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Covid-19 Vaccination and Sickle Cell Disease
Patient Questionnaire
This survey is for the purpose of discovering adult Sickle Cell patients reasons, for or against, taking the new Covid-19 vaccine.
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1.
Do you have Sickle Cell Disease?
(Required.)
Yes
No
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2.
If so, what is your hemoglobin genotype?
(Required.)
Hb SS
Hb SC
Sb- Thalassemia
I don't know
Other (please specify)
3.
As a Sickle Cell PATIENT will you get the new Covid-19 vaccination?
Yes
No
Maybe
I don't know
4.
If you answered "YES" to taking the new Covid-19 vaccine. Please tell us why.
5.
If you answered NO to receiving the new Covid-19 vaccine please check the MAIN reason why.
It's "too NEW" ( hasn't been available long enough)
I don't trust the expedited FDA process that was used to clear it for public use.
I'm waiting to "see what happens" with others who have already taken it.
I don't believe in vaccines.
I don't trust the medical community due their historical use of the Black community in medical experiments i.e. Tuskegee Experiment.
I'm afraid that I will contract Covid-19 from the vaccine.
I'm afraid of the possible side effects.
I feel I don't know enough about the new Covid-19 vaccine to make an educated decision.
I'm allergic to vaccines.
Other (please specify)
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6.
Would you take the new Covid-19 vaccine if, it were REQUIRED to physically return to school, work, or to travel abroad?
(Required.)
Yes
No
No. I won't take it under ANY circumstances
Maybe
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7.
Does the overcrowding and limited resources of our nation's hospitals have any influence over your decision to either take or not take the new Covid-19 vaccine?
(Required.)
Yes
No
Maybe
I never thought about it.
Other (please specify)