Vaccine Survey 12-18

Vaccine Survey

12 - 18 year olds
Have you felt any pressure to be vaccinated?

If you are aged 12-18 and have faced any issues regarding your vaccination status (irrelevant of what that is), then we would like to ask you to complete this 5 minute survey.
1. How old are you?*

12 - 13 yrs14 - 15 yrs16 - 18 yrs
2. Have you felt directly pressured to recieve the COVID-19 vaccination by anyone that you know:*

Parents or guardiansTeachersSchoolFriendsFriend's parentsSocial sport that you are involved inBoss/jobGovernmentNo
Someone else
3. Have you been prevented from doing something, or excluded from somewhere, because of your vaccination status?*

School events - eg campSportsVisiting a friends or family members houseSitting your drivers licenceYour jobConcertNo
Other event/s or place/s
Informed consent is a person's decision, given voluntarily, to agree to a healthcare treatment, procedure or other intervention.

Informed consent is given by a person having received accurate and relevant information about the healthcare intervention and alternative options available to them for their situation.
4. Do you feel you have been told or learned enough about the risks of COVID-19 for your situation so that you can or did give informed consent?*

YesNo
5. Do you feel you understand any risks of the COVID-19 vaccine?*

YesNo
6. Do you know anyone that has had an adverse reaction to the COVID-19 vaccine (adverse reaction means any type of medical response that followed receiving the vaccine)?*

YesNo
7. If you answered yes to 6, please provide information of adverse reaction and how that person is related to you.
8. Please provide your email address (which will be treated as confidential and will not be used other than for confirming one person per email has completed the survey)? (One email address per person)*
example@example.com
Should be Empty: