Healthcare Worker Influenza Vaccination Survey Report

Influenza Season September 2016 - March 2017

* Required

 

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*During this Flu Season did you received your Influenza Vaccine?

Yes, I received my Flu Shot at TTUHSC-EPYes, I received my Flu Shot at my Doctor's officeYes, I received my Flu Shot at another locationNO, I did not receive a Flu Shot during this flu season

*My Flu Shot was administered by:

Occupational Health / IC staffNursing StudentAmbulatory Clinic staffOutside pharmacy, Clinic or Doctor's officeN/A

*If you did not receive a Flu Shot this Influenza season please select the best response. *** I did not receive a Flu Shot because:

I am concerned I will get the Flu from the shotI am concerned I will have a reaction to the Flu ShotI always get sick after the Flu ShotI am afraid of shotsI didn't have timeGetting the vaccine was not convenientI never get the FluI am allergic to eggs or other medical reasonsMy Doctor advised against itImmunization is against my religionOtherN/A

Additional comments for any "Other" responses

*Which would you prefer ?

Flu Shot (Injection)FluMist (Nasal Mist)No preference

*Did yo experience any negative side effects ?

YesNo

*If Yes please select the best response

FeverChillsRashPainNausea / VomitingHeadacheOther

Additional comments for any "Other" responses

*The Occupational Health Team, in my opinion did a good job

Strongly Agree / AgreeNeutral / Neither Agree nor DisagreeDisagree / Strongly DisagreeNo opinionOther

Additional comments for any "Other" responses

*Overall I am glad I was vaccinated this Flu season and I found it to be a benefit

YesNoNo opinion

Additional comments are always Welcome!

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