Mandated Flu Vaccination Experience Question Title * 1. Please create a survey nickname for yourself. You will enter this throughout the course of the survey over the next 6 months so we can track your responses. DO NOT choose the name "anonymous", but rather choose something you will remember easily for each time you enter information. You may provide email if you want to receive information at the end of the data gathering period (6 months). Choose a nickname * Occupation: DR/NURSE/PA/NP/TECH/SUPPORT * City/Town: State/Province: Country: Email Address Question Title * 2. The purpose of this survey is to gather on-going data as related to Flu vaccinations and health care worker experiences whether they choose to comply with health care institution mandated vaccination or choose to wear a protective mask while on duty instead during the entire flu season. The survey will function as a daily log to document your experience and provide feedback anonymously. You may also provide information even if you get the flu vaccination in the future after having previously chosen the mask option. To start, please provide the approximate date of your institution's program initiation (leave blank if no mandate but if there is a program please provide the date): Date health care institution began their mandated program (as close as you can recall) Date Question Title * 3. Were you ill at all within the 72 hours prior to receiving the vaccination or choosing to wear a mask for the flu prevention program? Yes No If "Yes" please give symptoms Question Title * 4. Please Provide the Date you received the Flu Vaccination for the 2012 flu season. If you say you did not receive the flu vaccination, but subsequently do so later on, then please return here and update your experiences. Enter the date of your 2012 Flu vaccination Date I did not receive the 2012 flu vaccination and am wearing a mask instead Date Question Title * 5. Did you develop any symptoms so far subsequent to receiving the flu vaccination or wearing a mask while on duty? (If your answer is no but you subsequently develop symptoms later on, please return and update). Yes No Question Title * 6. Date you noticed symptoms if any Date Date Question Title * 7. Subsequent to your choice of receiving vaccination or wearing a mask, please note any symptoms you experience Fever Chills Myalgias Cough Wheezing Nausea Vomiting Diarrhea Dizziness Reflux Symptoms Sore Throat Congestion Ear Pain Abdominal Pain Missed Day/Hours of Work Hospitalized ER Visit PMD Visit (not follow up) None Other (please specify) Question Title * 8. If you did experience any symptoms, how many days did you experience them? Less than 1 Up to 2 Days Up to 5 days Up to 1 week More than 1 week Question Title * 9. Occupational Exposures are important since the premise of mandated vaccination or wearing a mask during the entire flu season is protection of the patient as well as the healthcare worker, please provide the date of the exposure event: Date Date Question Title * 10. Please provide a description of the type of exposure you experienced subsequent to your flu vaccination or decision to wear a mask. Please select all that apply. You may return to log subsequent unique events but list only one event or series of events per day. Person(s) coughed and/or sneezed on me outside my clinical duties Patient(s) coughed and/or sneezed on me during my clinical duties Medical colleague(s) coughed and/or sneezed on me during my clinical duties It appears I made use of a likely contaminated object None Other (please specify) Done