Currently, the Pfizer-BioNTech COVID-19 Vaccine is authorized for use in individuals 16 years of age and older. The Clinton County Health Department expects that the authorization for use will soon expand to include children 12 years of age and older. In anticipation of this change, we would like to gauge the current level of demand for Pfizer-BioNTech COVID-19 Vaccine in these age groups. Please complete this survey ONLY if you would grant permission for your child to receive COVID-19 vaccination at their school OR if your child has already been vaccinated. Please complete only one survey per household.

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* 1. How many students 16 years old or older live in your household AND would like to receive the COVID-19 vaccine at a school vaccine clinic?

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* 2. How many students 16 years old or older live in your household AND have already received the COVID-19 vaccine?

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* 3. How many students 12-15 years of age live in your household AND would like to receive the COVID-19 vaccine at a school vaccine clinic (if authorization for use is expanded to include this age group)?

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* 4. Please select the School District your child(ren) attend(s). Choose ONLY ONE option.

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* 5. If your children attend different school districts, please list the additional districts below. Include the number of children aged 12 and above that attend each of the additional districts listed.

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* 6. Will a parent/guardian be able to be present at the time of the vaccine if required?

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* 7. Will your child(ren) or a parent/guardian need transportation to attend a COVID-19 vaccination clinic at school?

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* 8. Please select the time that would work best for your child(ren) and a parent/guardian (if required to be present at the time of the vaccine).

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