Justification for nonsubstantive change - MOS W29, CABS W8 05-05-23

Justification for Nonsubstantial Change Request to MOS W29 and CABS W8

Monthly Outcomes Survey (MOS) Wave 29: fielding May 12-21

HHS ASPA is adding one question and removing one question to its Monthly Outcome Survey. The new question will assess the number of updated vaccine doses a respondent has received. There are also minor wording changes marked in red throughout. These wording changes update the guidance provided to align with the latest information from the FDA and CDC. These changes will not affect the burden hours per wave.

COVID-19 Attitudes and Behaviors Survey (CABS) Wave 8: programming May 12 to field 5/22-6/23

Revisions to the CABS questionnaire for Wave 8 are proposed to capture changes in COVID-19 vaccination and booster eligibility for children, assess intentions to get a semi-annual/annual COVID-19 vaccine among adults, and measure changes in COVID-19 beliefs over time by adding belief items back into the survey. To address wave-to-wave sample attrition, as part of Wave 8 fielding, we will add approximately 500 new respondents to the longitudinal sample to make the overall sample more demographically representative of the U.S. adult population. Please note that there is no projected cumulative change either in burden per respondent or burden for the entire wave.

Category	Item #	Item Text	Rationale
Brand new questions and additions	BEH5b2 (Grid)	If it were recommended by U.S. public health officials, how likely would you be to get a COVID-19 vaccine… BEH5b2_1: [Every six months] BEH5b2_2: [Once a year] BEH5b2_3: [As recommended to address surges in COVID-19 cases] BEH5b2_4: [As recommended to address new COVID-19 variants or subvariants] Response Options: 1) Very unlikely; 2) Unlikely; 3) Neither likely nor unlikely; 4) Likely; 5) Very likely; -99) REFUSED	Measure likelihood to vaccinate based on administration frequency. Note that this item was also added to recent waves of the MOS (27, 28) and CET (92).
	BEH5f_0	How many updated vaccines for COVID-19 did you receive? Updated vaccines became available in September 2022. Currently, adults ages 65 and older may receive one additional dose at least four months following their first updated vaccine dose. Individuals who are immunocompromised may receive one additional dose at least two months following their first updated vaccine dose – additional doses may be administered at the discretion of their healthcare provider.	Added item to allow for individuals who have received more than one bivalent COVID-19 vaccine dose to disclose their status
	BEH5f_1	What is the likelihood that you will get an updated COVID-19 vaccine?	Added item to measure updated COVID-19 vaccine readiness. Intended to replace equivalent item for initial COVID-19 vaccines
	BEH5g_2	You responded that you will wait to get [IF BEH5f_2 = 2 INSERT: an updated COVID-19 vaccine] How long will you wait?	Added item to measure updated COVID-19 vaccine readiness. Intended to replace equivalent item for initial COVID-19 vaccines
	BEH28b2 (Grid)	If it were recommended by U.S. public health officials, how likely would you be to get your [INSERT CHILD_AGE_x]-year-old [IF DOV_DUPE_x=0 INSERT: child] [IF DOV_DUPE_x=1 INSERT: children] COVID-19 vaccine… BEH28b2_1: [Every six months] BEH28b2_2: [Once a year] BEH28b2_3: [As recommended to address surges in COVID-19 cases] BEH28b2_4: [As recommended to address new COVID-19 variants or subvariants] Response Options: 1) Very unlikely; 2) Unlikely; 3) Neither likely nor unlikely; 4) Likely; 5) Very likely; -99) REFUSED	Measure likelihood to vaccinate one’s children based on administration frequency.
Revisions made to existing items to address changes to environment (pandemic, Campaign), or reintroduction of belief items that were not fielded in the last survey wave	COVID-19 Vaccines	The following questions will ask about your actions and beliefs about initial COVID-19 vaccines, boosters, and updated vaccine doses. Initial COVID-19 vaccines refer to the initial series of doses (i.e., 1 dose of J&J, 2 doses of Pfizer, Moderna, or Novavax). Initial COVID-19 vaccines were available from December 2020 to the middle of April 2023. Boosters refer to an additional 1 or 2 doses you may have received after your initial COVID-19 vaccines. Boosters were available from August 2021 to the end of August 2022. Updated vaccines for COVID-19 refer to COVID-19 vaccines reformulated to better target Omicron variants, sometimes called “updated boosters” or “bivalent boosters.” Updated vaccines became available in September 2022. Initial COVID-19 vaccines for Novavax and Johnson remain available, but individuals ages 6 and older are otherwise recommended to receive an updated vaccine(s) for COVID-19.	Added text to reflect that initial COVID-19 vaccines are no longer available and that certain individuals can receive 2+ updated vaccines.
	BEH5a2_b	U.S health officials and medical experts now recommend additional COVID-19 doses after the initial COVID-19 vaccine series (two doses of Pfizer, Moderna, or Novavax, or one dose of Johnson & Johnson). Boosters are additional doses you may have received after your initial COVID-19 vaccines. Boosters were available from August 2021 to the end of August 2022. Updated vaccines are COVID-19 vaccines reformulated to better target Omicron variants, sometimes called “updated boosters” or “bivalent boosters.” Updated vaccines became available in September 2022. Have you received a COVID-19 booster or updated vaccine? Subitems BEH5a2_b1: I have received one or more booster dose(s) (available August 2021-August 2022) BEH5a2_b2: I have received one or more updated vaccines (available starting September 2022)	Added text in bold to make clear that bivalent doses are the only types of COVID-19 vaccines available currently. Removed skip logic so that all respondents will receive question, whereas in previous waves, only individuals who had received monovalent doses would receive the item. Revised text in BEH5a2_b2 to adjust for FDA recommendation that allows certain eligible adults to receive more than one bivalent COVID-19 vaccine dose.
	BEH5e_10	Why did you decide to get a COVID-19 booster dose? Please select up to three of your top reasons. [My job required me to get a booster.]	Revised subitem text for clarity
	Text preceding items on updated COVID-19 vaccines	This section asks for your opinion on statements related to updated COVID-19 vaccines. Updated COVID-19 vaccines refer to COVID-19 vaccines reformulated to better target Omicron variants, sometimes called “updated boosters” or “bivalent boosters.” Updated vaccines became available in September 2022.	Added text to make clear the bivalent COVID-19 vaccine doses are the only available COVID-19 vaccines currently
	BEH27	[IF DOV_DUPE_x=0 INSERT: Has] [IF DOV_DUPE_x=1 INSERT: Have] your [IF CHILD_AGE_x >-99 INSERT:_[CHILD_AGE_x]-year-old] [IF DOV_DUPE_x=0 INSERT: child] [IF DOV_DUPE_x=1 INSERT: children] received an initial COVID-19 vaccine? *Children ages 6 months – 4 years old who received a Pfizer vaccine have 3 doses included in their initial vaccine series; 5-year-olds may receive 1 dose of the Pfizer vaccine. Children ages 6 months – 5 years old who received a Moderna vaccine have 2 doses included in their initial vaccine serie. Children ages 6 and older who received a Pfizer vaccine or a Moderna vaccine, have 1 dose included in their initial vaccine series. Children ages 12 – 17 years old who received a Novavax vaccine have 2 doses included in their initial vaccine series.	Revised italicized text to reflect new FDA recommendations for child COVID-19 vaccine administration
	BEH31	U.S. health officials and medical experts now recommend that children ages 6 months – 17 years of age receive an updated vaccine dose two months after completing their series of initial COVID-19 vaccine doses. [IF DOV_DUPE_x=0 INSERT: Has] [IF DOV_DUPE_x=1 INSERT: Have] your [IF CHILD_AGE_x >-99 INSERT:_[CHILD_AGE_x]-year-old] [IF DOV_DUPE_x=0 INSERT: child] [IF DOV_DUPE_x=1 INSERT: children] received [IF CHILD_AGE_X=5–17, INSERT: an updated vaccine dose for COVID-19]?	Modified text in second paragraph to focus more on the ages in which children are eligible for updated vaccines rather than the type of updated vaccine dose. Changes will make the question more accessible to a wider audience.
	ATT5_1 (Grid)	How much do you agree or disagree with the following statements? Select one response for each item. Subitems ATT5_1: [COVID-19 is probably a hoax.] ATT5_2: [Public health officials are exaggerating the seriousness of COVID-19.] ATT5_4: [There are people who want the pandemic to continue for their own personal gain.] ATT5_5: [COVID-19 was created in a lab.] ATT5_6: [COVID-19 is more dangerous than the flu.] Response Options: 1) Strongly disagree; 2) Disagree; 3) Neither agree nor disagree; 4) Agree; 5) Strongly agree; -99) REFUSED	Fielding again to measure change in level of COVID-19 misinformation over time.
	ATT9	How much do you agree or disagree with the following statements about COVID-19? Select one response for each item. ATT9_2a: [I am worried that an updated COVID-19 vaccine could give me COVID-19.] ATT9_3a: [I would rather build immunity by exposure to an infected individual than receive an updated COVID-19 vaccine.] ATT9_5a: [I am worried about side effects of an updated COVID-19 vaccine for myself.] ATT9_6a: [I am worried that side effects of an updated COVID-19 vaccine could be worse than COVID-19 itself.] Response Options: 1) Strongly disagree; 2) Disagree; 3) Neither agree nor disagree; 4) Agree; 5) Strongly agree; -99) REFUSED	Fielding to measure change in COVID-19 vaccine concerns and perceived risks as they pertain to updated vaccines. Note that these items have been adapted from items used to assess beliefs about initial vaccines.
	ATT11_1	How much do you agree or disagree with the following statements about vaccines in general? Select one response for each item. ATT11_1: [I am completely confident that vaccines are safe.] ATT11_2: [Vaccinations are effective.] ATT11_3: [I am confident that public authorities decide to approve vaccines when it is in the best interest of the community.] ATT11_4: [Diseases that have a vaccine (e.g., shingles, pneumonia) are not so bad that I need to get a vaccine for them.] ATT11_7: [When everyone is vaccinated, I do not have to get vaccinated, too.] ATT11_8: [I get vaccinated because it protects people with a weaker immune system.] Response Options: 1) Strongly disagree; 2) Disagree; 3) Neither agree nor disagree; 4) Agree; 5) Strongly agree; -99) REFUSED	Fielding again to measure change in perceptions of vaccine safety and effectiveness over time.
	CAM16_7	In the last week, have you used the following government sources to get information about COVID-19? Select yes or no for each item. [Dr. Collins/National Institute of Allergy and Infectious Diseases (NIAID)]	Removed reference to Dr. Fauci given his retirement
Select repeat items from the media diet survey (Wave 5B), and new items (marked with an asterisk) to enhance our understanding of media use	MD1a (Grid)	Which of the following media channels do you typically use? Please select all that apply. TV via cable, streaming (e.g., Netflix, Peacock), satellite, or antenna Social media (e.g., Facebook, Instagram, Twitter, Pinterest, YouTube) None of the above Refused (Not shown in survey)	Fielding again to measure media consumption habits over time.
	MD3_Cable	Now we are going to ask you about your use of cable television. For this question, please do not consider non-cable streaming services like Netflix, Peacock, etc. How often do you watch cable television via the following? Traditional cable provider (e.g., Comcast, Charter, Verizon) Satellite or antenna Sling TV YouTube TV Hulu Live TV Fubo TV Other (please specify) Response Options: 1) Never; 2) Every few months; 3) Every few weeks; 4) 1–2 days a week; 5) 3–6 days a week; 6) About once a day; 7) Several times a day; -99) REFUSED; -100) Valid Skip	Fielding again to measure media consumption habits over time.
	MD3_Cable_DaysWeek	Broadcast television includes television watched through a traditional cable provider, a satellite provider, or an antenna. How many days per week do you watch broadcast television?	Fielding to measure media consumption habits.
	MD3_Cable_HoursDay	Broadcast television includes television watched through a traditional cable provider, a satellite provider, or an antenna. How many hours per day do you watch broadcast television?	Fielding to measure media consumption habits.
	MD3_Online_DaysWeek	Online television includes television watched through SlingTV, YouTubeTV, Hulu Live, or FuboTV. How many days per week do you watch online television?	Fielding to measure media consumption habits.
	MD3_Online_HoursDay	Online television includes television watched through SlingTV, YouTubeTV, Hulu Live, or FuboTV. How many hours per day do you watch online television?	Fielding to measure media consumption habits.
	MD3a_Stream	Now we are going to ask you about your use of streaming video services. For this question, please do not consider TV via cable, satellite, antenna, or alternative cable service. How often do you watch the following? Amazon Prime Video Apple TV Crunchyroll Discovery+ Disney+ ESPN+ Google TV HBO Max/Max Hulu IMDb TV Netflix Paramount+ Peacock TV The Roku Channel Tubi YouTube Zeebi Other (please specify) Response Options: 1) Never; 2) Every few months; 3) Every few weeks; 4) 1–2 days a week; 5) 3–6 days a week; 6) About once a day; 7) Several times a day; -99) REFUSED; -100) Valid Skip	Fielding again to measure media consumption habits over time.
	MD3a_Stream_DaysWeek	Streaming television includes television watched through the following services: Amazon Prime Video, AppleTV, Crunchyroll, Discovery+, Disney+, ESPN+, Google TV, HBO Max, Hulu, IMDb TV, Netflix, Paramount+, Peacock TV, The Roku Channel, Tubi, YouTube, Zeebi, etc. How many days per week do you watch streaming television?	Fielding to measure media consumption habits.
	MD3a_Stream_HoursDay	Streaming television includes television watched through the following services: Amazon Prime Video, AppleTV, Crunchyroll, Discovery+, Disney+, ESPN+, Google TV, HBO Max, Hulu, IMDb TV, Netflix, Paramount+, Peacock TV, The Roku Channel, Tubi, YouTube, Zeebi, etc. How many hours per day do you watch streaming television?	Fielding to measure media consumption habits.
	MD9_SM (Grid)	How often do you use the following types of social media? Facebook Instagram LinkedIn Pinterest Reddit Snapchat TikTok Twitter WhatsApp YouTube Other (please specify) Response Options: 1) Never; 2) Every few months; 3) Every few weeks; 4) 1–2 days a week; 5) 3–6 days a week; 6) About once a day; 7) Several times a day; -99) REFUSED; -100) Valid Skip	Fielding again to measure media consumption habits over time.
	MD9_SM_DaysWeek	Social media includes the following platforms: Facebook, Instagram, LinkedIn, Pinterest, Reddit, Snapchat, TikTok, Twitter, WhatsApp, YouTube, etc. How many days per week do you use social media?	Fielding to measure media consumption habits.
	MD9_SM_HoursDay	Social media includes the following platforms: Facebook, Instagram, LinkedIn, Pinterest, Reddit, Snapchat, TikTok, Twitter, WhatsApp, YouTube, etc. How many hours per day do you use social media?	Fielding to measure media consumption habits.
	MD12_DISINFO_1	Lastly, we will ask you to recall whether media you consumed over the last week have said the following: COVID-19 is about as dangerous as a common flu.	Fielding to measure COVID-19 disinformation
	MD12_DISINFO_2	Lastly, we will ask you to recall whether media you consumed over the last week have said the following: Recent heart attacks among athletes have been attributed to COVID-19 vaccinations.	Fielding to measure COVID-19 disinformation
Repeat item from previous survey waves	DEM10	Last year, that is in 2022, what was your total household income from all sources, before taxes?	Fielding again to get most up-to-date measure of household income
Deletions	BEH2	What is the likelihood that you will [IF BEH1a=0 or -99 INSERT: get an initial COVID-19 vaccine] [IF BEH1b=2 AND BEH1c=1, -99, or -100 INSERT: complete initial COVID-19 vaccination]? Do not include booster doses or updated vaccine doses for COVID-19 when answering this question.	We will not use this item in future analyses.
	BEH3a	How soon will you get an initial COVID-19 vaccine? Do not include booster doses or updated vaccine doses for COVID-19 when answering this question.	We will not use this item in future analyses.
	BEH3b	How soon will you get the second dose of an initial COVID-19 vaccine?	We will not use this item in future analyses.
	BEH3c	You responded that you will wait to get [IF BEH3a=2 INSERT: an initial COVID-19 vaccine] [IF BEH3b=2 INSERT: the second dose of an initial COVID-19 vaccine]. How long will you wait?	We will not use this item in future analyses.
	BEH19_2	The following question asks about your thoughts and behaviors about social distancing to prevent the spread of COVID-19. How much do you agree or disagree with the following statements? Select one response for each item. [It is easy for me to maintain social distancing.]	We will not use this item in future analyses.
	CAM20b	Before today, have you called the CDC phone number, 800-CDC-INFO (800-232-4636), to schedule a vaccine or booster appointment? Include COVID-19 vaccines from your initial vaccine series, booster doses, and updated vaccine doses for COVID-19 when answering this question.	We will not use this item in future analyses.
	COV18a	How far do you live from most members of your immediate social network? Please choose the option that best describes your experience.	We will not use this item in future analyses.
	COV18b	How often do you physically meet with members of your immediate social network?	We will not use this item in future analyses.
	MOB2	Are you currently pregnant?	We will not use this item in future analyses.
	MOB5	In general, how would you rate your mental or emotional health?	We will not use this item in future analyses.
	MOB6	Have you ever been diagnosed with an anxiety disorder?	We will not use this item in future analyses.
	MOB7	Have you ever been diagnosed with depression?	We will not use this item in future analyses.
	DEM11	The CDC is tracking an outbreak of Monkeypox, also known as mpox, that has spread across several countries that don’t normally report monkeypox, including the United States. Monkeypox is a disease caused by infection with the monkeypox virus, which is part of the same family of the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. ACAM200 and JYNNEOS (also known as Imvamune or Imvanex) are licensed vaccines in the United States to prevent smallpox, which have been also used to treat Monkeypox. What is the likelihood that you will receive ACAM200 or JYNNEOS if you were exposed to Monkeypox?	This item is no longer relevant to the current public health climate, and we will not use this item in future analyses.

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