Skip to main content
. 2021 Feb 27;39(14):1968–1976. doi: 10.1016/j.vaccine.2021.02.060

Table A3.

Key questions and items in the survey questionnaire (translated from the Chinese version used).

Construct Question No. and type Items Response Scale
Perception for financing mechanism 37
[Single Choice]
Do you think that individuals need to pay out of pocket for COVID-19 vaccination? 1 = No
2 = Yes, pay for a portion
3 = Yes, pay fully
40
[Single Choice]
Do you think that governments need to pay for COVID-19 vaccination? 1 = No
2 = Yes, pay for a portion
3 = Yes, pay fully
41
[Single Choice]
Do you think that health insurance needs to pay for COVID-19 vaccination? 1 = No
2 = Yes, pay for a portion
3 = Yes, pay fully
The out of pocket WTP 38
[Open-ended]
If individuals are required to pay for COVID-19 vaccination to complete a full immunization, what is the self-paid proportion that you are willing to pay? [Range:0–100%]
39
[Single Choice]
What is the maximum amount that you are willing to pay for COVID-19 vaccination (receiving all doses of the series as the vaccination schedule), if you want to get vaccinated? 1 = Refused vaccination
2 = Willing to get vaccinated if free
3 = CNY 10
4 = CNY 50
5 = CNY 100
6 = CNY 200
7 = CNY 500
8 = Willing to pay for any price
50
[Open-ended]
What is the maximum amount that you are willing to pay for COVID-19 vaccination (receiving all doses of the series as the vaccination schedule), if you want to get vaccinated? [For respondents who choose 'Refused vaccination' in Q39, skip Q50]

Note: […] Brackets indicate text that participants did not see, including question type and response options.