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Mu8qNEs8ELHXCRVvDKzhWC9rwQipdWxNZue9NRGoZjYvCwpDYSKTwRxmips45cL9NQvShPx7X4jjJCjSMUJSuouKfTRuFuC

COVID Vaccination Survey for Suburban Healthcare/Essential Workers and Residents

As the COVID vaccine continues to be distributed throughout Cook County, the Cook County Department of Public Health is surveying individual healthcare and essential workers who live or work in suburban Cook County, as well as suburban Cook County residents to understand their interest in receiving the vaccine. The survey responses will be used to understand demand and build appropriate capacity to vaccinate. This is not a vaccine registry. It is a survey tool to assist in planning as additional vaccine is distributed. By completing the survey, individuals will be added to a list to receive updates on COVID-19 vaccine availability including the timing and scheduling.

Healthcare or other related ORGANIZATIONS with individuals in Phase 1a who would like updates regarding when their staff can receive COVID-19 vaccine should go here: https://redcap.dph.illinois.gov/surveys/?s=YK3WLELLJR

Please note that the vaccine supply is still limited. High risk individuals as defined by the CDC are currently being prioritized.

The Cook County Department of Public Health comprises 125 municipalities, not including Chicago, Evanston, Skokie, Stickney, and Oak Park, who have their own state-certified health departments. We are happy to include you in our communications, but if you are seeking information about the vaccine distribution in those areas, we refer you to their respective public health departments, such as the Chicago Department of Public Health.

Phase 1a:

Long-term care residents, defined by the CDC as adults who reside in facilities that provide a range of services, including medical and personal care, to persons who are unable to live independently, and staff at Skilled Nursing Facilities, Assisted Living Facilities, Residential Treatment Centers for Substance Abuse, etc.
- LTCF Staff: Nurses and Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Dentists and Hygienists, LTCF Facility Staff, Pharmacists, Mental Health Clinicians, Environmental Services Staff, Reception Staff, Medical Facility Surveyor, Dietary staff, Interpreters, Laundry & security staff.
Healthcare personnel are defined by the CDC as paid and unpaid workers in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials. Inclusion in Phase 1a is not dependent upon payment for a person’s work or job title. Situations associated with higher risk of transmission include caring for COVID- 19 patients. This includes;
- Hospital Settings: Nurses & Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Pharmacists, Emergency Medical Services (EMS), including Fire Departments staff acting as EMS & Air Medical Transport (Rotor & Fixed Wing), COVID Sample Lab workers, Organ Harvesters & Students on Clinical Rotations. Other workers in hospital settings at elevated risk, such as Environmental Services Staff, Reception Staff, X-Ray Technician’s, Phlebotomists, Infectious Waste Workers, Dietary staff, Laundry staff, security staff, Crisis intervention staff, Interpreters, Clergy/pastoral/chaplains.
- Non-hospital healthcare: Clinicians, such as Nurses & Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Dentists & Hygienists, Pharmacists, Plasma and Blood Donation Staff, Morticians, Public Health Nurses, Home Health, School Nurses, Optometrist, COVID Testing Staff, Dermatologist, Dialysis staff, Urgent care workers, Corrections nurses/aides, Physical/occupational/speech therapists, Vaccine clinic workers, Emergency Medical Services (EMS), including Fire Departments staff acting as EMS & Air Medical Transport (Rotor & Fixed Wing).
- Other Congregate Care: Nurses and Nursing Assistants, Physicians (MD, NP, PA), Respiratory Technicians, Group Home/Residential Staff, Pharmacists, Environmental Services Staff, Reception Staff, Home Aide/Caregiver, Corrections nurses/assistants, Congregate Care Surveyor, Hospice & palliative care staff, community health workers when acting as health aid or health translator.

Please complete this survey if you are an individual.

For more information, see the CCDPH Vaccination Website: https://cookcountypublichealth.org/communicable-diseases/covid-19/covid-vaccine/

All responses are optional. All information will be kept confidential.

For general questions for CCDPH regarding COVID-19 and vaccine please email: ccdph.covid19@cookcountyhhs.org

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Yes

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First Responders (Firefighters, Police)

Education (teachers, support staff, daycare)

Food & Agriculture

Manufacturing

Corrections workers

U.S. Postal service workers

Public transit workers

Grocery store workers

Other

Transportation and logistics

Food Service

Shelter & Housing (construction)

Finance

IT & Communication

Energy

Media

Legal

Public Safety (Engineers)

Water & Wastewater

Other

Yes

N/A

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Yes

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Cancer

Chronic kidney disease

Chronic lung disease

Down Syndrome

Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies

Immunocompromised state (weakened immune system) from solid organ transplant

Very overweight or obese

Pregnancy

Sickle cell disease

Smoking

Type 2 diabetes mellitus

Other

Yes

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Yes

Unsure

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