COVID Vaccine

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* 1. Age? (Select one)

0-17

18-24

25-49

50-64

65+

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* 2. Race?

White

Hispanic

African-American

Asian

Native American

Other

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* 3. Gender?

Male

Female

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* 4. Zip Code?

27889

27865

27860

27808

27806

27821

27814

27817

27810

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* 5. Have you already received the COVID-19 vaccine?

Yes

No