ASPA_CET Weekly Survey_2_12_21 (002)

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

CET – Annotated Questionnaire

Note: The questions below are the proposed questions for the third 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 3 only. This week we have added questions that examine sources of information about getting the vaccines, additional concerns about getting the vaccines, and the change in Valentine’s Day plans due to the pandemic.
ASPA will provide OMB with updates to the questionnaire for subsequent Waves.

Standard Questions
Modular Questions
One-Time Questions

HHS Familiarity & Perceptions

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 Q3//

// Page Break //

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 //

Item #: Q3
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 Q3=0 OR -99//
Item #: Q4
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 Q3=1//
Item #: Q5
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 Q3=0 OR -99//
Item #: Q6
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 Q3=1//
Item #: Q7
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 Q6=2//
Item #: Q8-Q10
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 Q6=1//
Item #: Q11
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
elgibility. How much do you agree or disagree with the following statements?
//PROGRAMMING NOTE:  RANDOMIZE eligibility_1 – eligibility_5//

eligibility _1
I know where to look to find out when I am eligible to receive the COVID-19 vaccines.
eligibility _1: Eligibility
eligibility _2
I know what COVID-19 vaccination priority group/phase (e.g., 1b, 1c) I am in.
eligibility _2: Priority group
eligibility _3
I know how to schedule an appointment when it is time for me to get the COVID-19 vaccine.
eligibility _3: How to schedule
eligibility _4
I know where to schedule an appointment when it is time for me to get the COVID-19 vaccine.
eligibility _4: Where to schedule
eligibility _5
I know how to prepare for my eventual COVID-19 vaccine appointments (e.g., what to bring).
eligibility _5: How to prepare

Value
Value Label
1
Strongly disagree
2
Disagree
3
Neither agree nor disagree
4
Agree
5
Strongly agree
-99
Refused
-100
Valid skip

// Page Break //

//PROGRAMMING NOTE: DISPLAY IF Q6=1//
Item #: Q12-Q14
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
eligible_sources. Which of the following sources have you used to find out about COVID-19 vaccine eligibility and distribution? Select all that apply.
//PROGRAMMING NOTE:  RANDOMIZE eligible_sources_1-eligible_sources_10//

eligible_sources_1
Your state health department
eligible_sources_1: State
eligible_sources_2
Your county/city health department
eligible_sources _2: County/city
eligible_sources_3
National public health departments (e.g., CDC, HHS)
eligible_sources _3: National public health departments
eligible_sources_4
Local or national chain pharmacies
eligible_sources _4: Pharmacies
eligible_sources_5
Health care provider
eligible_sources _5: Health care provider
eligible_sources_6
Advertising campaigns
eligible_sources _6: Ad campaigns
eligible_sources_7
Family members
eligible_sources _7: Family
eligible_sources_8
Friends
eligible_sources _8: Friends
eligible_sources_9
Coworkers
eligible_sources _9: Coworkers
eligible_sources_10
Your employer
eligible_sources _10: Employer
eligible_sources_11
Other
eligible_sources _11: Other
eligible_sources_12
None of the above, I have not looked for information on vaccine eligibility or distribution
eligible_sources _12: None

Value
Value Label
0
No
1
Yes 
-99
Refused
-100
Valid skip

// Page Break //

//PROGRAMMING NOTE: SHOW IF AT LEAST ONE FROM eligible_sources_1-eligible_sources_10= 1. PIPE “YES” RESPONSES ////
Item #: Q15
Question Type: Multi-Punch Grid
// Soft Prompt: “We would like your response to this question.” //
eligible_sources. From which of the following sources did you see or hear about vaccine eligibility and distribution? Select all that apply.
//PROGRAMMING NOTE:  MATCH ORDER OF eligible_sources_1-eligible_sources_5. //

source_1
Your state health department
eligible_sources_1: State
source_2
Your county/city health department
eligible_sources _2: County/city
source_3
National public health departments (e.g., CDC, HHS)
eligible_sources _3: National public health departments
source_4
Local or national chain pharmacies
eligible_sources _4: Pharmacies
source_5
Advertising campaigns
eligible_sources _5: Ad campaigns

Value
Value Label
1
Website
2
Newspaper (online or print)
3
Social media
4
Television
5
Radio
6
Other

Value
Value Label
0
No
1
Yes 
-99
Refused
-100
Valid skip

// Page Break //

//PROGRAMMING NOTE: SHOW IF AT LEAST ONE FROM eligible_sources_1-eligible_sources_11 = 1. //
Item #: Q16
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
eligible_others. Have you looked into vaccine eligibility only for yourself, for yourself and others (e.g., family members/friends), or only for others?
Variable Label: eligible_others: Vaccine eligibility for others?
Value
Value Label
1
Only for myself
2
For myself and others (e.g., family members/friends) 
3
Only for others (e.g., family members/friends)
-99
Refused

//PROGRAMMING NOTE: DISPLAY IF Q6=1//
Item #: Q17-Q19
Question Type: Grid
// Soft Prompt: “We would like your response to this question.” //
vacc_concerns. How concerned are you about the following aspects of getting a COVID-19 vaccine?
//PROGRAMMING NOTE:  RANDOMIZE vacc_concerns_1 – vacc_concerns_15. Split grid across three pages (every 5 questions). //

vacc_concerns_1
Difficulty signing up for COVID-19 vaccine appointment(s)
vacc_concerns_1: Difficulty signing up
vacc_concerns_2
Having my COVID-19 vaccine appointment(s) cancelled
vacc_concerns_2: Cancelled appointments
vacc_concerns_3
My state will run out of COVID-19 vaccine before I get my second dose
vacc_concerns_3: Run out
vacc_concerns_4
Whether the COVID-19 vaccine will be free and/or if it will be covered by my insurance
vacc_concerns_4: Free
vacc_concerns_5
Finding out where to go to get a COVID-19 vaccine
vacc_concerns_5: Where to get
vacc_concerns_6
Getting reliable information, or information I trust, about the COVID-19 vaccines
vacc_concerns_6: Reliable information
vacc_concerns_7
Contracting COVID-19 before both doses of the vaccine become effective
vacc_concerns_7: Contracting COVID-19 first
vacc_concerns_8
The side effects of getting a COVID-19 vaccine
vacc_concerns_8: Side effects
vacc_concerns_9
Whether the vaccines will work against new or emerging variants of COVID-19
vacc_concerns_9: Work against variants
vacc_concerns_10
How long the vaccines will protect me from contracting COVID-19
vacc_concerns_10: Length of protection
vacc_concerns_11
What I should or shouldn’t do do after getting a COVID-19 vaccine (e.g., wear a mask, socially distance)
vacc_concerns_11: Behave after vaccine
vacc_concerns_12
Proving that I’m eligible to receive a COVID-19 vaccine
vacc_concerns_12: Proving eligibility
vacc_concerns_13
How I will know whether or not the COVID-19 vaccine is working
vacc_concerns_13: Vaccine working
vacc_concerns_14
Where to go to sign up for vaccine appointment(s)
vacc_concerns_14: Where to sign up

Value
Value Label
1
Not at all concerned
2
Slightly concerned
3
Moderately concerned
4
Very concerned
-99
Refused

// Page Break //

Item #: Q20
Question Type: Single punch
// Soft Prompt: “We would like your response to this question.” //
vday. How much, if at all, have you changed your Valentine’s Day plans this year as a result of the COVID-19 pandemic?
Variable Label: vday: Vday plans changed
Value
Value Label
1
Not at all
2
Not too much
3
Some
4
A great deal
99
Not applicable, do not celebrate Valentine’s Day
-99
Refused

// Page Break //

Item #: Q21
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 #: Q22
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