Additional COVID Questions

Att 2 - 2021 Sample Child Covid-19 Vaccination Questions.pdf

National Health Interview Survey

Additional COVID Questions

OMB: 0920-0214

Document [pdf]
Download: pdf | pdf
Question ID: CVV.0010.00.3

Question Text:

Response:

Fills:

Variable name: SHTCVD19_C

Interview module: CVV(2021 Future Content.2021 draft

The next questions are about coronavirus or COVID-19 vaccination. Has
^SCNAME had a COVID-19 vaccination?
Read if necessary: The COVID-19
vaccination has been available since 2020.

1.
2.
DK:
RF:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1> [goto SHTCVD19NM_C]
<2,RF,DK> [goto next section]

Question ID: CVV.0020.00.3

Variable name: SHTCVD19NM_C

Interview module: CVV(2021 Future Content.2021 draft

Universe: SHTCVD19_C=1
Question Text:

Response:

Fills:

How many COVID-19 vaccinations has ^SCNAME received?

1.
2.
3.
DK:
RF:

1 vaccination
2 vaccinations
More than 2 vaccinations
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-3> [goto CVDVAC1M_C]
 [goto next section]

Page 1 of 7

Question ID: CVV.0030.01.3

Variable name: CVDVAC1M_C

Interview module: CVV(2021 Future Content.2021 draft

Universe: SHTCVD19NM_C=1,2,3
Question Text:

Response:

Fills:

1 of 2 During what month and year did ^SCNAME receive ^hisher_C most
recent COVID-19 vaccination? Enter month of most recent COVID-19
vaccination.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
DK:
RF:

January
February
March
April
May
June
July
August
September
October
November
December
Don't Know
Refused

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1-12,DK>[goto CVDVAC1Y_C]
 if SHTCVD19NM_C=2,3 [goto CVDVAC2M_C]
else if SHTCVD19NM_C=1 [goto SHTCVD19AV_C]

Page 2 of 7

Question ID: CVV.0030.02.1

Variable name: CVDVAC1Y_C

Interview module: CVV(2021 Future Content.2021 draft

Universe: ((CVDVAC1M_C GE 1 AND CVDVAC1M_C LE 12) OR CVDVAC1M_C=DK)
Question Text:

Response:

2 of 2

DK:
RF:

Enter year of most recent COVID-19 vaccination.

Don't Know
Refused

Skip Instructions:  and SHTCVD19NM_C=2,3
CVDVAC2M_C]
else [goto SHTCVD19AV_C]
if CVDVAC1M_C and CVDVAC1Y_C = a future date
ERR1_CVDVAC1Y_C];
if CVDVAC1M_C and CVDVAC1Y_C = a date prior to birth
ERR2_CVDVAC1Y_C];
if CVDVAC1M_C and CVDVAC1Y_C = a date prior to 2020
ERR3_CVDVAC1Y_C]

[goto

[goto
[goto
[goto

Check Name: ERR1_CVDVAC1Y_C

Text:

{check ERR1_CVDVAC1Y_C} Future date invalid

Hard / Soft Edit: Hard
Universe: (CVDVAC1Y_C gt current year) or (CVDVAC1Y_C=current year and
CVDVAC1M_C gt current month)

Check Name: ERR2_CVDVAC1Y_C

Text:

{check ERR2_CVDVAC1Y_C} Date prior to birth

Hard / Soft Edit: Hard
Universe: CVDVAC1M_C and CVDVAC1Y_C = date prior to birth date

Page 3 of 7

Check Name: ERR3_CVDVAC1Y_C

Text:

{check ERR3_CVDVAC1Y_C} Date before 2020

Hard / Soft Edit: Hard
Universe: (CVDVAC1Y_C lt 2020)

Question ID: CVV.0040.01.3

Variable name: CVDVAC2M_C

Interview module: CVV(2021 Future Content.2021 draft

Universe: SHTCVD19NM_C=2,3
Question Text:

Response:

Fills:

1 of 2 During what month and year did ^SCNAME receive ^hisher_C next most
recent COVID-19 vaccination?
Enter month of the next most recent COVID-19
vaccination.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
DK:
RF:

January
February
March
April
May
June
July
August
September
October
November
December
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

^hisher_C

if GEN.SEX_FINAL[PX_C]=1 fill "his";
else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill
"their"

Page 4 of 7

Skip Instructions: <1-12,DK> [goto CVDVAC2Y_C]
 [goto next section]

Question ID: CVV.0040.02.3

Variable name: CVDVAC2Y_C

Interview module: CVV(2021 Future Content.2021 draft

Universe: ((CVDVAC2M_C GE 1 AND CVDVAC2M_C LE 12) OR CVDVAC2M_C=DK)
Question Text:

Response:

2 of 2

DK:
RF:

Enter year of next most recent COVID vaccination.

Don't Know
Refused

Skip Instructions:  [goto next section]
If CVDVAC2M_C and CVDVAC2Y_C = a date in the future [goto
ERR1_CVDVAC2Y_C]
If CVDVAC2M_C and CVDVAC2Y_C = a date prior to birth [goto
ERR2_CVDVAC2Y_C]
If CVDVAC2M_C and CVDVAC2Y_C = a date prior to 2020
[goto ERR3_CVDVAC2Y_C]
If CVDVAC2M_C and CVDVAC2Y_C = a date more recent than answer given
in (CVDVAC1M_C and CVDVAC1Y_C) [goto ERR4_CVDVAC2Y_C]

Check Name: ERR1_CVDVAC2Y_C

Text:

{check ERR1_CVDVAC2Y_C}

Future date invalid

Hard / Soft Edit: Hard
Universe: (CVDVAC2Y_C gt current year) or (CVDVAC2Y_C=current year and
CVDVAC2M_C gt current month)

Page 5 of 7

Check Name: ERR2_CVDVAC2Y_C

Text:

{check ERR2_CVDVAC2Y_C}

Date prior to birth

Hard / Soft Edit: Hard
Universe: CVDVAC2M_C and CVDVAC2Y_C = a date prior to birth

Check Name: ERR3_CVDVAC2Y_C

Text:

{check ERR3_CVDVAC2Y_C}

Date before 2020

Hard / Soft Edit: Hard
Universe: (CVDVAC2Y_C lt 2020)

Check Name: ERR4_CVDVAC2Y_C

Text:

{check ERR4_CVDVAC2Y_C} The date entered for the second most recent COVID
vaccination is after the date of the most recent COVID vaccination. Please verify.

Hard / Soft Edit: Soft
Universe: (CVDVAC2Y_C gt CVDVAC1Y_C) or (CVDVAC2Y_C=CVDVAC1Y_C and
CVDVAC2M_C gt CVDVAC1M_C)

Question ID: CVV.0050.00.3

Variable name: SHTCVD19AV_C

Interview module: CVV(2021 Future Content.2021 draft

Universe: SHTCVD19NM_C=1
Question Text:

Did a doctor or other health professional tell you that ^SCNAME needs an
additional dose of the COVID-19 vaccination?

Response:

Page 6 of 7

1.
2.
DK:
RF:
Fills:

Yes
No
Don't Know
Refused

^SCNAME

Fill ALIAS of HHSTAT_C=1

Skip Instructions: <1,2,RF,DK> [goto next section]

Page 7 of 7


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