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Quad-Counties Vaccine Perceptions Survey 2021

Quad-Counties Vaccine Perceptions Survey

Thank you for taking the time to complete this survey. You received this questionnaire because you are a resident of the Quad-County region (resident of Carson City, Lyon, Douglas, or Storey Counties). The purpose of this survey is to learn what residents think about COVID-19 vaccination. This will take approximately 5 minutes to complete. Statements are ranked on a scale from 1 to 5, with 1 representing “strongly disagree” and 5 representing “strongly agree”. For all other questions, please answer to your best ability. You must be 18 years of age or older to complete this survey.


Gracias por tomarse el tiempo para completar esta encuesta. Recibió este cuestionario porque es residente de la región de Quad-County (residente de los condados de Carson City, Lyon, Douglas o Storey). El propósito de esta encuesta es conocer lo que piensan los residentes sobre la vacuna COVID-19. Esto tardará aproximadamente 5 minutos en completarse. Las declaraciones se clasifican en una escala del 1 al 5, donde 1 representa "muy en desacuerdo" y 5 representa "totalmente de acuerdo". Para todas las demás preguntas, responda lo mejor que pueda. Debe tener 18 años o más para completar esta encuesta.

 
1. I feel like I have enough information about vaccines to decide if I should get the COVID-19 vaccine.

Siento que tengo suficiente información sobre las vacunas para decidir si debo recibir la vacuna COVID-19. 
  *This question is required.
 12345 
Strongly DisagreeStrongly Agree
2. Carson City Health and Human Services has done a good job of sharing information about the COVID-19 vaccines with the community. 

Carson City Health and Human Services ha hecho un buen trabajo al compartir información sobre las vacunas COVID-19 con la comunidad.
  *This question is required.
 12345 
Strongly DisagreeStrongly Agree
3. I have had concerns about vaccinations in the past. 

He tenido inquietudes acerca de las vacunas en el pasado. 
  *This question is required.
 12345 
Strongly DisagreeStrongly Agree
4. I have concerns about getting a COVID-19 vaccine. 

Me preocupa recibir la vacuna COVID-19.
  *This question is required.
 12345 
Strongly DisagreeStrongly Agree
5. Some barriers that keep me from receiving the COVID-19 vaccine include (please select all that apply):

Algunas barreras que me impiden recibir la vacuna COVID-19 incluyen (seleccione todas las que correspondan):
  *This question is required.
6. Do you have children under the age of 18? 

¿Tiene hijos menores de 18 años? *This question is required.
7. As a parent or guardian, I feel like I have enough information about vaccines to decide if my child/children should get the COVID-19 vaccine. 

Como padre o tutor, siento que tengo suficiente información sobre las vacunas para decidir si mi hijo o hijos deben recibir la vacuna COVID-19. *This question is required.
 12345 
Strongly DisagreeStrongly Agree
7. What county do you reside in? 

¿En qué condado reside? *This question is required.
9. What is your gender?

¿Cuál es tu género?
  *This question is required.
10. What is your race? 

¿Cuál es tu raza?
  *This question is required.
11. What is your ethnicity?

¿Cuál es su origen étnico?
  *This question is required.