Attitudes and beliefs about Covid-19 vaccine uptake

 

1. What is your position in the work place? *

 

2. How long have you been working in the current role? *

 

3. What is your age (in years)? *

 

4. What is your gender? *

 

5. Which religion do you follow? *

 

6. Which of the following best describes your ethnicity? *

 

7. Do you consider yourself to have a disability or long term health condition that has significant impact on your day o day life? *

 

8. Have you had a Covid-19 vaccine? *

 

9. Do you know anyone who has had a Covid-19 infection? *

 

10. If yes, have they had a serious illness which needed medical intervention in the community or at a hospital?

 

11. Have you known anyone who has had a long Covid-19 infection or long term complications due to Covid-19 infection? *

 

12. Factors influencing decision to accept the vaccine *

Strongly AgreeAgreeNeither Agree or DisagreeDisagreeStrongly Disagree
I wanted to avoid getting the Covid-10 infection
I wanted to protect my family at home
I was recommended to take the Covid-19 vaccine
I wanted to protect the patients I cared for
I know someone who got sick with the Covid-19 infection
I don't want to be off sick with Covid-19
My line manager suggested I have the vaccine
 

13. Factors influencing decision to decline the vaccine *

Strongly AgreeAgreeNeither Agree or DisagreeDisagreeStrongly Disagree
Vaccine can give me Covid-10 infection
Vaccine can cause serious side effects
I don't need the Covid-19 vaccine
I don't believe that the Covid-19 vaccine really prevents Covid
I forgot to get the Covid-19 vaccine
I don't trust the Covid-19 vaccine
I am not aware of the long term safety of Covid-10 vaccine
I was not supported at work to take time off to attend the vaccination
 

14. Section 2 - Factors influencing decision to decline the vaccine *

Strongly AgreeAgreeNeither Agree or DisagreeDisagreeStrongly Disagree
Covid-19 is a serious illness
Covid-19 infection can be easily treated
I am at risk of catching Covid-19 infection
I believe that vaccines are useful
Getting the Covid-19 vaccine is a good way to protect against catching Covid-19
The Covid-19 vaccine itself doesn't cause Covid-19 illness
I have concerns about the side effects of the Covid-19 vaccines
I am healthy and I don't need the Covid-19 vaccine
Getting the Covid-19 vaccine not only protects you but also your patients
Getting the Covid-19 vaccine not only protects you but also your family
I am aware that vaccination against Covid-19 is recommended for all health care related workers
Covid-19 vaccine is easily accessible
No one recommended me to take the Covid-19 vaccine
The Covid-19 vaccination should be mandatory for all health care related workers
I don't believe Covid-19 is a true pandemic
I am not sure if the vaccine is tested enough in ethnic minorities in clinical trials
 

15. Does your religion / cultural beliefs prevent you from not taking the vaccine? *

 

16. The single most important motivating factor for taking the Covid-19 vaccine was *

 

17. Were you concerned about one of more of the following conditions that prevented you from taking the vaccine? Please select one or more from the following. Check all that apply.

 

18. if there is any other reason for not taking the vaccine, please describe below

 

19. The single most important factor for NOT taking the Covid-19 vaccine was *

 

20. We are interested to learn about the beliefs on Covid-19 among healthcare workers. Please describe any other beliefs not covered above.

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