07 December 2022 : Clinical Research
A Prospective Questionnaire-Based Study to Evaluate Factors Affecting the Decision to Receive COVID-19 Vaccination in 267 Patients with Inflammatory Bowel Disease in Poland
Michał Łodyga
12ABCDEF*, Katarzyna Maciejewska 1ABCDF, Grażyna Rydzewska 13ADFG
DOI: 10.12659/MSM.938665
Med Sci Monit 2022; 28:e938665
Table 1 Vaccination questionnaire.
| Question 1. | What kind of IBD do you have? |
| Question 2. | In what year was IBD diagnosed? |
| Question 3. | What medications do you take because of IBD? |
| Question 4. | Have you ever been operated on due to IBD? If so, how many times? |
| Question 5. | What medications do you take for other gastroenterological diseases? |
| Question 6. | Do you suffer from any other chronic diseases, apart from gastrointestinal diseases? |
| Question 7. | In addition to the above-mentioned, do you take other medications chronically? |
| Question 8. | Have you ever suffered from COVID-19? |
| Question 9. | If so, how severe was the course of the disease? |
| Question 10. | Have any of your relatives with whom you live suffered from COVID-19? |
| Question 11. | If so, how severe was the course of the disease? |
| Question 12. | Are you vaccinated against COVID-19? |
| Question 13. | Why did you decide to be vaccinated against COVID-19? (multiple answers possible) |
| Question 14. | Who recommended you be vaccinated against COVID-19? |
| Question 15. | Did you need a medical certificate from a gastroenterologist or other specialist authorising vaccination against COVID-19? |
| Question 16. | Did you inform the gastroenterologist about the vaccination? |
| Question 17. | Were you afraid of being vaccinated against COVID-19? |
| Question 18. | Are your family or people with whom you live vaccinated? |
| Question 19. | Are friends and colleagues vaccinated? |
| Question 20. | Why did you decide not to get vaccinated against COVID-19? (multiple answers possible) |
| Question 21. | Have you been vaccinated against influenza? |
| Question 22. | Have you been vaccinated against pneumococcus? |
| Question 23. | Have you been vaccinated against hepatitis B? |
| Question 24. | Have you been vaccinated against other infectious diseases in adulthood? |
| Question 25. | Sex |
| Question 26. | Age |
| Question 27. | Smoker |
| Question 28. | Consume alcohol |
| Question 29. | Education |
| Question 30. | Place of residence |
| Question 31. | Average net income per person in the household |
| Question 32. | Employment |
| IBD – inflammatory bowel disease. | |