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. 2021 Aug 6;14:100241. doi: 10.1016/j.lanwpc.2021.100241

Table A3.

Survey questions on COVID-19 vaccine hesitancy/acceptance and reasons for vaccine hesitancy/acceptance

1. How likely are you to get vaccinated for the coronavirus (Covid-19) once the vaccine is available to you?
Very unlikely 1
Somewhat unlikely 2
Unsure 3
Somewhat likely 4
Very likely 5
I have already received at least one dose of the Covid-19 vaccine 10
Prefer not to say 6
N/A 7
ASK 2a IF 1 = (1 | 2 | 3)
ASK 3a IF 1 = (4 | 5)
2a. For what reasons would you be unlikely to get a vaccine for coronavirus (Covid-19) if it was offered to you?
(Check all that apply)
I am worried about unknown future effects of the vaccine 1
I am worried about side effects 2
Vaccines are limited and other people need it more than me 3
I don't trust vaccines 4
The chances of me becoming seriously unwell from the coronavirus are low 5
The impact of the coronavirus is being greatly exaggerated 6
I don't think it would be effective at stopping me catching the coronavirus 7
I have a condition which would make it unsafe for me 8
Herd immunity will protect me even if I don't have the vaccine 9
I don't have time 10
I have been advised by a health or medical professional not to get the vaccine 11
Other (please tell us) 12
Don't know 88
Prefer not to say 99
ASK 2b if a response other than only “Don't know” or “Prefer not to say” are given AND 2A=MR
Skip to end of section if only “Don't know” and “Prefer not to say” selected.
2b. Of those reasons you selected, what would you say is the most important reason you would be unlikely to get the vaccine?
(Choose 1 only)
[Populate the answer options selected from 2a] n
Don't know 11
Prefer not to say 12
Skip to next section
3a. For what reasons are you likely to get a vaccine for coronavirus (Covid-19) if it was offered to you?
(Check all that apply)
To stop me catching the coronavirus or getting very ill from it 1
To help allow my social and family life to get back to normal 2
To help allow my community to get back to normal 3
To help protect other people from catching the coronavirus 4
Because the vaccine won't work unless most people in New Zealand get it 5
Because I am a key worker working with high risk groups 6
Because I take the vaccines offered or recommended to me 7
Other (please tell us) 8
Don't know 88
Prefer not to say 99
3b. Of those reasons you selected, what would you say is the most important reason you will likely get the vaccine?
(Choose 1 only)
[Populate the answer options selected from 3a] n
Don't know 11
Prefer not to say 12