Attitudes and beliefs about Covid-19 vaccine uptake

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What is your position in the work place?

Other

This is required

How long have you been working in the current role?

What is your age (in years)?

What is your gender?

Which religion do you follow?

Which of the following best describes your ethnicity?

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

Have you had a Covid-19 vaccine?

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

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

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

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

If yes, please describe them briefly

This is required

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

If other, please describe

This is required

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.

Significant allergy

Medical complications

Pregnancy and related concerns

Concerns related to fertility being affected by the vaccine

Significant symptoms of long term Covid-19

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

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

Fear of side effects

Don't believe that the vaccine works

Concerns about the safety of the vaccine

Not applicable

Others

* If others, please describe below

Required

This is required

Attitudes and beliefs about Covid-19 vaccine uptake

What is your position in the work place?

How long have you been working in the current role?

What is your age (in years)?

What is your gender?

Which religion do you follow?

Which of the following best describes your ethnicity?

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

Have you had a Covid-19 vaccine?

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

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

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

Factors influencing decision to accept the vaccine

Factors influencing decision to decline the vaccine

Section 2 - Factors influencing decision to decline the vaccine

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

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

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.

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

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

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

Page 1

What is your position in the work place?

How long have you been working in the current role?

What is your age (in years)?

What is your gender?

Which religion do you follow?

Which of the following best describes your ethnicity?

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

Have you had a Covid-19 vaccine?

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

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

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

Factors influencing decision to accept the vaccine

Factors influencing decision to decline the vaccine

Section 2 - Factors influencing decision to decline the vaccine

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

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

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.

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

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

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