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Structured Research Questionnaire
Research Study on Vaccine Hesitancy and Misinformation on Social Media: Understanding the Impacts on COVID-19 Vaccination
Dear Reader, please help in completing this research by supplying appropriate and genuine answers to the following questions as it pertains to your views and experiences regarding vaccines and misinformation. All answers are very important to the completion of this research, and your responses will be treated with great preference to confidentiality. Thank You!
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Gender
*
Male
Female
Non-Binary
Other
Age
*
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
What is your racial/ethnic identity?
*
White
Black or African American
Hispanic or Latino
Asian
Other
What is your highest level of education?
*
Less than high school
High school graduate
Some college
Bachelor's Degree
Graduate Degree
Currently in High School
What is your political affiliation?
*
Democrat
Republican
I do not have a political affiliation
Other
Occupation
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Have you been vaccinated against COVID-19?
*
Yes
No
If you are not vaccinated, please state your main reason:
Vaccine hesitancy (concerns about vaccine safety/efficacy)
Misinformation or doubts from media/social media
Religious beliefs
Other
How would you rate your overall trust in public health authorities and scientists?
*
Very High
High
Average
Low
Very Low
Do you believe that misinformation on social media has affected public perception of vaccines?
*
Yes
No
I'm not sure
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What is your primary source of information regarding health?
*
Social Media
News Websites
TV News
Peer-reviewed journals
Healthcare professionals
Other
How often do you consume news from conservative media outlets?
*
Always
Often
Sometimes
Rarely
Never
I'm not sure
How often do you consume news from liberal media outlets?
*
Always
Often
Sometimes
Rarely
Never
I'm not sure
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How serious do you believe COVID-19 is as a public health threat?
*
Very Serious
Serious
Somewhat Serious
Not serious at all
How likely are you to vaccinate your children against COVID-19? (optional)
Very Likely
Likely
Unsure
Unlikely
Very Unlikely
Have you ever encountered misinformation about COVID-19 vaccines?
*
Yes
No
If yes, please indicate the type of misinformation you encountered:
*
Vaccines cause severe side effects
Vaccines contain microchips
Vaccines are ineffective
Other
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Do you think preemptive education about vaccines could reduce misinformation?
*
Yes
No
Not Sure
What strategy do you believe would be effective in countering misinformation about vaccines?
*
Use of trusted community leaders to disseminate information
Educational campaigns targeting social media
Engaging healthcare professionals in public discussions
Other
How important do you believe it is to address misinformation related to vaccines in your community?
*
Very important
Important
Somewhat Important
Not important at all
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Any additional comments or suggestions regarding vaccine communication and misinformation:
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