Let us know what you think getting the COVID-19 vaccine (BANES)

Please spare a few moments to tell us what you think about the COVID-19 vaccine roll-out. The NHS is doing everything it can to deliver COVID-19 vaccines in BANES, but there might be things that can be improved.

We want to know:

- What was your experience of the vaccine appointment(s)
- Whether you would be willing to have the vaccine if you have not already had it
- What you think about information on the vaccination programme.

Your feedback is confidential but can help services spot issues affecting care for you and your loved ones.

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* 1. Have you received the COVID-19 vaccine?

Yes

Yes, both doses

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* 2. Overall, how would you rate your vaccine appointments?

Very good

Fairly good

Neither good nor bad

Fairly bad

Very bad

Don't know / not sure

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* 3. Did you experience any difficulties when booking or attending your COVID-19 vaccine appointment(s)?

Yes

Other (please specify)

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* 4. What difficulties did you experience? [Select all that apply]

I did not feel safe at the vaccine centre

I had difficulty getting transport to my appointment

I found it difficult or impossible to book an appointment at a location near to my home

I had difficulties using the online or phone booking system

I did not feel I had enough information before my appointment

Other [free text box – please tell us more]

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* 5. Do you feel information about your vaccine appointments was communicated clearly and effectively? [Select one]

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Don't know /unsure

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* 6. Overall, how would you rate your first COVID-19 vaccine appointment? [select one]

Very good

Fairly good

Neither good nor bad

Fairly bad

Very bad

Don't know / unsure

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* 7. Did you experience any difficulties when booking or attending your first COVID-19 vaccine appointment?

Yes

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* 8. What difficulties did you experience? [Select all that apply]

I did not feel safe at the vaccine centre

I had difficulty getting transport to my appointment

I found it difficult or impossible to book an appointment at a location near to my home

I had difficulties using the online or phone booking system

I did not feel I had enough information before my appointment

Other [free text box – please tell us more]

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* 9. Do you feel information about your first vaccine appointment was communicated clearly and effectively? [Select one]

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Don’t know/unsure

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* 10. Is there anything you are concerned about for your second vaccine appointment?

Yes

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* 11. What concerns do you have about your second vaccine appointment? [Select as many as apply

I feel I should have been contacted by now to make an appointment

I will not receive it within the recommended efficacy period

I am concerned about the news around blood clots

I am concerned about information I have seen in the media (TV, newspaper, Radio) since my first vaccine appointment

I am concerned about information I have heard from family and friends since my first vaccine appointment

I am concerned about information I received from a health care professional since my first vaccine appointment

I had a bad experience attending my first vaccine appointment

I had side effects after the first dose

My second dose appointment is at a different location to my first

I’m worried that I won’t get the same vaccine as I had for the first dose

Other [free text box – please tell us more]

What do you think about getting the COVID vaccine

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* 12. Do you intend to get the COVID-19 vaccine when it is made available to you at no charge through the NHS?

Definitely would

Probably would

Not sure

Probably would not

Definitely would not

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* 13. If you are unsure or do not want to receive the COVID-19 vaccine, please tell us why:

Tell us a bit more about you

By telling us more information about yourself, you can help us better understand how people's experiences may differ depending on their personal characteristics. However, if you do not wish to answer these questions you do not have to.

Healthwatch will be using participant demographic information to inform its research. Namely, to show trends in demographic data, such as age or gender. The data will not be shared with any third party organisation and no individual will be identified personally.

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* 14. Please tell us which age category you fall into:

13 - 17

18-24

25-34

35-44

45-54

55-64

65 - 74

75 +

I’d prefer not to say

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* 15. Please tell us which gender you identify with:

Woman

Man

Non-binary

I'd prefer not to say

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* 16. Is your gender different to the sex that was assigned to you at birth?

Yes

I'd prefer not to say

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* 17. Please select your ethnic background:

Arab

Asian / Asian British: Bangladeshi

Asian / Asian British: Chinese

Asian / Asian British: Indian

Asian / Asian British: Pakistani

Asian / Asian British: Any other Asian / Asian British background

Black / Black British: African

Black / Black British: Caribbean

Black / Black British: Any other Black / Black British background

Gypsy, Roma or Traveller

Mixed / Multiple ethnic groups: Asian and White

Mixed / Multiple ethnic groups: Black African and White

Mixed / Multiple ethnic groups: Any other Mixed / Multiple ethnic background

White: British / English / Northern Irish / Scottish / Welsh

White: Irish

White: Any other White background

Another ethnic background

I'd prefer not to say

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* 18. Please tell us which sexual orientation you identify with:

Asexual

Bisexual

Gay

Heterosexual / Straight

Lesbian

Pansexual

Other

I'd prefer not to say

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* 19. Please tell us about your religion or beliefs:

Buddhist

Christian

Hindu

Jewish

Muslim

Sikh

No religion

I'd prefer not to say

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* 20. Please tell us about your marital or civil partnership status

Single

Married

In a civil partnership

Co habiting

Separated

Divorced / dissolved civil partnership

Widowed

I'd prefer not to say

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* 21. Are you currently pregnant or have you been pregnant in the last year?

Yes

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* 22. Do you consider yourself to be a carer, have a disability or a long-term health condition? (Please select all that apply)

Yes, I consider myself to be a carer

Yes, I consider myself to have a disability

Yes, I consider myself to have a long-term condition

None of the above

I’d prefer not to say

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* 1. Have you received the COVID-19 vaccine?

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* 2. Overall, how would you rate your vaccine appointments?

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* 3. Did you experience any difficulties when booking or attending your COVID-19 vaccine appointment(s)?

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* 4. What difficulties did you experience? [Select all that apply]

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* 5. Do you feel information about your vaccine appointments was communicated clearly and effectively? [Select one]

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* 6. Overall, how would you rate your first COVID-19 vaccine appointment? [select one]

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* 7. Did you experience any difficulties when booking or attending your first COVID-19 vaccine appointment?

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* 8. What difficulties did you experience? [Select all that apply]

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* 9. Do you feel information about your first vaccine appointment was communicated clearly and effectively? [Select one]

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* 10. Is there anything you are concerned about for your second vaccine appointment?

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* 11. What concerns do you have about your second vaccine appointment? [Select as many as apply

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* 12. Do you intend to get the COVID-19 vaccine when it is made available to you at no charge through the NHS?

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* 13. If you are unsure or do not want to receive the COVID-19 vaccine, please tell us why:

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* 14. Please tell us which age category you fall into:

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* 15. Please tell us which gender you identify with:

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* 16. Is your gender different to the sex that was assigned to you at birth? ﻿

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* 17. Please select your ethnic background:

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* 18. Please tell us which sexual orientation you identify with:

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* 19. Please tell us about your religion or beliefs:

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* 20. Please tell us about your marital or civil partnership status

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* 21. Are you currently pregnant or have you been pregnant in the last year?

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* 22. Do you consider yourself to be a carer, have a disability or a long-term health condition? (Please select all that apply)

* 16. Is your gender different to the sex that was assigned to you at birth?