COVID-19 Vaccination Coverage Survey - Cycle 2

Household information (DEM1) - Question identifier:DEM1_Q05

Including yourself, how many people live in your household?

Min = 1; Max = 20

Household information (DEM1) - Question identifier:DEM1_Q10

Including yourself, how many of these people are [18] years of age or more?

Min = 0; Max = 20

Household information (DEM1) - Question identifier:DEM1_Q15

What is your gender?

• 1: Male
• 2: Female
• 3: Or please specify

Household information (DEM1) - Question identifier:DEM1_Q19

What is your age?

Min = 15; Max = 121

Household information (DEM1) - Question identifier:DEM1_Q20

What is your age group?

• 1: 15 to 24 years
• 2: 25 to 34 years
• 3: 35 to 44 years
• 4: 45 to 54 years
• 5: 55 to 64 years
• 6: 65 years and over

Household information (DEM1) - Question identifier:DEM1_Q30

To confirm the geographic region that you live in, please provide your postal code.

Long Answer Length = 6

Vaccination (VX) - Question identifier:VX_R05

The following questions are about vaccination against COVID-19.

Vaccination (VX) - Question identifier:VX_Q05

Have you been vaccinated against COVID-19?

• 1: Yes
• 2: No

Vaccination (VX) - Question identifier:VX_Q10A

Does the vaccine you received require one or two doses?

• 1: One dose
• 2: Two doses
• 9: DK

Vaccination (VX) - Question identifier:VX_Q10B

How many doses of the COVID-19 vaccine have you received so far?

• 1: One dose
• 2: Two doses

Vaccination (VX) - Question identifier:VX_Q15A

When did you receive [your most recent dose of/]the COVID-19 vaccine?

Month

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December

Vaccination (VX) - Question identifier:VX_Q15B

When did you receive [your most recent dose of/]the COVID-19 vaccine?

Year

• 1: 2020
• 2: 2021
• 3: 2022

Vaccination (VX) - Question identifier:VX_Q20

Where did you receive [your most recent dose of/]the COVID-19 vaccine?

• 1: A COVID-19 vaccination clinic not located within a healthcare facility (e.g., a clinic located within a mall or a hockey rink)
• 2: Public Health Unit, community health centre or CLSC
• 3: Medical clinic or doctor's office
• 4: Hospital
• 5: Pharmacy
• 6: Workplace
• 7: Other

Vaccination (VX) - Question identifier:VX_Q25

What is the main reason why you haven't been vaccinated against COVID-19?

• 01: I do not want to be vaccinated at this time
• 02: I do not want to be vaccinated at all
• 03: I am not part of a priority group for vaccination at this time
• 04: I don't have confidence in the vaccine that was offered to me
• 05: I have an appointment in the future
• 06: I have not been able to get an appointment yet
• 07: I don't know how or where to get vaccinated
• 08: I was sick at the time the vaccine was offered to me
• 09: The vaccine is not recommended for me (e.g., I have a pre-existing medical condition)
• 10: I have already had COVID-19
• 11: I haven't had the time
• 12: Other reason

Vaccination (VX) - Question identifier:VX_Q30

Why don't you want to be vaccinated against COVID-19?

• 01: I am not at high risk of getting COVID-19
• 02: If I get COVID-19, I will not be very sick
• 03: The severity of the pandemic has been overstated
• 04: Vaccines in general are not effective in preventing diseases
• 05: Vaccines in general are not safe
• 06: I do not trust the effectiveness of the COVID-19 vaccines
• 07: I do not trust the safety of the COVID-19 vaccines
• 08: Philosophical or religious reasons
• 09: Other reason

Vaccination (VX) - Question identifier:VX_Q35

In the future, how likely is it that you will get vaccinated against COVID-19?

Is it:

• 1: Very likely
• 2: Somewhat likely
• 3: Somewhat unlikely
• 4: Very unlikely

Health (HL) - Question identifier:HL_R05

The following questions are about your health.

Health (HL) - Question identifier:HL_Q05A

Have you ever been diagnosed with or tested positive for COVID-19?

• 1: Yes
• 2: No

Health (HL) - Question identifier:HL_Q05B

Did you have any symptoms of COVID-19?

• 1: Yes
• 2: No

Health (HL) - Question identifier:HL_Q05C

Were you hospitalized?

• 1: Yes
• 2: No

Health (HL) - Question identifier:HL_Q10

Which of the following health conditions do you have?

Would you say:

• 01: Obesity
• 02: Heart disease
• 03: Diabetes
• 04: Liver disease
• 05: Chronic kidney disease
• 06: Alzheimer's disease
• 07: Chronic lung disease (e.g., Asthma, COPD)
• 08: Immunocompromised or immunosuppressed (e.g., due to AIDS, an organ transplant, cancer treatment or congenital immunodeficiency)
• 09: I have none of these health conditions

Employment (OS) - Question identifier:OS_Q05

Are you currently working in any of the following sectors?

Would you say:

• 01: Healthcare and its support services (e.g., inpatient or outpatient services, long-term care facilities, laboratories and pharmacies)
• 02: Vaccine manufacturing
• 03: Education and its support services
• 04: Food production and distribution (e.g., agriculture, food processing and grocery stores
  Exclude: restaurants)
• 05: Child care
• 06: Public transportation and its support services (Include: transit systems such as bus, train, air and ferry)
• 07: Emergency services (e.g., fire, police, ambulance, paramedic services and the military)
• 08: I don't work in any of the above sectors

Knowledge and beliefs (KB) - Question identifier:KB_Q05A

Please indicate to what extent you agree or disagree with each of the following statements.
In general, vaccines are safe

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05B

Please indicate to what extent you agree or disagree with each of the following statements.
In general, vaccines are effective in protecting people from disease

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05C

Please indicate to what extent you agree or disagree with each of the following statements.
I am confident that Canada's regulation process approves vaccines only if they are safe and effective

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05D

Please indicate to what extent you agree or disagree with each of the following statements.
By being vaccinated against COVID-19, I am protecting myself from the disease

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05E

Please indicate to what extent you agree or disagree with each of the following statements.
By being vaccinated against COVID-19, I am helping to protect the health of others in my community

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05F

Please indicate to what extent you agree or disagree with each of the following statements.
I distrust COVID-19 vaccines because they were developed too quickly

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05G

Please indicate to what extent you agree or disagree with each of the following statements.
I am confident that COVID-19 vaccines are safe

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05H

Please indicate to what extent you agree or disagree with each of the following statements.
I am confident that COVID-19 vaccines are effective in preventing the disease

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05I

Please indicate to what extent you agree or disagree with each of the following statements.
Only those at risk of becoming seriously ill from COVID-19 need to be vaccinated

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05J

Please indicate to what extent you agree or disagree with each of the following statements.
It is better to develop immunity from having COVID-19 rather than from a vaccine

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05K

Please indicate to what extent you agree or disagree with each of the following statements.
Physical distancing, frequent handwashing and wearing a mask are enough to protect me from COVID-19

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05L

Please indicate to what extent you agree or disagree with each of the following statements.
Those who have had COVID-19 do not need to be vaccinated

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q05M

Please indicate to what extent you agree or disagree with each of the following statements.
The severity of the pandemic has been overstated

• 1: Strongly agree
• 2: Agree
• 3: Disagree
• 4: Strongly disagree

Knowledge and beliefs (KB) - Question identifier:KB_Q10

Which sources do you trust to provide information about COVID-19 vaccines?

Would you say:

• 01: Public Health Agency of Canada and Health Canada
• 02: Provincial, territorial or regional health authorities
• 03: World Health Organization (WHO)
• 04: Pharmaceutical companies producing the COVID-19 vaccines
• 05: Health scientists and researchers
• 06: My physician
• 07: Other healthcare professionals (e.g., nurses, pharmacists)
• 08: Alternative health providers (e.g., naturopaths, homeopaths)
• 09: Friends or family
• 10: Other people's experience or knowledge
• 11: Other source

Sociocultural information (ABM) - Question identifier:ABM_Q01

Are you First Nations, Métis or Inuk (Inuit)?

Would you say:

• 1: No, not First Nations, Métis or Inuk (Inuit)
• 2: Yes, First Nations (North American Indian)
• 3: Yes, Métis
• 4: Yes, Inuk (Inuit)

Sociodemographic characteristics (PG) - Question identifier:PG_Q05

The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.

Are you:

• 01: White
• 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
• 03: Chinese
• 04: Black
• 05: Filipino
• 06: Arab
• 07: Latin American
• 08: Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai)
• 09: West Asian (e.g., Iranian, Afghan)
• 10: Korean
• 11: Japanese
• 12: Other

Immigration and citizenship (IM) - Question identifier:IM_Q01A

Where were you born?

• 1: Born in Canada
• 2: Born outside Canada

Immigration and citizenship (IM) - Question identifier:IM_Q01B

Are you a Canadian citizen?

• 1: Yes, a Canadian citizen by birth
• 2: Yes, a Canadian citizen by naturalization (Canadian citizen by naturalization refers to an immigrant who was granted citizenship of Canada under the Citizenship Act.)
• 3: No, not a Canadian citizen

Immigration and citizenship (IM) - Question identifier:IM_Q01C

Are you a landed immigrant or permanent resident?

• 1: No
• 2: Yes

Immigration and citizenship (IM) - Question identifier:IM_Q02

In what year did you first become a landed immigrant or a permanent resident?

Min = 0; Max = 9999

Education (ED) - Question identifier:ED_Q05

What is the highest certificate, diploma or degree that you have completed?

• 1: Less than high school diploma or its equivalent
• 2: High school diploma or a high school equivalency certificate
• 3: Trades certificate or diploma
• 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
• 5: University certificate or diploma below the bachelor's level
• 6: Bachelor's degree (e.g., B.A., B.A. (Hons), B.Sc., B.Ed., LL.B)
• 7: University certificate, diploma or degree above the bachelor's level

Marital status (MS) - Question identifier:MS_Q01

What is your marital status?

Is it:

• 1: Married (For Quebec residents only, select the "Married" category if your marital status is "civil union".)
• 2: Living common law (Two people who live together as a couple but who are not legally married to each other.)
• 3: Never married (not living common law)
• 4: Separated (not living common law)
• 5: Divorced (not living common law)
• 6: Widowed (not living common law)

Household information (DEM) - Question identifier:DEM_Q05

Including yourself, how many children aged 17 and under live with you?

• 1: None
• 2: One
• 3: Two
• 4: Three
• 5: Four
• 6: Five or more

Household information (DEM) - Question identifier:DEM_Q10

Including yourself, how many people living with you are [priority age] years of age or older?

• 1: None
• 2: One
• 3: Two
• 4: Three
• 5: Four
• 6: Five or more

Total household income (THI) - Question identifier:THI_R01

Now a question about total household income for the year before the COVID-19 pandemic.

Total household income (THI) - Question identifier:THI_Q05

What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, [2019]?

Min = -99999999; Max = 99999999

Total household income (THI) - Question identifier:THI_Q10

Please indicate which group includes your total household income, before taxes and deductions, for the year ending December 31, 2019?

• 1: Less than $30,000
• 2: $30,000 to less than $60,000
• 3: $60,000 to less than $90,000
• 4: $90,000 to less than $120,000
• 5: $120,000 to less than $150,000
• 6: $150,000 and over