Great! Now, think back to the last time you got vaccinated… we have some questions for you!

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Supplemental Figure 1. Sample of safety survey distributed to students following vaccination.

Trumenba

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Questionnaire

1. What is your age?

2. M or F?

3. Which dose of the vaccine are you getting today?

1. Dose 1 2. Dose 2 3. Dose 3

Great! Now, think back to the last time you got

vaccinated… we have some questions for you!

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32 PART I: This section will address any symptoms or ailments that occurred after receiving your last dose of the Trumenba® vaccine. Please circle your answers.

4. After receiving your last dose of the Trumenba® vaccine, did you ever experience pain at the injection site? (If yes, please answer 5-9. If no, please circle “No” and GO TO THE NEXT PAGE.)

a. Yes

b. No  Skip to next page

5. If yes, which of the following best describes the pain you experienced?

a. Did not interfere with my daily activity b. Interfered with my daily activity somewhat c. Interfered with my daily activity a lot d. Completely prevented my daily activity

6. When did your pain start?

a. Day of vaccination ( = “Day 0”) b. The next day ( = “Day 1”) c. Day 2-4

d. Day 5-7 e. Day 8-14

7. For how many days did you have this pain?

a. Less than 1 day b. 1-2 days

c. 3-4 days

d. More than 4 days

8. Did your pain resolve within 7 days of receiving the Trumenba® vaccine?

a. Yes b. No

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33 9. After receiving your last dose of the Trumenba® vaccine, did you experience

fatigue? (If yes, please answer 10-13. If no, please circle “No” and GO TO THE NEXT PAGE.)

a. Yes

10. If yes, which of the following best describes the fatigue you experienced?

11. When did your fatigue start?

d. Day 5-7 e. Day 8-14

12. For how many days did you have this fatigue?

c. 3-4 days

d. More than 4 days

13. Did your fatigue resolve within 7 days of receiving the Trumenba®

vaccine?

a. Yes b. No

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34 14. After receiving your last dose of the Trumenba® vaccine, did you experience

headaches? (If yes, please answer 15-18. If no, please circle “No” and GO TO THE NEXT PAGE.)

a. Yes

15. If yes, which of the following best describes the headache you experienced?

16. When did your headache start?

d. Day 5-7 e. Day 8-14

17. For how many days did you have this headache?

c. 3-4 days

d. More than 4 days

18. Did your headache resolve within 7 days of receiving the Trumenba®

vaccine?

a. Yes b. No

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35 19. After receiving your last dose of the Trumenba® vaccine, did you experience any

muscle pain, other than at the injection site? (If yes, please answer 20-24. If no, please circle “No” and GO TO THE NEXT PAGE.)

a. Yes

20. If yes, which of the following best describes the muscle pain you experienced?

21. When did your muscle pain start?

d. Day 5-7 e. Day 8-14

22. For how many days did you have this muscle pain?

c. 3-4 days

d. More than 4 days

23. Did your muscle pain resolve within 7 days of receiving the Trumenba® vaccine?

a. Yes b. No

24. Aside from pain at the injection site, where was this muscle pain?

(circle as many as apply)

a. Other parts of the arm in which I received the shot b. Both arms

c. Legs d. Back e. Neck f. Shoulders g. All over

h. Other (please specify): _____________________________

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fevers? (If yes, please answer 26-31. If no, please circle “No” and GO TO THE NEXT PAGE.)

a. Yes

26. If yes, when did your fever start?

d. Day 5-7 e. Day 8-14

27. For how many days did you have this fever?

c. 3-4 days

d. More than 4 days

28. Did your fever resolve within 7 days of receiving the Trumenba®

vaccine?

a. Yes b. No

29. Did you take your temperature?

a. Yes b. No

30. If yes, what was the highest temperature you had?

a. 98.0°F – 100.3°F b. 100.4°F – 102.0°F c. Above 102.0°F

31. Did you use Tylenol or any other anti-fever medications during this time?

a. Yes b. No

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37 32. After receiving your last dose of the Trumenba® vaccine, did you experience chills?

(If yes, please answer 33-35. If no, please circle “No” and GO TO THE NEXT PAGE.)

a. Yes

33. If yes, when did your chills start?

d. Day 5-7 e. Day 8-14

34. For how many days did you have these chills?

c. 3-4 days

d. More than 4 days

35. Did your chills resolve within 7 days of receiving the Trumenba®

vaccine?

a. Yes b. No

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other symptoms not listed above? (If yes, please answer 37. If no, please circle “No”

and skip to question 38.) a. Yes

b. No  Skip to Question #38.

37. If yes, what were they?

38. After receiving your last dose of the Trumenba® vaccine, were you diagnosed by a physician with any medical illnesses? (If yes, please answer 39. If no, please circle

“No” and GO TO THE NEXT PAGE.) a. Yes

39. If yes, what were you diagnosed with?

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39 PART II: This section will address any serious events you may have experienced after you were given your LAST dose of the Trumenba® vaccination. Please circle your answers.

Note: if you answer “yes” to any of these questions, please notify a staff member immediately, and please call the PC student health center at 401-865-2422.

40. Did you have any allergic reaction that you think might have been caused by Trumenba®? (If yes, please answer 41. If no, please circle “No” and skip to question 42.)

a. Yes

41. If yes, what was your reaction?

42. Did you experience any of the following symptoms on the day of, or the day after, you received Trumenba®? (Please circle as many as apply.)

a. Difficulty breathing

b. Swelling of the lips, mouth, throat, or face c. Hives, welts, or a severe rash

d. Other (please specify): _______________________________

e. Or, I DID NOT EXPERIENCE ANY OF THESE SYMPTOMS

43. Have you been hospitalized at all since your last dose of Trumenba®? (If yes, please answer 44. If no, please circle “No” and skip to question 45.)

a. Yes

44. If yes, why were you hospitalized?

45. If you are female-- have you become pregnant (or do you think you could be pregnant) since your last dose of Trumenba®?

a. Yes b. No

46. If you are female-- are you currently breastfeeding?

a. Yes b. No

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Remember, all answers to this survey are kept confidential.

Please use the space below to provide any additional comments. Thank you for participating in this survey! 