Are you aged between 18 and 55? * Yes No Are you in good health? * Yes No Can you easily attend regular visits at Liverpool School of Tropical Medicine * Yes No Have you read the participant information sheet? * Yes No Are you registered with a GP practice in the UK? * Yes No Are you already enrolled in another clinical trial? * Yes No If yes, please give details * Have you previously participated in a pneumococcal challenge study? * Yes No Have you previously received a pneumococcal or RSV vaccine? * Yes No Are you allergic to any antibiotics? * Yes No Do you have a medical history which predisposes you to severe illness or infection including chronic respiratory, heart, liver, kidney or neurological disease, cochlear implants, immune deficiency or bleeding disorders? * Yes No Are you currently pregnant, breastfeeding or planning on becoming pregnant in the next 12 months? * Yes No Have you had any major pneumococcal illness or pneumonia requiring hospitalisation in the last 10 years? * Yes No Have you had an acute upper respiratory tract infection in the last four weeks? * Yes No Do you have a direct caring role or share living accommodation with individuals at higher risk of infection (adults >65 years, children < 3 years of age, adults with chronic ill health or immunosuppression, adults classified as clinically extremely vulnerable by the NHS) * Yes No Are you a health-care worker? * Yes No Are you a current or ex-smoker (regular cigarettes, cigars, vaping or smoking within the last 6 months) * Yes No Have you taken any medication that affects the immune system in the last 3 months * Yes No Have you take long-term antibiotics. * Yes No Have you received blood products within the last year * Yes No Have you used any medication or prouct to treat symptoms of rhinitis or nasal congestion within the last month? * Yes No Do you regularly drink more than 3 units a day (male) or 2 units a day (female) or regularly use recreational drugs? * Yes No Thank you, but unfortunately, you need to be within easy traveling distance of a study site. Unfortunately, we can’t consider you for this trial until you have read the participant information leaflet provided at : **weblink** Please read the leaflet and then resume this questionnaire if you are still interested in participating in the trial. Thank you for your responses. You may be eligible to participate in this trial. Please proceed to the next section where we will ask for your consent to record more medical information. Thank you for your interest. Your answers will be reviewed by our team and if you are eligible we will be in touch. Thank you for your interest in the trial. In order to help manage the risks of COVID-19 we are trying to minimise the time volunteers spend at our screening visits. To help with this, we would like to gather information about your medical history here. This will be used to help decide if you are eligible to take part in the study. Giving your consent means that you are happy for us to store and use your personal information for the purposes of this trial. Information will be stored in accordance with the UK GDPR and Data Protection Act. Further information can be found at: https://compliance.web.ox.ac.uk/individual-rights I agree for the Oxford Vaccine Group to record my personal information and information about my medical history. I agree to be contacted by the Oxford Vaccine Group for the purposes of this trial. * Yes No I understand and agree that the medical information I give here will be recorded, stored and used to assess eligibility * Yes No I give permission for the study team to access my medical records either from the GP or NHS databases for the purposes of assessing eligibility * Yes No I'm happy for the study team to contact me by telephone and discuss my eligibility for the study, including my medical history. I understand that this information will be recorded and stored for the purposes of the study. * Yes No Thank you for your interest. Unfortunately, you are not eligible to join this trial. Your data has not been stored. If you are interested in hearing more about our other studies, you can sign up to our newsletter here http://newsletter.ovg.ox.ac.uk/OVG/lists/?p=subscribe&id=1. What is your title? E.g. Mrs, Miss, Ms, Mr, Dr, Prof * What is your full first name (as it appears on your passport)? * What is your last name? * What is your date of birth? * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20232024202520262027 What is your gender? * Male Female Non-binary or transgender What is your occupation? * Health and social care setting workers Drivers and transport workers Retail workers in essential shops and branches (e.g. food, chemists, banks) Hospitality/retail workers in non-essential shops and branches Cleaning and domestic workers Public safety workers (e.g. police, fire services, security) Religious workers Construction workers and labourers Other occupation Unemployed Student Retired If other, please specify * How will you primarily attend your clinic visits? * Solely reliant on public transport Car Motorbike Bicycle Walking What is your email address? * What is your phone number? * What is your address? * What is your postcode? * What are your GP practice details? * Do you have any medical conditions? * Yes No Please list all here * Do you have any mental health conditions? * Yes No Please list all here * Are you currently taking any medication? * Yes No Please list here * Applicable only to volunteers who have ever been able to become pregnant: Are you post-menopausal (must have had no periods for at least 12 months, must not be on any hormonal contraception and be over the age of 50) * Yes No Not applicable If answers No: Are you currently using any form of contraception and would you agree to continue using this for the duration of the trial? * Yes No What is your method of contraception? * Oral, injected or implanted hormonal contraception e.g. “the pill”, “mini-pill”, “depot injection” or “implant” Intrauterine device (IUD) or intrauterine system (IUS) (commonly referred to as having “a coil”) Have had a total hysterectomy (surgical removal of the womb) Bilateral tubal occlusion (commonly referred to as “tube-tie” or “female sterilisation”) Barrier methods of contraception (condom or occlusive cap [diaphragm] with spermicide) Partner has had male sterilisation (vasectomy) - as long as this is your only partner Practice true abstinence – as long as this is your preferred and usual lifestyle Not applicable – same sex partner Please note periodic abstinence and the withdrawal method are not acceptable methods of contraception Do you have any allergies? (All allergies including food, medication and insect bites/stings) * Yes No If yes, please detail * Are you currently taking part in any other research studies? * Yes No If yes, please detail * Math question * 6 + 8 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
