Survey Monkey Questions on H1N1 Vaccine Administration

Keywords / Description:

This sheet was developed by the Massachusetts Region 4A Medical Reserve Corps. The sheet explains how to use Survey Monkey to poll citizens on H1N1 vaccine administration. The sheet provides the following five sample questions

Will you allow your child to receive the H1N1 vaccine to be administered by your school?
If you wouldn't have your child receive the H1N1 vaccine at the school, would you go to your pediatrician to get the vaccine?
Are you going to not allow your child to get the H1N1 vaccine?
If your child is sick will you keep them at home?
If you are pregnant, are you willing to receive the H1N1 vaccine?

Instructions on how to set up a free Survey Monkey questionnaire are also included.

Toolkit:

Influenza Toolkit

Keyword Area:

Immunization, MRC, Pandemic Influenza

Jurisdiction:

Institutional Author:

Massachusetts Region 4A Medical Reserve Corps

Submitted:

02/08/2010

Modified:

02/23/2010

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