Interest in local COVID-19 Vaccination or Booster Clinic

To determine the interest and potential volume for a local COVID-19 vaccination clinic for families or staff of the King Philip, Norfolk, Plainville and Wrentham Schools, we appreciate your completion of this survey. This will enable us to request a mobile vaccination clinic if it will meet the community's needs.

Thank you for your time and assistance.

Question Title

* 1. I would be interested in a local COVID-19 Vaccination Clinic in September.

Yes

Question Title

* 2. I am interested in one of more members of my family receiving:

A 1st or 2nd dose of the Moderna or Pfizer BiNax Now Vaccination for a 5-11 year old.

A 1st or 2nd does of the Moderna or Pfizer BiNax Now Vaccination for an individual 12+.

A Janssen vaccination for an individual 18+.

A primary dose for a child 6 months-4 years.

A first booster for a child 5-17 (Pfizer only).

A first booster for individual 18+.

A second booster.
The following individuals may be eligible for a 2nd mRNA COVID-19 booster:
People who are ages 50 years or older (PfizerBioNTech or Moderna boosters)
People who are 12 years or older who are moderately or severely immunocompromised. (Eligible people ages 12–17 years can only receive Pfizer-BioNTech booster)
People 18 years or older who received the Janssen as both primary and booster dose. (Janssen is not authorized as a 2nd booster)

None of the above.

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* 3. Total number of family members needing either primary, 2nd or booster dose.

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* 4. If you are replying as a parent/caregiver rather than a staff member of King Philip, Norfolk, Plainville or Wrentham Schools, what town do you reside in?

Norfolk

Plainville

Wrentham