1.
How has the new variant omicron shifted or impacted attitudes in your community toward COVID-19 vaccines?
(Select one of the available choices or enter a different value.) Question - Not Required - How has the new variant omicron shifted or impacted attitudes in your community toward COVID-19 vaccines? Click this to indicate that you will select an existing value. Tab to next input." How has the new variant omicron shifted or impacted attitudes in your community toward COVID-19 vaccines?
Please select response
My community takes COVID-19 more seriously than before Omicron
My community takes COVID-19 less seriously than before Omicron
How has the new variant omicron shifted or impacted attitudes in your community toward COVID-19 vaccines? Click this to indicate that you will enter a new value. Tab to next input." How has the new variant omicron shifted or impacted attitudes in your community toward COVID-19 vaccines? Provide your answer here
2.
In addition to the primary series of vaccines, what are the attitudes in your community regarding the Covid-19 booster shot?
(Select one of the available choices or enter a different value.) Question - Not Required - In addition to the primary series of vaccines, what are the attitudes in your community regarding the Covid-19 booster shot? Click this to indicate that you will select an existing value. Tab to next input." In addition to the primary series of vaccines, what are the attitudes in your community regarding the Covid-19 booster shot?
Please select response
Positive
Negative
Unsure
In addition to the primary series of vaccines, what are the attitudes in your community regarding the Covid-19 booster shot? Click this to indicate that you will enter a new value. Tab to next input." In addition to the primary series of vaccines, what are the attitudes in your community regarding the Covid-19 booster shot? Provide your answer here
3.
Question - Not Required -
Share a positive childhood COVID-19 vaccine messaging that is resonating with your community?
(Maximum response 255 chars, approx. 5 rows of text)
4.
Question - Not Required -
List any barriers to childhood COVID-19 vaccine that are resonating in your community?
(Maximum response 255 chars, approx. 5 rows of text)
5.
Share insights on other preventive methods recommended to help stop the spread of COVID-19: Masking
(Select one of the available choices or enter a different value.) Question - Not Required - Share insights on other preventive methods recommended to help stop the spread of COVID-19: Masking Click this to indicate that you will select an existing value. Tab to next input." Share insights on other preventive methods recommended to help stop the spread of COVID-19: Masking
Please select response
Necessary
Optional
Unnecessary
I am vaccinated I don't need mask
Share insights on other preventive methods recommended to help stop the spread of COVID-19: Masking Click this to indicate that you will enter a new value. Tab to next input." Share insights on other preventive methods recommended to help stop the spread of COVID-19: Masking Provide your answer here
6.
In your communities, what are thoughts on testing?
(Select one of the available choices or enter a different value.) Question - Not Required - In your communities, what are thoughts on testing? Click this to indicate that you will select an existing value. Tab to next input." In your communities, what are thoughts on testing?
Please select response
Access to testing is a barrier
Cost of testing is a barrier
Testing is very accessible
In your communities, what are thoughts on testing? Click this to indicate that you will enter a new value. Tab to next input." In your communities, what are thoughts on testing? Provide your answer here
7.
The American Lung Association has very informative and valuable resources for patients, caregivers, and health professionals. We are asking our partners to help us share our resources. We understand that there are a lot of organizations that may be asking to do the same. What are the possible ways your organization could share American Lung Association valuable resources?
(Select one of the available choices or enter a different value.) Question - Not Required - The American Lung Association has very informative and valuable resources for patients, caregivers, and health professionals. We are asking our partners to help us share our resources. We understand that there are a lot of organizations that may be asking to do the same. What are the possible ways your organization could share American Lung Association valuable resources? Click this to indicate that you will select an existing value. Tab to next input." The American Lung Association has very informative and valuable resources for patients, caregivers, and health professionals. We are asking our partners to help us share our resources. We understand that there are a lot of organizations that may be asking to do the same. What are the possible ways your organization could share American Lung Association valuable resources?
Please select response
Share to email list
Share on website
Share on social media
The American Lung Association has very informative and valuable resources for patients, caregivers, and health professionals. We are asking our partners to help us share our resources. We understand that there are a lot of organizations that may be asking to do the same. What are the possible ways your organization could share American Lung Association valuable resources? Click this to indicate that you will enter a new value. Tab to next input." The American Lung Association has very informative and valuable resources for patients, caregivers, and health professionals. We are asking our partners to help us share our resources. We understand that there are a lot of organizations that may be asking to do the same. What are the possible ways your organization could share American Lung Association valuable resources? Provide your answer here
8.
Question - Not Required -
If sharing resources is not an option, please share your thoughts on what we can change to make our resources more appealing or different, for example, format, etc.
(Maximum response 255 chars, approx. 5 rows of text)
9.
Question - Not Required -
Thinking about other vaccines that protect against infectious diseases, did you get a flu shot this year?
Please select response
Yes
No
10.
Question - Not Required -
Did anyone in your family miss a regularly scheduled vaccine due to the pandemic?
Please select response
Yes
No
11.
Question - Not Required -
If "Yes," do you have plans to get vaccinated?
Please select response
Yes
No
12.
Thinking about post COVID-19 infection symptoms, many people who were infected are experiencing physical, mental and emotional challenges. Do you know someone with lingering symptoms?
(Select one of the available choices or enter a different value.) Question - Not Required - Thinking about post COVID-19 infection symptoms, many people who were infected are experiencing physical, mental and emotional challenges. Do you know someone with lingering symptoms? Click this to indicate that you will select an existing value. Tab to next input." Thinking about post COVID-19 infection symptoms, many people who were infected are experiencing physical, mental and emotional challenges. Do you know someone with lingering symptoms?
Please select response
Respiratory (shortness of breath, coughing)
Neurological (loss of taste/smell, internal vibrations, fatigue)
Emotional/Mental (anxiety, depression)
I don't know anyone with post COVID-19 infection symptoms
Thinking about post COVID-19 infection symptoms, many people who were infected are experiencing physical, mental and emotional challenges. Do you know someone with lingering symptoms? Click this to indicate that you will enter a new value. Tab to next input." Thinking about post COVID-19 infection symptoms, many people who were infected are experiencing physical, mental and emotional challenges. Do you know someone with lingering symptoms? Provide your answer here
13.
Please provide your contact information so we can keep track of who has completed this survey. Thank you.
