Healthcare & Clinical

Seasonal Flu and COVID-19 Vaccine Intentions Survey

Tracks whether people plan to get vaccinated for flu and COVID-19 this season, what's holding hesitant respondents back, which access barriers get in the way, and which information sources they trust most. An AI follow-up probes the specific concerns behind low intention scores so public health teams can address the actual objection rather than a guess.

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샘플 질문

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질문 13개 · 약 7분

Q01

메시지

Thanks for taking a few minutes to share your thoughts on flu and COVID-19 vaccines this season. There are no right or wrong answers — we're just trying to understand people's plans and concerns. About 4-5 minutes.

Q02

객관식필수

Did you get a flu vaccine last flu season (roughly September through March)?

Yes
No
Not sure

Q03

의견 척도필수

How likely are you to get a flu vaccine this season?

척도: 1 – 7

최소:Definitely will not최대:Definitely will

Q04

객관식필수

Which best describes your current COVID-19 vaccination status?

Never received a COVID-19 vaccine
Received initial vaccine series only
Received initial series plus one or more boosters, but not the most recent update
Up to date with the most recently recommended COVID-19 vaccine
Not sure

Q05

의견 척도필수

How likely are you to get the currently recommended COVID-19 vaccine or booster this season?

척도: 1 – 7

최소:Definitely will not최대:Definitely will

Q06

객관식

Which of the following, if any, describe reasons you might not get a flu or COVID-19 vaccine this season?

Concerned about side effects
Don't think I need it / low personal risk
Don't think it works well enough
Had a bad reaction before
Haven't gotten around to it
Prefer to build immunity naturally
Distrust of vaccine safety data
Distrust of pharmaceutical companies or government

Q07

AI 인터뷰

Explore the reasoning behind this person's likelihood ratings for flu and COVID-19 vaccination, especially if either score was neutral or low. If they selected specific hesitancy reasons, probe what evidence, source, or experience would actually change their mind, and whether their view differs between the flu and COVID-19 vaccines specifically. If they rated both highly, briefly confirm what motivates them to keep up to date rather than assuming it's automatic.

Q08

매트릭스

How much do you trust each of the following sources for information about flu and COVID-19 vaccines?

7개 행 × 5개 열

Your doctor or nurse
Pharmacist
Local or state health department
CDC or national public health agency
Family and friends
외 2개

열: Not at all trustworthy · Slightly trustworthy · Moderately trustworthy · Very trustworthy · Extremely trustworthy

Q09

객관식

In the past 12 months, has anything made it harder for you to get a vaccine you wanted?

Cost or insurance concerns
Difficulty finding an appointment
Not enough time off work or school
Transportation issues
Nearest location too far away
Not sure where to go

Q10

객관식

If you were to get vaccinated this season, where would you most likely go?

Pharmacy
Doctor's office or clinic
Workplace or school vaccination event
Community health center or public health clinic
Not sure

Q11

객관식

What is your age range?

18-24
25-34
35-44
45-54
55-64
65 or older
Prefer not to say

Q12

객관식

What is your health insurance status?

Insured through employer
Insured through government program (e.g., Medicare, Medicaid)
Individually purchased insurance
Uninsured
Not sure
Prefer not to say

Q13

메시지

Thank you for sharing your perspective. Your responses will be combined with others to help public health teams understand vaccine plans and reduce barriers to access — no individual answers will be shared.

포함된 기능

AI 후속 질문
정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.
주의력 확인 장치
성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.
AI가 작성한 문안
문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.
자동 리포트
응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

Directly tracks intention for both flu AND COVID-19 vaccines in the same instrument, with separate status and likelihood questions for each rather than treating vaccination as one generic topic.
Uses an AI follow-up interview (AI follow-up interview block) to probe the actual reasoning behind a respondent's likelihood ratings, so low scores get diagnosed instead of just recorded.
Includes a dedicated reasons/barriers multiple-choice question plus a separate access-barrier question, letting public health teams distinguish 'won't' from 'can't' get vaccinated.
Captures a trust-in-sources matrix and channel/location preference alongside age and insurance status, giving segmentable data for targeting outreach and messaging.

QuestionPro

COVID-19 Survey Template + Sample Questionnaire

This is a general COVID-19 questionnaire template on an established survey platform, not a template purpose-built for tracking dual flu/COVID vaccine intentions or hesitancy reasoning. It's fielding-ready in the sense of being a static, editable questionnaire, but it isn't focused on the intention-vs-barrier-vs-trust structure this topic needs. Useful as a broad pandemic-attitudes starting point rather than a vaccination-intention diagnostic tool.

잘하는 점

Backed by a mature, full-featured survey platform with extensive logic and reporting tools
Provides a ready sample questionnaire so researchers aren't starting from a blank page
Easy to customize question wording and branching within QuestionPro's builder

아쉬운 점

Static question set with no adaptive AI follow-up to probe the specific reasons behind vaccine hesitancy
No automated per-response quality scoring or transparent prompt methodology
Not structured around the flu+COVID dual-intention, trust-source, and access-barrier framework this topic calls for

자주 묻는 질문