Pudong New Area Questionnaire about vaccination among students in international school

* 1、Name of student:(yon can also fill in nickname)

* 2、Gender of student:

* 3、Date of birth: MM / DD /YYYY:

* 4、Nationality

* 5、Grade

* 6、Residence status in Shanghai

* 1、Your gender:

* 2、Your age: （从15到90）

* 3、Nationality

* 4、Relationship to child

* 5、Education:

* 6、Occupation

* 7、Religion:

* 8、The number of people in your family(only for the nuclear family with the children and their parents included) ：

* 9、Annual family income (only for the nuclear family with the children and their parents included)

* 1、Do you think it necessary to have your child vaccinated?

* 2. Do you take your child to get vaccinated as appointed?

* 3、If you choose "① Yes" in "question 2" , skip this question; If you choose "② No",  the reason is (multiple choices): 【多选题】

* 4. When the child moves to a new residence, do you think you should contact the clinic to arrange the vaccination for the child as soon as possible?

* 5. Do you agree that the purpose of vaccination is mainly to prevent the infection of contagious diseases?

* 6. Do you think children will need vaccination records when they go to college in the future?

* 7. Do you think children's vaccination records should be properly kept?

* 8、Do you know which of the following vaccines that are routinely administered to children? (multiple choices) 【多选题】

* 9. Do you know that a person should stay in the clinic for medical observation after vaccination?

* 10. Did you think that you should tell doctors about the child's health status and allergy history before vaccination?

* 11. If, on the scheduled date for vaccination, the child reports a body temperature at 37.5 ℃, do you think he/she should be vaccinated or not?

* 12. Do you agree a child only needs medical observation at home with no special treatment required if he/she develops slight red and swelling spots at the injection point within 3 days after vaccination?

* 13、Do you agree a child only needs medical observation at home with no special treatment required if he/she reports no discomfort except a low fever within 3 days after vaccination?

* 14. Do you agree that a child, when moving to a new country or region, should get his/her vaccination program retuned to the local situations such as disease control?

* 15. Do you think your child has completed the vaccination as recommended by his/her doctor ?

* 16. If the school informs you to take your child to get vaccination shots missed, will you do so in time?