Vaccine survey

1. Have you received one of the COVID-19 vaccine?

• Yes
• No

2. Have you tried to schedule an appointment to receive the vaccine? 

• Yes
• No

2. Have you received your second shot for the COVID-19 vaccine?

• Yes
• No

2. Are you eligible to receive the COVID-19 vaccine? 

• Yes
• No

2. Do you want to get the COVID-19 vaccine? 

• Yes
• No

2. Will you get the COVID-19 vaccine when it's available? 

• Yes
• No

2. How long have you tried to schedule an appointment? 

• Less than 1 week
• 1-2 weeks
• 3-4 weeks
• More than 4 weeks

2. Did you experience any side effects with either shot? 

• Yes
• No

2. Now that you're vaccinated, do you feel more confident going out in public? 

• Yes
• No

2. Now that you're vaccinated, do you feel more confident going out in public? 

• Yes
• No