Consent Statement Hello, my name is [enumerator]. I am from APIN Public Health Initiatives. We are conducting a study aimed at assessing household and community acceptability of the COVID-19 vaccine and factors affecting it in selected communities in Nigeria. The outcome of this survey will help to design and implement programs to improve community health outcomes during this COVID-19 pandemic. You have been chosen to participate in this activity because you are a community dweller whose perception will determine community uptake of health services. The process will entail an interview using a semi-structured questionnaire. The interview will also be recorded to permit us to listen and analyze the responses at the end of the interview. There are no direct benefits for participating, but your participation will help to inform the design of programs aimed at improving the health of households in communities like this one. The information provided by you will be held in strict confidence. Neither your name nor other information that could be used to identify you will be recorded. Your information may be stored electronically, and we will use industry standard and nationally required practices to ensure its security. Any information you provide will only be made available to other researchers without any information that could identify you and only for the purpose of research. The survey should take about 30 minutes to complete. Participation is completely voluntary. If we should come to any question you do not want to answer, just let me know and I will go on to the next question. You are also free to stop the interview at any time, should you feel uncomfortable.
Questions	Responses				Skip Pattern
Would you like to participate in this study?
Field Personnel Information
Q001 Enumerator’s Name and Identification code
Respondent’s Background Characteristics
Q002 How old were you at your last birthday	002 AGE IN COMPLETED YEARS ............................ \|___\|___\|
Q003 What is the Respondent Gender?		Male
		Female
		Others
Q004 Does the gender correspond to the respondent biological sex?		Yes
		No
Q005 What is the highest level of education that you attained?		No Formal Education
		Completed Primary Education
		Completed Secondary Education
		Completed Tertiary Education
Q006 What is your religion?		Christianity
		Islam
		Traditional
		Others (specify___________)
Q007 What is your current marital status?		Never Married
		Married
		Cohabiting (Unmarried living together)
		Separated/Divorced
		Widow/widower
		Others (Specify_____________)
Section 1 COVID-19 vaccination acceptability
Q 101 Have you heard of COVID-19 infection?		Yes			If No, go to the end
		No
Q 102 Kindly mention some of the common symptoms of COVID-19 infection		Fever
		Cough
		Shortness of Breath or Difficulty Breathing
		Fatigue
		Muscle or Body Aches
		Headache
		Sore Throat
		Nausea or Vomiting
		Diarrhea
		Loss of taste or smell
		Others (Specify____________)
Q 103 Tell us some of the preventive measures for COVID-19 infection		Wear a mask
		Avoid crowds/gatherings
		Physically distance from others (≥2m)
		Wash hands frequently with soap and water
		Use alcohol-based hand rub
		Other (specify)
Q104 Have you heard of COVID-19 vaccination?		Yes			If No skip to Q306
		No
Q105 Source of information about COVID-19 vaccination		Healthcare workers working in the health facilities in this community
		Other HCWs outside this community
		Health educators within the community
		Electronic media e.g radio, TV
		Print media
		Community leaders or influencers
		Friend/Neighbour
		Others (Specify___________)
Q 106 How would you evaluate yourself in terms of risk of contracting COVID-19?		No risk
		Low risk
		High risk
Q 107 How would you rate yourself on the risk of dying from COVID-19?		No risk
		Low risk
		High risk
Q 108 Have you taken COVID-19 vaccination jab?		Yes			If yes, skip to Q 310
		No
Q 109 If No, why have you not taken COVID-19 vaccination?		I don’t know any available vaccination center
		The vaccination centers are far and not easily accessible………………..a
		There are no vaccines in our community vaccination centers………………b
		It causes harm or has side/adverse effect on the body
		It causes sterility
		It reduces libido and cause male impotency
		It is a strategy to depopulate the blacks
		It is a monitoring device
		Others (Specify_____________)
Q 110 How close is the vaccination centre to the community?		Within 5km radius			Skip if 309 is “a”
		5-10km radius
		More than 10km radius
Q 111 How many fixed post or vaccination camps do you have in your community?		---------------- [Type in] Type 99 if don’t know			Skip if 309 is “a”
Q 112 have you had mobile COVID-19 vaccination visit to your community in the last few months?		Yes
		No
How often do they visit the community?		Very often
		Often
		Occasionally
		Rarely
		Very rarely
Q 113 Would you like to take COVID-19 vaccination?		Yes
		No
Q 114 Would you encourage your family to take COVID-19 vaccination		Yes
		No
I am going to read a series of statements or questions to you and I would like you to tell me if you agree or disagree with the statement	Disagree		Don’t know/unsure	Agree
Q 115 COVID-19 vaccine is very effective in preventing and controlling COVID-19 diseases
Q 116 Vaccinated people have no/reduced risk of contracting COVID-19 vaccine compared to the unvaccinated
Q 117 Vaccinating a larger percentage of a community reduces the community risk of having COVID-19 infection outbreak
Q 118 Previously COVID-19 diagnosed individual do not require the vaccine
Q 119 COVID-19 vaccine has minimal side/adverse effects and is very tolerable
Q 120 COVID-19 vaccine is free