ASPA
COVID-19 PUBLIC EDUCATION CAMPAIGN A
campaign to increase vaccine acceptance and reinforce basic
prevention measures
CET – Annotated Questionnaire (Wave 9)
Note: The questions below are the proposed questions for the ninth wave of the Weekly Current Events Tracker (CET). 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 9 only or are being asked again to update data on a variable of interest. This wave’s module is Trusted Vaccine Messengers and Vaccine Challenges. This week we have added questions on COVID-19 risk perceptions and personal experiences with COVID-19 diagnoses.ASPA will provide OMB with updates to the questionnaire for subsequent Waves. |
Standard Questions
Modular Questions
One-Time or Repeat Questions Being Asked Again to Update Data
For the next section we would like to talk about current events.
// Page Break //
//PROGRAMMING NOTE: RANDOMIZE ORDER OF Q1/Q2 and Q3/Q4 (I.E., 50% SEE Q1/Q2 FIRST, 50% SEE Q3/Q4 FIRST)//
//BASE: All respondents//
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 |
// Page Break //
//BASE: hhs_fam= 2, 3, 4, OR -99//
Item #: Q2
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 //
//BASE: All respondents//
Item #: Q3
Question type: Single punch
// Soft Prompt: “We would like your response to this question.” //
cdc_fam: How familiar are you with the Centers for Disease Control and Prevention (CDC)?
Variable Label: cdc_fam: Familiarity with CDC
Value |
Value Label |
1 |
Not at all familiar |
2 |
Slightly familiar |
3 |
Moderately familiar |
4 |
Very familiar |
-99 |
Refused |
// Page Break //
//BASE: cdc_fam= 2, 3, 4, OR -99//
Item #: Q4
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
cdc_trust. How much trust do you have in the Centers for Disease Control and Prevention (CDC) to provide you with accurate information about the coronavirus or COVID-19?
Variable Label: cdc_trust: Trust in CDC
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 //
//BASE: All respondents//
Item #: Q5
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 //
//BASE: All respondents//
Item #: Q6
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 //
//BASE: All respondents//
Item #: Q7
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
beh1_cet. Food and Drug Administration (FDA)-authorized vaccines to prevent COVID-19 are 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 //
//BASE: beh1_cet =0 OR -99//
Item #: Q8
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 |
-100 |
Valid Skip |
// Page Break //
//BASE: beh1_cet=1//
Item #: Q9
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 |
-100 |
Valid Skip |
// Page Break //
//BASE: beh1_cet =0 OR -99//
Item #: Q10
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
beh3a_cet. Food and Drug Administration (FDA)-authorized vaccines to prevent COVID-19 are 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 //
//BASE beh3a_cet =2//
Item #: Q11-Q12
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 wait because of my age. |
beh4_1_cet: Age |
beh4_2_cet |
I will wait 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 //
//PROGRAMMING NOTE: DISPLAY IF Q9≠3 OR -100//
Item #: Q13-Q15
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_source12.//
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 |
The U.S. Food and Drug Administration (FDA) |
vacc_source5: Source of Vaccine: FDA |
vacc_source6 |
Pharmaceutical companies |
vacc_source6: Source of Vaccine: Pharmaceutical companies |
vacc_source7 |
Local public health officials (e.g. state, county, city, or town) |
vacc_source7: Source of Vaccine: Local public health officials |
vacc_source8 |
The American Medical Association |
vacc_source8: Source of Vaccine: The American Medical Association |
vacc_source9 |
Medical websites, like WebMD or the Mayo Clinic |
vacc_source9: Source of Vaccine: Medical websites like WebMD or the Mayo Clinic |
vacc_source10 |
Your local hospital leadership (e.g., Chief Medical Officer) |
vacc_source10: Local hospital leadership |
vacc_source11 |
President Biden |
vacc_source11: President Biden |
vacc_source12 |
Vice President Harris |
vacc_source12: Vice President Harris |
Value |
Value Label |
1 |
Not at all likely |
2 |
Not very likely |
3 |
Somewhat likely |
4 |
Very likely |
-99 |
Refused |
// Page Break //
Item #: Q16-Q17
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
fam_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_source10.//
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 |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q9≠3 OR -100//
Item #: Q18
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
vacc_distance. How far would you need to travel to get to the COVID-19 vaccination site located nearest to your home?
Variable Label: vacc_distance: Distance to vaccine site
Value |
Value Label |
1 |
Less than 15 minutes |
2 |
15 minutes – 30 minutes |
3 |
30 minutes – 1 hour |
4 |
More than 1 hour |
5 |
I don’t know where my nearest site is |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q9≠3 OR -100//
Item #: Q19-Q20
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
vacc_barrier. When it comes to getting a COVID-19 vaccine, how difficult do you expect the following to be?
Variable Label: vacc_barrier: Barriers to getting vaccine
//PROGRAMMING NOTE: RANDOMIZE vacc_1_barrier-vacc_6_barrier
Variable Name |
Variable Text |
Variable Label |
vacc_1_barrier |
Getting to and/or from the vaccination site |
vacc_1_barrier: Travel
|
vacc_2_barrier
|
Finding appointment times that work with my schedule |
vacc_2_barrier: Appointment times
|
vacc_3_barrier
|
Having access to the technology needed to schedule the vaccine appointment (e.g., computer, mobile device, internet) |
vacc_3_barrier: Technology
|
vacc_4_barrier |
Cost of traveling to and from the vaccination site |
vacc_4_barrier: Travel cost |
vacc_5_barrier |
Other costs associated with getting the vaccine (e.g., childcare, time off from work) |
vacc_5_barrier: Other costs |
vacc_6_barrier
|
Getting the documentation needed to get a vaccine (e.g., driver’s license or other form of identification) |
vacc_6_barrier: Documentation
|
Value |
Value Label |
1 |
Not at all difficult |
2 |
Slightly difficult |
3 |
Moderately difficult |
4 |
Very difficult |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
//PROGRAMMING NOTE: DISPLAY IF Q9≠3 OR -100//
Item #: Q21-Q22
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
vacc_resource. When it comes to getting a COVID-19 vaccine, how much would each resource, if available, increase your likelihood to get vaccinated?
Variable Label: vacc_resource: Vaccine resources
//PROGRAMMING NOTE: RANDOMIZE vacc_1_resource-vacc_7_resource
Variable Name |
Variable Text |
Variable Label |
vacc_1_resource |
If transportation was provided for traveling to and from the vaccine site |
vacc_1_resource: Travel
|
vacc_2_resource
|
If more flexibility was offered in scheduling my vaccine appointments (e.g., later appointment times, more weekend availability) |
vacc_2_resource: Appointments
|
vacc_3_resource
|
If my employer offered paid time off to get the vaccine |
vacc_3_resource: Compensation
|
vacc_4_resource
|
If I received automatic notifications with updates on my vaccine eligibility status and appointment scheduling options |
vacc_4_resource: Notifications |
vacc_5_resource
|
If vaccine scheduling could be done in-person |
vacc_5_resource: In-Person |
vacc_6_resource |
If vaccine registration sites were available in more languages |
vacc_7_resource: Language
|
vacc_7_resource |
If I could bring my child(ren) with me to the vaccine site |
vacc_8_resource: Child |
Value |
Value Label |
1 |
Not at all |
2 |
Not very much |
3 |
A fair amount |
4 |
A great deal |
99 |
Not applicable |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
//BASE: All respondents//
Item #: Q23-Q24
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
cv_diagnose. Have you or any of the following people been diagnosed with the coronavirus or COVID-19?
Variable Label: cv_diagnose: Diagnosed with COVID-19
//PROGRAMMING NOTE: RANDOMIZE cv_diagnose_1-cv_diagnose_6
Variable Name |
Variable Text |
Variable Label |
cv_diagnose_1 |
I have once |
cv_diagnose_1: Myself
|
cv_diagnose_2 |
I have more than once |
cv_diagnose_2: Myself More Than Once
|
cv_diagnose_3 |
An immediate family member |
cv_diagnose_3: Immediate Family Member
|
cv_diagnose_4 |
An extended family member |
cv_diagnose_4: Extended Family Member |
cv_diagnose_5
|
A friend |
cv_diagnose_5: Friend |
cv_diagnose_6 |
No, I do not know anyone that has been diagnosed with coronavirus or COVID-19 |
cv_diagnose_6: No One |
Value |
Value Label |
0 |
No |
1 |
Yes |
-99 |
Refused |
-100 |
Valid skip |
// Page Break //
//BASE: All respondents//
Item #: Q25
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
covid19_threat. How much of a threat is the coronavirus outbreak for _____?
Variable Label: covid19_threat: COVID-19 threat concerns
//PROGRAMMING NOTE: RANDOMIZE covid19_threat_1-covid19_threat_7
Variable Name |
Variable Text |
Variable Label |
covid19_threat_1 |
Your personal health |
covid19_threat_1: Personal Health |
covid19_threat_2 |
Your personal financial situation |
covid19_threat_2: Personal Finances
|
covid19_threat_3 |
The health of your community |
covid19_threat_3: Day to Day
|
covid19_threat_4 |
The health of the US population as a whole |
covid19_threat_4: US Population
|
covid19_threat_5
|
The US economy |
covid19_threat_5: US Economy |
Value |
Value Label |
1 |
Not a threat |
2 |
A minor threat |
3 |
A moderate threat |
4 |
A major threat |
-99 |
Refused |
For
internal communications only
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |