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pdf2026 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IMQ-IMMUNIZATION
Question Text/Description
Code List
Routing
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) SHNGTIME
(02) NSHNGWHY
(-8) BOX IM3
(-9) BOX IM3
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX IM2
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) BOX IM2
(02) BOX IM2
(-8) BOX IM3
(-9) BOX IM3
(01) PHARMACY/DRUG STORE
(02) DOCTORS OFFICE OR GROUP PRACTICE
(03) CLINIC (MEDICAL
CLINIC/NEIGHBORHOOD/FAMILY HEALTH
CENTER/RURAL HEALTH CLINIC/COMPANY
CLINIC/WORKPLACE)
(04) HOSPITAL/WALK-IN URGENT CENTER
(05) VA FACILITY
(06) COMMUNITY SITE (HEALTH FAIR/SHOPPING
MALL/CHURCH/SCHOOL/LIBRARY)
(07) AT HOME
(08) SENIOR CENTER
(91) OTHER, SPECIFY
(-8) DON'T KNOW
(-9) REFUSED
(01)-(08) SHINGCOST
(91) SHNGSTOS
(-8) SHINGCOST
(-9) SHINGCOST
IMMUNIZATION QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=ALL
SPALIVE=1
SEASON=WINTER or SUMMER
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after HIQ PVQ.
BOX IM1
SHINGVAC
PV6
routing
yes/no
IF (SEASON= SUMMER), GO TO BOX PVBEG.
ELSE, IF SP HAS NEVER BEEN ASKED SHINGVAC (P_SHINGVAC=.), GO TO SHINGVAC.
ELSE IF SP HAS NEVER REPORTED RECEIVING SHINGLES VACCINE (P_SHINGVAC=2 (NO), -8 (DK), or -7
(RF)), GO TO SHINGYR.
ELSE GO TO BOX IM3.
Shingles is an illness that results in a rash or blisters on the skin and is usually painful. There are two vaccines
that have been used to prevent shingles. The first was Zostavax®, which was available in the U.S. from 2006
through 2020 and required one shot. The other is Shingrix®, which has been available since 2017 and requires
two shots.
[Have you/Has (SP)] ever had a vaccine for Shingles?
IF THE RESPONDENT HAD ONE DOSE OF A SHINGLES VACCINE, SELECT YES.
SHNGTIME
SHINGYR
SHNGTIME
SHINGYR
code one
yes/no
Did [you/(SP)] get [your/their] Shingles vaccine since January 1, 2023?
Shingles is an illness that results in a rash or blisters on the skin and is usually painful. There are two vaccines
that have been used to prevent shingles. The first was Zostavax®, which was available in the U.S. from 2006
through 2020 and required one shot. The other is Shingrix®, which has been available since 2017 and requires
two shots.
Since (CURRENT MONTH, CURRENT YEAR - 1), [have you/has (SP)] had a vaccine for Shingles?
IF THE RESPONDENT HAD ONE DOSE OF A SHINGLES VACCINE, SELECT YES.
BOX IM2
routing
If SHINGVAC=YES or SHINGYR=YES, go to SHNGSITE SHINGCOST.
ELSE GO TO NSHNGWHY.
SHNGSITE
SHNGSITE
code one
Where did [you/(SP)] go for [your/(SP)'s] Shingles vaccine?
SHNGSTOS
SHNGSTOS
verbatim text
OTHER (SPECIFY)
SHINGCOST
SHINGCOST
yes/no
Did [you/(SP)] pay some or all of the cost of the Shingles vaccine?
SHINGCOST
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX IM3
Page 1 of 6
2026 MCBS Community Questionnaire
Variable Name
NSHNGWHY
MR Screen Name
NSHNGWHY
BOX IM3
Question Type
code all
code one
routing
IMQ-IMMUNIZATION
Question Text/Description
For What is the main reason didn't [you/(SP)] get a Shingles vaccine?
[PROBE: Any other reason?]
CHECK ALL THAT APPLY.
PNEUTIME
PV7
PNEUTIME
yes/no
code one
This shot is usually given only once or twice in a person's lifetime and is different from the flu shot. It is also
called the pneumococcal vaccine. There are two types of pneumonia shots: polysaccharide, also known as
Pneumovax®23, and conjugate, also known as Prevnar®20 or Vaxneuvance®.
Did [you/(SP)] get [your/their] pneumonia vaccine since January 1, 2023?
Since (CURRENT MONTH, CURRENT YEAR - 1), [have you/has (SP)] had a pneumonia shot?
PNEUYR
PNEUYR
yes/no
BOX IM4
routing
This shot is usually given only once or twice in a person's lifetime and is different from the flu shot. It is also
called the pneumococcal vaccine. There are two types of pneumonia shots: polysaccharide, also known as
Pneumovax®23, and conjugate, also known as Prevnar®20 or Vaxneuvance®.
PNEUSITE
code one
Where did [you/(SP)] go for [your/(SP)'s] pneumonia shot?
PNEUSTOS
PNEUSTOS
verbatim text
OTHER (SPECIFY)
PNEUCOST
yes/no
(01) WORRIED ABOUT SIDE EFFECTS/ALLERGIC TO
INGREDIENTS IN VACCINE/MEDICAL REASON FOR
NOT GETTING VACCINE
(02) VACCINE IS NOT NEEDED OR NECESSARY
(03) FORGOT/TOO BUSY
(04) SHOT COULD BE PAINFUL/DON'T LIKE
NEEDLES
(05) COULDN'T AFFORD VACCINE/OTHER COSTRELATED CONCERNS
(06) INTEND TO GET VACCINE BUT HAVE NOT YET
BOX IM3
GOTTEN IT
(07) PROVIDER DID NOT RECOMMEND VACCINE
(08) VACCINE NOT AVAILABLE/COULDN'T FIND A
PLACE OFFERING THE VACCINE
(09) DIFFICULTY MAKING AN
APPOINTMENT/TRANSPORTATION PROBLEMS
(10) DISEASE IS NOT SERIOUS
(11) DOESN'T TRUST THE GOVERNMENT
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) PNEUTIME
(02) NPNEUWHY
(-8) BOX IM5
(-9) BOX IM5
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX IM4
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) BOX IM4
(02) BOX IM4
(-8) BOX IM5
(-9) BOX IM5
(01) PHARMACY/DRUG STORE
(02) DOCTORS OFFICE OR GROUP PRACTICE
(03) CLINIC (MEDICAL
CLINIC/NEIGHBORHOOD/FAMILY HEALTH
CENTER/RURAL HEALTH CLINIC/COMPANY
CLINIC/WORKPLACE)
(04) HOSPITAL/WALK-IN URGENT CENTER
(05) VA FACILITY
(06) COMMUNITY SITE (HEALTH FAIR/SHOPPING
MALL/CHURCH/SCHOOL/LIBRARY)
(07) AT HOME
(08) SENIOR CENTER
(91) OTHER, SPECIFY
(-8) DON'T KNOW
(-9) REFUSED
(01)-(09) PNEUCOST
(91) PNEUSTOS
(-8) PNEUCOST
(-9) PNEUCOST
If PNEUSHOT=YES or PNEUYR=YES, go to PNEUSITE PNEUCOST.
ELSE GO TO NPNEUWHY.
PNEUSITE
PNEUCOST
Routing
IF SP HAS NEVER BEEN ASKED PNEUSHOT (P_PNEUSHOT=.), GO TO PNEUSHOT.
ELSE IF SP HAS NEVER REPORTED RECEIVING PNEUMONIA VACCINE (=2 (NO), -8 (DK), or -7 (RF)), GO
TO PNEUYR.
ELSE GO TO BOX IM5.
[Have you/Has (SP)] EVER had a pneumonia shot?
PNEUSHOT
Code List
Did [you/(SP)] pay some or all of the cost of the pneumonia shot?
PNEUCOST
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX IM5
Page 2 of 6
2026 MCBS Community Questionnaire
Variable Name
NPNEUWHY
MR Screen Name
NPNEUWHY
BOX IM5
RSVVAC
RSVVAC
Question Type
code all
code one
routing
yes/no
IMQ-IMMUNIZATION
Question Text/Description
For What is the main reason didn't [you/(SP)] get a pneumonia shot?
[PROBE: Any other reason?]
CHECK ALL THAT APPLY.
RSVYR
RSVTIME
RSVYR
code one
yes/no
Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, coldlike symptoms. Adults aged 60 years and older may receive a single dose of RSV vaccine.
Did [you/(SP)] get [your/their] RSV vaccine since January 1, 2023?
Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, coldlike symptoms. Adults aged 60 years and older may receive a single dose of RSV vaccine
Since (CURRENT MONTH, CURRENT YEAR - 1), [have you/has (SP)] had a vaccine for RSV?
BOX IM6
routing
RSVSITE
code one
Where did [you/(SP)] go for [your/(SP)'s] RSV vaccine?
RSVSTOS
RSVSTOS
verbatim text
OTHER (SPECIFY)
RSVCOST
yes/no
(01) WORRIED ABOUT SIDE EFFECTS/ALLERGIC TO
INGREDIENTS IN VACCINE/MEDICAL REASON FOR
NOT GETTING VACCINE
(02) VACCINE IS NOT NEEDED OR NECESSARY
(03) FORGOT/TOO BUSY
(04) SHOT COULD BE PAINFUL/DON'T LIKE
NEEDLES
(05) COULDN'T AFFORD VACCINE/OTHER COSTRELATED CONCERNS
(06) INTEND TO GET VACCINE BUT HAVE NOT YET
BOX IM5
GOTTEN IT
(07) PROVIDER DID NOT RECOMMEND VACCINE
(08) VACCINE NOT AVAILABLE/COULDN'T FIND A
PLACE OFFERING THE VACCINE
(09) DIFFICULTY MAKING AN
APPOINTMENT/TRANSPORTATION PROBLEMS
(10) DISEASE IS NOT SERIOUS
(11) DOESN'T TRUST THE GOVERNMENT
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) RSVTIME
(02) NRSVWHY
(-8) BOX IMEND
(-9) BOX IMEND
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX IM6
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) BOX IM6
(02) BOX IM6
(-8) BOX IMEND
(-9) BOX IMEND
(01) PHARMACY/DRUG STORE
(02) DOCTORS OFFICE OR GROUP PRACTICE
(03) CLINIC (MEDICAL
CLINIC/NEIGHBORHOOD/FAMILY HEALTH
CENTER/RURAL HEALTH CLINIC/COMPANY
CLINIC/WORKPLACE)
(04) HOSPITAL/WALK-IN URGENT CENTER
(05) VA FACILITY
(06) COMMUNITY SITE (HEALTH FAIR/SHOPPING
MALL/CHURCH/SCHOOL/LIBRARY)
(07) AT HOME
(08) SENIOR CENTER
(91) OTHER, SPECIFY
(-8) DON'T KNOW
(-9) REFUSED
(01)-(09) RSVCOST
(91) RSVSTOS
(-8) RSVCOST
(-9) RSVCOST
If RSVVAC=YES or RSVYR=YES, go to RSVSITE RSVCOST.
ELSE GO TO NRSVWHY.
RSVSITE
RSVCOST
Routing
IF SP HAS NEVER BEEN ASKED RSVVAC (P_RSVVAC=.), GO TO RSVVAC.
ELSE IF SP HAS NEVER REPORTED RECEIVING RSV VACCINE (P_RSVVAC=2 (NO), -8 (DK), or -7 (RF)),
GO TO RSVYR.
ELSE GO TO BOX IMEND.
[Have you/Has (SP)] EVER had a vaccine for RSV?
RSVTIME
Code List
Did [you/(SP)] pay some or all of the cost of the RSV vaccine?
RSVCOST
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX IMEND
Page 3 of 6
2026 MCBS Community Questionnaire
Variable Name
NRSVWHY
PVINTRO
FLUSHOT
VACPAID
FLUCODE
MR Screen Name
NRSVWHY
Question Type
code all
code one
IMQ-IMMUNIZATION
Question Text/Description
For What is the main reason didn't [you/(SP)] get an RSV vaccine?
[PROBE: Any other reason?]
CHECK ALL THAT APPLY.
BOX PVBEG
routing
IF (SEASON=WINTER), GO TO PVINT-PVINTRO.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO PVF1-FLUSHOT^=1/YES), GO TO
PVINT-PVINTRO.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO PVF1-FLUSHOT=1/YES), GO TO BOX
CVBEG.
PVINT
No entry
IF SEASON=WINTER, FILL "Now I’d like to ask you some questions about the seasonal flu vaccine."
ELSE IF SEASON=SUMMER, FILL "At the time of the last interview, we recorded that [you/(SP)] had not gotten
a seasonal flu vaccine for the [CURRENT YEAR MINUS 1] - [CURRENT YEAR] flu season."
PVF1
yes/no
Since [July 1st, (ROUND YEAR MINUS 1)/[MREFDATE]], [have you/has (SP)] had a seasonal flu vaccine?
IF THE RESPONDENT MENTIONS A SHORT NEEDLE OR NEEDLELESS INJECTOR, CODE AS “YES”.
VACPAID
yes/no
Did [you/(SP)] pay some or all of the cost of the seasonal flu vaccine?
BOX PV1
routing
IF SEASON=WINTER OR (IF SEASON=SUMMER AND P_FLUSHOT in (., -7, -8), GO TO PVF2-FLUCODE.
ELSE GO TO BOX CVBEG.
PVF2
code one
What is the main reason didn't [you/(SP)] get a seasonal flu vaccine since July 1st?
Code List
Routing
(01) WORRIED ABOUT SIDE EFFECTS/ALLERGIC TO
INGREDIENTS IN VACCINE/MEDICAL REASON FOR
NOT GETTING VACCINE
(02) VACCINE IS NOT NEEDED OR NECESSARY
(03) FORGOT/TOO BUSY
(04) SHOT COULD BE PAINFUL/DON'T LIKE
NEEDLES
(05) COULDN'T AFFORD VACCINE/OTHER COSTRELATED CONCERNS
(06) INTEND TO GET VACCINE BUT HAVE NOT YET BOX IMEND
BOX PVBEG
GOTTEN IT
(07) PROVIDER DID NOT RECOMMEND VACCINE
(08) VACCINE NOT AVAILABLE/COULDN'T FIND A
PLACE OFFERING THE VACCINE
(09) DIFFICULTY MAKING AN
APPOINTMENT/TRANSPORTATION PROBLEMS
(10) DISEASE IS NOT SERIOUS
(11) DOESN'T TRUST THE GOVERNMENT
(-8) DON'T KNOW
(-9) REFUSED
PVF1-FLUSHOT
(01) YES
(02) NO
(-8) DON’T KNOW
(-9) REFUSED
(01) VACPAID
(02) BOX PV1
(-8) BOX CVBEG
(-9) BOX CVBEG
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
BOX PV1
(01) WORRIED ABOUT SIDE EFFECTS/ALLERGIC TO
INGREDIENTS IN VACCINE/MEDICAL REASON FOR
NOT GETTING VACCINE
(02) VACCINE IS NOT NEEDED OR NECESSARY
(03) FORGOT/TOO BUSY
(04) SHOT COULD BE PAINFUL/DON'T LIKE
NEEDLES
(05) COULDN'T AFFORD VACCINE/OTHER COSTRELATED CONCERNS
(06) INTEND TO GET VACCINE BUT HAVE NOT YET
BOX CVBEG
GOTTEN IT
(07) PROVIDER DID NOT RECOMMEND VACCINE
(08) VACCINE NOT AVAILABLE/COULDN'T FIND A
PLACE OFFERING THE VACCINE
(09) DIFFICULTY MAKING AN
APPOINTMENT/TRANSPORTATION PROBLEMS
(10) DISEASE IS NOT SERIOUS
(11) DOESN'T TRUST THE GOVERNMENT
(91) OTHER
(-8) DON’T KNOW
(-9) REFUSED
Page 4 of 6
2026 MCBS Community Questionnaire
Variable Name
MR Screen Name
BOX CVBEG
IMQ-IMMUNIZATION
Question Type
Question Text/Description
routing
IF (SEASON=WINTER), GO TO COVSHOT.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO COVSHOT^=1/YES), GO TO COVSHOT.
ELSE IF (SEASON=SUMMER) AND (WINTER ROUND RESONSE TO COVSHOT=1/YES), GO TO BOX
IMEND.
The next questions are about coronavirus or COVID-19 vaccination.
COVSHOT
COVSHOT
yes/no
Since July 1st, (ROUND YEAR MINUS 1), [have you/has (SP)] had a COVID-19 vaccination?
IF NEEDED: Please include booster shots.
What is the main reason [you/(SP)] did not get a COVID-19 vaccine [in [PREVIOUS YEAR]]?
NOVCREAS
NOVCREAS
code one
[PROBE: Any other reason?]
IF R IS NOT ELIGIBLE FOR THEIR NEXT DOSE, SELECT "NOT ELIGIBLE FOR NEXT DOSE YET."
Since [PREVIOUS YEAR], [have you/has (SP)] had COVID-19?
YRHDCVD
yes/no
BOX CV2
routing
[IF NEEDED: Include being told by a doctor or other health professional that you had or likely had COVID-19.
Also include antibodies or blood tests as well as other forms of testing for COVID-19, such as a nasal swabbing
or throat swabbing. Also include if you had close contact with someone who had COVID-19 and you had
symptoms.]
EVRCOVID
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) BOX CV1
(02) NOVCREAS-NOVCREAS
(-8) BOX CV1
(-9) BOX CV1
(01) NOT ELIGIBLE FOR NEXT DOSE YET
(02) WORRIED ABOUT SIDE EFFECTS/ALLERGIC TO
INGREDIENTS IN VACCINE/MEDICAL REASON FOR
NOT GETTING VACCINE
(03) VACCINE IS NOT NEEDED OR NECESSARY
(04) FORGOT/TOO BUSY
(05) SHOT COULD BE PAINFUL/DON'T LIKE
NEEDLES
(06) COULDN'T AFFORD VACCINE/OTHER COSTRELATED CONCERNS
(07) INTEND TO GET VACCINE BUT HAVE NOT YET
BOX CV1
GOTTEN IT
(08) PROVIDER DID NOT RECOMMEND VACCINE
(09) VACCINE NOT AVAILABLE/COULDN'T FIND A
PLACE OFFERING THE VACCINE
(10) DIFFICULTY MAKING AN
APPOINTMENT/TRANSPORTATION PROBLEMS
(11) DISEASE IS NOT SERIOUS
(12) DOESN'T TRUST THE GOVERNMENT
(91) OTHER
(-8) DON’T KNOW
(-9) REFUSED
yes/no
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) CVDSVRE
(02) BOX CV2
(-8) BOX CV2
(-9) BOX CV2
IF INTTYPE is C007 [sample_person.INTTYPE=7], GO TO EVRCOVID,
ELSE GO TO BOX IMEND.
[Have you/Has (SP)] ever had COVID-19?
EVRCOVID
Routing
IF (SEASON=WINTER), GO TO YRHDCVD.
ELSE IF (SEASON=SUMMER) GO TO BOX IMEND.
BOX CV1
YRHDCVD
Code List
[IF NEEDED: Include being told by a doctor or other health professional that you had or likely had COVID-19.
Also include antibodies or blood tests as well as other forms of testing for COVID-19, such as a nasal swabbing
or throat swabbing. Also include if you had close contact with someone who had COVID-19 and you had
symptoms.]
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) LONGCVD
(02) BOX CVEND
(-8) BOX CVEND
(-9) BOX CVEND
Page 5 of 6
2026 MCBS Community Questionnaire
Variable Name
CVDSVRE
CVDHOSP
LONGCVD
MR Screen Name
CVDSVRE
CVDHOSP
IMQ-IMMUNIZATION
Question Type
Question Text/Description
code one
(01) NO SYMPTOMS
(02) MILD SYMPTOMS
When [you/(SP)] had COVID-19 in [PREVIOUS YEAR], how would you describe [your/(SP)’s] COVID-19
(03) MODERATE SYMPTOMS
symptoms when they were at their worst? Would you say [you/(SP)] had no symptoms, mild symptoms, moderate
(04) SEVERE SYMPTOMS
symptoms, or severe symptoms?
(-8) DON'T KNOW
(-9) REFUSED
yes/no
In [PREVIOUS YEAR] [were you/was (SP)] hospitalized overnight for COVID-19?
[IF NEEDED: This could include visiting the emergency room or being admitted to the hospital.]
Code List
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
LONGCVD
yes/no
Did [you/(SP)] have any symptoms lasting 3 months or longer that [you/(SP)] did not have prior to having COVID(01) YES
19?
(02) NO
(03) NOT APPLICABLE, RECENTLY DIAGNOSED
[IF NEEDED: Long term symptoms may include tiredness or fatigue, difficulty thinking, concentrating,
WITH COVID-19 (LESS THAN THREE MONTHS)
forgetfulness or memory problems, sometimes referred to as "brain fog," difficulty breathing or shortness of
(-8) DON'T KNOW
breath, joint or muscle pain, fast-beating or pounding heart (also known as heart palpitations), chest pain,
(-9) REFUSED
dizziness on standing, depression, anxiety or mood changes.]
BOX IMEND
routing
GO TO CVQ KNQ.
Routing
CVDHOSP
LONGCVD
BOX IMEND
Page 6 of 6
| File Type | application/pdf |
| Author | NORC |
| File Modified | 2025-06-27 |
| File Created | 2025-06-27 |