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COVID-19 & Vaccination
COVID-19 Back-to-Normal Study:
https://aurametrix.com/nct04832932
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Your anonymous ID or approximate age, country
Your answer
Have you ever had COVID-19?
Not sure / Probably not
Always tested negative
Yes, had mild or asymptomatic form of COVID-19
Yes, had moderate form of COVID-19
Yes, survived severe COVID-19 or a long hauler
Had it more than once
Before 1st dose
Between 1st and 2nd dose
Between 2nd and 3rd dose
After 3rd dose
After 4th or more doses
Not sure / Probably not
Always tested negative
Yes, had mild or asymptomatic form of COVID-19
Yes, had moderate form of COVID-19
Yes, survived severe COVID-19 or a long hauler
Had it more than once
Before 1st dose
Between 1st and 2nd dose
Between 2nd and 3rd dose
After 3rd dose
After 4th or more doses
Vaccination Status
Have not been vaccinated
Vaccinated with at least one dose
Fully vaccinated and boosted
Other:
Clear selection
When approximately did you get vaccinated or had COVID-19? Did you get COVID-19 or experienced COVID-like symptoms despite vaccination?
Your answer
Vaccine name or manufacturer
AstraZeneca (2 doses are given 4 weeks apart)
Moderna mRNA-1273 (2 doses are given 4 weeks apart)
Moderna Spikevax Omicron BA.1 bivalent booster mRNA-1273.214
Moderna Spikevax Omicron BA.4/5 bivalent booster mRNA-1273.222
Pfizer/BioNTech (2 doses are given 3 weeks apart)
Pfizer/BioNTech's Omicron BA.1 booster
Pfizer/BioNTech's Omicron BA.4/5 booster
Johnson & Johnson (1 dose)
Novavax (2 doses are given 3 weeks apart)
Sputnik V (2 doses are given 3-4 weeks apart); Sputnik Lite: 1 dose
Sinopharm (2 doses 3 weeks apart)
Sinovac/Coronavac (2 doses 2-4 weeks apart)
Covaxin/Bharat Biotech (2 doses 4 weeks apart)
Other
Have you experienced any of these side effects hours or up to 14 days after vaccine injection? (whichever dose was the worst). Check all that apply. Examples of less common side effects: abdominal pain, diarrhea, tingling/numbing, sweating, enlarged lymph nodes on the opposite side of injection, changes in smell/taste
Mild
Moderate
Severe
Injection site pain
Sore arm
Swelling of the lymph nodes in the same arm as the injection
General Muscle Pain
Joint Pain
Tiredness/Fatique
Chills
Fever
Headache
Nausea or Vomiting
Flu-like symptoms
Rash outside of injection site
Eye, Ear, Oral symptoms
Muscle weakness
Other
Mild
Moderate
Severe
Injection site pain
Sore arm
Swelling of the lymph nodes in the same arm as the injection
General Muscle Pain
Joint Pain
Tiredness/Fatique
Chills
Fever
Headache
Nausea or Vomiting
Flu-like symptoms
Rash outside of injection site
Eye, Ear, Oral symptoms
Muscle weakness
Other
Did you or your blood relatives have any unusual or long-term effects of coronavirus disease, if applicable?
Your answer
Did you or your blood relatives have any uncommon or long-term effects of COVID-19 vaccine?
Your answer
Did COVID-19 or the vaccine exacerbated or relived your pre-existing health conditions (flare-ups vs remission), if applicable?
Your answer
Please list medical conditions, medications, supplements, dietary restrictions, genetics - anything, you think, could affect your reaction to vaccines or coronavirus
Your answer
Any other thoughts or comments regarding this survey or the study in general?
Your answer
By clicking submit you consent to share this data with the dedicated human-research-protection-trained researcher
http://bit.ly/BTN-consent
(This form describes how we protect your data. You can withdraw and request to delete your data at any time: contact
studies@aurametrix.com
)
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