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Vaccine Questionnaire
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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Vaccine questions
1
1. Which of the following best describes your current vaccination status?
Choose one answer
Fully vaccinated according to national recommendations
Partially vaccinated (not fully up-to-date)
Unvaccinated or declined vaccination
2
2. In your opinion, what are the most significant benefits of vaccination?
3
3. What are the main reasons you might choose NOT to get vaccinated, if applicable?
4
4. Which sources of information do you trust most when learning about vaccines and vaccination-related topics?
Choose one answer
Word of mouth
Social Media
Government sources
Published scientific articles
5
5. How concerned are you about potential risks associated with vaccines?
Choose one answer
Not at all concerned
Somewhat concerned
Very concerned
Extremely concerned
6
6. Do you believe the benefits of vaccination outweigh the potential risks?
Choose one answer
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
7
7. Have you ever experienced any adverse reactions after receiving a vaccination? If yes, please describe
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8. In your opinion, should vaccination be mandatory for certain groups (e.g., healthcare workers, school children), or should it remain a personal choice?
Choose one answer
Mandatory for all
Mandatory for specific groups only
Personal choice only
9
9. What factors, if any, might influence your decision to vaccinate in the future?
10
10. Are there any specific concerns or stories you've heard around vaccines which you could name?
11
11. Have you ever considered seeking alternative health advice or treatments instead of conventional vaccination? If so, what motivated this choice?
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12. Is there any aspect of vaccines that you would like to know more about?
13
13. Lastly, what is your age?
Only use numbers
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