Vaccine: Neighbors in my community |
fam_vacc_source6 |
Local schools |
fam_vacc_source6: Source of Vaccine: Local schools |
fam_vacc_source7 |
My employer |
fam_vacc_source7: Source of Vaccine: My employer |
fam_vacc_source8 |
My local government |
fam_vacc_source8: Source of Vaccine: My local government |
fam_vacc_source9 |
My place of worship |
fam_vacc_source9: Source of Vaccine: My place of worship |
fam_vacc_source10 |
My pharmacist/pharmacy |
fam_vacc_source10: Source of Vaccine: My pharmacist/pharmacy |
Value |
Value Label |
1 |
Not at all likely |
2 |
Not very likely |
3 |
Somewhat likely |
4 |
Very likely |
99 |
Not applicable |
-99 |
Refused |
For
internal communications only
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Lindsey Strausser |
File Modified | 0000-00-00 |
File Created | 2023-07-29 |