Mashpee Wampanoag Tribe Covid-19 Vaccine Survey

Question Title

* 1. What is your age?

18-54

55-64

65 and older

Question Title

* 2. Please select your status.

Mashpee Wampanoag Tribal member

Mashpee Wampanoag Tribal Spouses and household members

Question Title

* 3. Have you received a vaccine shot for Covid-19 yet?

Yes

Question Title

* 4. Where did you receive your Covid-19 Vaccine

At the Mashpee Wampanoag Health Services Clinic (IHS)

Some other vaccination site other than the (IHS)

Did not get the vaccine

Question Title

* 5. Which Vaccine did you receive?

Moderna Vaccine

Pfizer Vaccine

Johnson & Johnson Vaccine

Do not know

Did not get vaccine yet

Question Title

* 6. If you received your vaccine from a site other than IHS clinic , please provide a copy of your vaccination paperwork to our IHS at 483 Great Neck Road, Mashpee, MA

Question Title

* 7. If you have received the vaccine, did you have one or two doses?

One dose

Two doses

None yet

Question Title

* 8. If you have not received the Covid -19 Vaccine yet, are you willing to recieve it?

Yes

I have received the vaccine

Question Title

* 9. IF you are unwilling to get the vaccine, please indicate why not. What are your concerns? All of the vaccines can help prevent serious illness and hospitalization should you get Covid-19.

Question Title

* 10. The Mashpee Wampanoag Health Services clinic (IHS)now has the Johnson & Johnson Vaccine on hand as well as the Moderna vaccine. The Johnson & Johnson vaccine only requires one shot. Which is your preferred vaccine?

Moderna, two shot series vaccine

Johnson & Johnson , 1 shot vaccine

Mashpee Wampanoag Tribe Covid-19 Vaccine Survey

Question Title

* 1. What is your age?

Question Title

* 2. Please select your status.

Question Title

* 3. Have you received a vaccine shot for Covid-19 yet?

Question Title

* 4. Where did you receive your Covid-19 Vaccine

Question Title

* 5. Which Vaccine did you receive?

Question Title

* 6. If you received your vaccine from a site other than IHS clinic , please provide a copy of your vaccination paperwork to our IHS at 483 Great Neck Road, Mashpee, MA

Question Title

* 7. If you have received the vaccine, did you have one or two doses?

Question Title

* 8. If you have not received the Covid -19 Vaccine yet, are you willing to recieve it?

Question Title

* 9. IF you are unwilling to get the vaccine, please indicate why not. What are your concerns? All of the vaccines can help prevent serious illness and hospitalization should you get Covid-19.

Question Title

* 10. The Mashpee Wampanoag Health Services clinic (IHS)now has the Johnson & Johnson Vaccine on hand as well as the Moderna vaccine. The Johnson & Johnson vaccine only requires one shot. Which is your preferred vaccine?

Question Title

* 11. Why do you prefer this companies vaccine over the others?

Question Title

* 12. If you are willing to get the vaccine, please call 508-539-2561 to schedule today.