Philippines COVID-19 Vaccines Outcomes and Experiences Survey

Basic information about you and your experiences with COVID-19 Vaccination

This questionnaire is being disseminated by the Lunas Pilipinas Coalition to collect data that will help us understand the COVID-19 vaccination experience in the Philippines and assess the government's pandemic response. You may answer this questionnaire for yourself or for others (for example, your children, a relative, friend, employee, acquaintance, or other loved one), whether you are vaccinated or unvaccinated.

We will first ask basic questions to get to know you. Then we will ask specific questions related to COVID-19 vaccination and your experience with it. Please answer all questions with regards to your current situation. Feel free to make comments in the provided comment boxes.

If you are answering this questionnaire on behalf of others, please use 1 questionnaire per person.

Thank you for your time and consideration in answering this questionnaire. The information that you have provided will help ensure that we learn from the pandemic experience.

1.I am answering this questionnaire ...

For myself

For someone else

2.What is your province?

3.What is your city?

5.What is your sex at birth?

Male

Female

Prefer not to answer

6.What is your education level?

Other (please specify)

7.What is your current occupation / employment status?

Other (please specify)

9.Do you plan to take any further doses of Covid-19 Vaccine?

Yes

Maybe, if required or recommended by health authorities

Other (please specify)

10.Please list the vaccine brands received, and date of receipt of each dose. (Please skip this question if you are not vaccinated.)

12.How pressured did you feel to take the COVID-19 Vaccines? (Note: Please answer this question even if you are not vaccinated.)

Other (please expound on your experience)

13.Where were you vaccinated? Check all that apply. (Please skip this question if you are not vaccinated.)

Local vaccination center

Drive through vaccination center

In a hospital / medical center

At my home / health workers brought vaccination to me

At my work / health workers brought vaccination to my workplace

Other (please specify)

14.When you were vaccinated, were you made aware that you might experience adverse effects/harm from the injections? (Please skip this question if you are not vaccinated.)

Yes, I was informed for all the vaccinations I had.

Yes, but only for some of the vaccinations I had.

No, I was not informed for any of the vaccinations I had.

Please explain.

15.Do you know that there is a PhilHealth compensation/indemnity fund for persons who are injured or die after COVID-19 vaccination? (Please answer this question even if you are not vaccinated.)

Yes

I have never heard of the PhilHealth COVID-19 indemnity fund.

Please explain.

16.Do you know that adverse effects/injuries/deaths from the COVID-19 vaccines can be reported to the Philippine Food and Drug Administration (FDA pharmacovigilance system)?

Yes.

No.

I have never heard of the FDA pharmacovigilance system.

Other (please specify)

17.How has your health been after you received the COVID-19 vaccines? (Please skip this question if you are not vaccinated.)

Please provide details about your health with symptoms, if possible.

18.How would you describe the health issues you had after COVID-19 vaccination (if any)? (Please skip this question if you are not vaccinated.)

I did not experience any side effects.

Mild - I felt unwell but was able to do normal activities.

Moderate - I felt unwell and was not able to do normal activities for some time.

Severe - I was very unwell/bedridden/hospitalized/did not recover.

Please explain.

19.If your health has worsened since the vaccinations, please answer this question: Have you or your doctor reported this health problem/ adverse event to the Philippine FDA? (Please skip this question if you are not vaccinated.)

Yes - I (or my doctor) filed a report

No - I did not report because I did not want to draw attention to myself.

No - I did not see any benefit or value in filing a report.

I wanted to report, but I did not know how.

I did not know there was a reporting system

Other (please specify)

20.Have you been infected with COVID-19? (Please answer this question even if you are not vaccinated.)

Yes

Please specify.

21.Please indicate how many times you were diagnosed as infected with COVID-19, and the month and year for each infection. If you are vaccinated, please indicate the month and year that you received each dose of the vaccine.

22.Looking back, would you want to take the COVID-19 vaccines again the way you did?

I am very glad I could be vaccinated.

I am no longer sure whether I made the right choice.

I would not take the vaccines.

I am very glad that I am not vaccinated.

Please explain.

23.Please comment how you feel now about having received the COVID-19 vaccine. (If you are not vaccinated, please comment on how you feel about your decision to not be vaccinated.)

24.Do you intend to receive further COVID-19 Vaccinations if the government recommends/requires it?

Yes

Please explain your decision.

25.Is there anything else you would like to share? Would you like to tell us your story?

26.Do you or your loved ones need help in relation to any adverse effects that you have experienced from the COVID-19 vaccination? If you wish to be contacted, please indicate your name and contact details (mobile number, landline, email address, FB name) below.

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