Parent Opinions & Beliefs Towards Vaccinations
Adapted from Opel, Mangione-Smith, Taylor, Korfiatis, Wiese, Catz, and Martin: PACV Survey, Hum Vaccin 2011 April; 7(4): 419-425. April 1 2011.
This survey will ask you a number of questions about vaccinations for your child(ren). Please respond as honestly as you can. This survey will take you about 10-20 minutes. If you have questions, please contact Clara Holder at clara.holder@coloradoimmunitycorps.org.
Relationship to child(ren)
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Age
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Marital Status
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Education
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Household Income
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Race/Ethnicity
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What is your ZIP code?
Have you ever delayed having your child get a shot for reasons other than illness or allergy?
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Have you ever decided not to have your child get a shot for reasons other than illness or allergy?
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How sure are you that following the recommended shot schedule is a good idea for your child?
Not sure at all
Completely sure
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It is my role as a parent to question shots.
Disagree completely
Agree completely
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If you had another infant today, would you want him/her to get all the recommended shots?
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Overall, how hesitant about childhood shots would you consider yourself to be?
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Children get more shots than are good for them.
Strongly disagree
Strongly agree
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I believe that many of the illnesses shots prevent are severe.
Strongly disagree
Strongly agree
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It is better for my child to develop immunity by getting sick than to get a shot.
Strongly disagree
Strongly agree
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It is better for children to get fewer vaccines at the same time.
Strongly disagree
Strongly agree
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How concerned are you that any one of the childhood shots might have a serious side effect?
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How concerned are you that any one of the childhood shots might not be safe?
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How concerned are you that a shot might not prevent the disease?
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Do you know of anyone who has had a bad reaction to a shot?
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The only reason I have my child get shots is so they can enter daycare or school.
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I trust the information I receive about shots.
Strongly disagree
Strongly agree
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I am able to openly discuss my concerns about shots with my child's doctor or nurse.
Strongly disagree
Strongly agree
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Where does your child(ren) get their shots?
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All things considered, how much do you trust your child's doctor or nurse?
Do not trust at all
Completely trust
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Has the COVID-19 pandemic changed your opinion of vaccines? If so, how?
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