| # |
Name |
Label |
Type |
Format |
Valid |
Invalid |
Question |
| 1 |
IM1 |
Vaccination card for child |
Discrete |
numeric 1.0 |
5246
|
658
|
Is there a vaccination card for (name)? |
| 2 |
IM2D |
Day of BCG immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 3 |
IM2M |
Month of BCG immunization |
Continuous |
numeric 2.0 |
1924
|
3980
|
|
| 4 |
IM2Y |
Year of BCG immunization |
Continuous |
numeric 4.0 |
1924
|
3980
|
|
| 5 |
IM3AD |
Day of OPV0 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 6 |
IM3AM |
Month of OPV0 immunization |
Continuous |
numeric 2.0 |
1622
|
4282
|
|
| 7 |
IM3AY |
Year of OPV0 immunization |
Continuous |
numeric 4.0 |
1622
|
4282
|
|
| 8 |
IM3BD |
Day of OPV1 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 9 |
IM3BM |
Month of OPV1 immunization |
Continuous |
numeric 2.0 |
1772
|
4132
|
|
| 10 |
IM3BY |
Year of OPV1 immunization |
Continuous |
numeric 4.0 |
1772
|
4132
|
|
| 11 |
IM3CD |
Day of OPV2 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 12 |
IM3CM |
Month of OPV2 immunization |
Continuous |
numeric 2.0 |
1545
|
4359
|
|
| 13 |
IM3CY |
Year of OPV2 immunization |
Continuous |
numeric 4.0 |
1545
|
4359
|
|
| 14 |
IM3DD |
Day of OPV3 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 15 |
IM3DM |
Month of OPV3 immunization |
Continuous |
numeric 2.0 |
1289
|
4615
|
|
| 16 |
IM3DY |
Year of OPV3 immunization |
Continuous |
numeric 4.0 |
1289
|
4615
|
|
| 17 |
IM4AD |
Day of DPT1 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 18 |
IM4AM |
Month of DPT1 immunization |
Continuous |
numeric 2.0 |
1717
|
4187
|
|
| 19 |
IM4AY |
Year of DPT1 immunization |
Continuous |
numeric 4.0 |
1717
|
4187
|
|
| # |
Name |
Label |
Type |
Format |
Valid |
Invalid |
Question |
| 20 |
IM4BD |
Day of DPT2 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 21 |
IM4BM |
Month of DPT2 immunization |
Continuous |
numeric 2.0 |
1502
|
4402
|
|
| 22 |
IM4BY |
Year of DPT2 immunization |
Continuous |
numeric 4.0 |
1502
|
4402
|
|
| 23 |
IM4CD |
Day of DPT3 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 24 |
IM4CM |
Month of DPT3 immunization |
Continuous |
numeric 2.0 |
1250
|
4654
|
|
| 25 |
IM4CY |
Year of DPT3 immunization |
Continuous |
numeric 4.0 |
1250
|
4654
|
|
| 26 |
IM6D |
Day Measles or MMR immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 27 |
IM6M |
Month Measles or MMR immunization |
Continuous |
numeric 2.0 |
1058
|
4846
|
|
| 28 |
IM6Y |
Year of Measles or MMR immunization |
Continuous |
numeric 4.0 |
1058
|
4846
|
|
| 29 |
IM7D |
Day of Yellow Fever immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 30 |
IM7M |
Month of Yellow Fever immunization |
Continuous |
numeric 2.0 |
918
|
4986
|
|
| 31 |
IM7Y |
Year of Yellow Fever immunization |
Continuous |
numeric 4.0 |
918
|
4986
|
|
| 32 |
IM8AD |
Day of Vitamin A 1 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 33 |
IM8AM |
Month of Vitaimn A 1 imunization |
Continuous |
numeric 2.0 |
547
|
5357
|
|
| 34 |
IM8AY |
Year of Vitamin A 1 immunization |
Continuous |
numeric 4.0 |
547
|
5357
|
|
| 35 |
IM8BD |
Day of Vitamin A 2 immunization |
Continuous |
numeric 2.0 |
2035
|
3869
|
|
| 36 |
IM8BY |
Year of Vitamin A 2 immunization |
Continuous |
numeric 4.0 |
141
|
5763
|
|
| 37 |
IM9 |
Received additional vaccinations |
Discrete |
numeric 1.0 |
2035
|
3869
|
In addition to the vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including
vaccinations received in campaigns or immunization days?
|
| 38 |
IM10 |
Child ever received any vaccinations |
Discrete |
numeric 1.0 |
3211
|
2693
|
Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign
or immunization day?
|
| 39 |
IM11 |
Child ever given BCG vaccination |
Discrete |
numeric 1.0 |
2543
|
3361
|
Has (name) ever been given a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that caused
a scar?
|
| # |
Name |
Label |
Type |
Format |
Valid |
Invalid |
Question |
| 40 |
IM12 |
Child ever given Polio vaccination |
Discrete |
numeric 1.0 |
2543
|
3361
|
Has (name) ever been given any "vaccination drops in the mouth" to protect him/her from getting diseases - that is, polio? |
| 41 |
IM13 |
Polio first given just after birth or later |
Discrete |
numeric 1.0 |
2387
|
3517
|
How old was he/she when the first dose was given - just after birth (within two weeks) or later? |
| 42 |
IM14 |
Times child given Polio vaccination |
Continuous |
numeric 2.0 |
2387
|
3517
|
How many times has he/she been given these drops? |
| 43 |
IM15 |
Child ever given DPT vaccination |
Discrete |
numeric 1.0 |
2543
|
3361
|
Has (name) ever been given "DPT vaccination injections" - that is, an injection in the thigh or buttocks - to prevent him/her
from getting tetanus, whooping cough, diphtheria? (sometimes given at the same time as polio)
|
| 44 |
IM16 |
Times child given DPT vaccination |
Discrete |
numeric 2.0 |
2079
|
3825
|
How many times? |
| 45 |
IM17 |
Child ever given Measles or MMR vaccination |
Discrete |
numeric 1.0 |
2543
|
3361
|
Has (name) ever been given "Measles vaccination injections" or MMR - that is, a shot in the arm at the age of 9 months or
older - to prevent him/her from getting measles?
|
| 46 |
IM18 |
Yellow Fever given |
Discrete |
numeric 1.0 |
2543
|
3361
|
Has (NAME) ever been given "Yellow Fever vaccination injections" - that is, a shot in the arm at the age of 9 months or older
- to prevent him/her from getting yellow fever? (sometimes given at the same time as measles)
|
| 47 |
IM19A |
Child participated in national immunization day A |
Discrete |
numeric 1.0 |
5246
|
658
|
Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or
child health days: Date/type of campaign A
|
| 48 |
IM19B |
Child participated in national immunization day B |
Discrete |
numeric 1.0 |
5246
|
658
|
Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or
child health days: Date/type of campaign B
|
| 49 |
IM19C |
Child participated in national immunization day C |
Discrete |
numeric 1.0 |
5246
|
658
|
Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or
child health days: Date/type of campaign C
|