Document
COVID-19 Current Events Tracker (CET)
ICR 202201-0990-005 · OMB 0990-0476 · Object 118143601.
This document may belong to an older filing. More recent activity for OMB 0990-0476:
Document Viewer [docx]
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | COVID-19 Current Events Tracker (CET) |
| Author | Lindsey Strausser |
| Last Modified By | Writer |
| File Modified | 2021-02-23 |
| File Created | 2026-10-04 |
| Conversion State | complete |
Extracted Text
CET – Annotated Questionnaire (Wave 5) Note: The questions below are the proposed questions for the fifth 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 5 only. This week we have added questions that examine opinion changes on HHS, trusted vaccine messengers, and challenges to getting vaccinated. 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 // Page Break // //PROGRAMMING NOTE: IF Q1=1, SKIP TO Q5// 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 // //PROGRAMMING NOTE: Randomize order of Q4 & Q5, i.e., 50% see Q4 first, 50% see Q5 first.// Item #: Q4 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 #: Q5 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: hhs_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 // 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 // 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 // //PROGRAMMING NOTE: DISPLAY IF Q6=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 // //PROGRAMMING NOTE: DISPLAY IF Q6=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 // //PROGRAMMING NOTE: DISPLAY IF Q6=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 // //PROGRAMMING NOTE: DISPLAY IF Q6=1// Item #: Q11 Question Type: Single punch // Soft Prompt: “We would like your response to this question.” // BEH3b_CET. Food and Drug Administration (FDA)-authorized vaccines to prevent COVID-19 are 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 Q9=2// Item #: Q12-Q14 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 BEH4_1_CET-BEH4_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 #: Q15-Q17 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.// 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_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 vacc_source12 Your local hospital leadership (e.g., Chief Medical Officer) vacc_source12: Local hospital leadership vacc_source13 President Biden vacc_source13: President Biden vacc_source14 Vice President Harris vacc_source14: 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 #: Q18-Q19 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_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 #: Q20 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 #: Q21-Q22 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_7_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_5_barrier: Travel cost vacc_5_barrier Other costs associated with getting the vaccine (e.g., childcare, time off from work) vacc_6_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_7_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 #: Q23-Q24 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_8_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