Acceptability of COVID-19 Certificates: A Qualitative Study in Geneva, Switzerland, in 2020

Public views on the Covid-19 immunity certificate: A scoping review

INTRODUCTION

Already in its first implementation, the introduction of the Covid-19 immunity certificate has generated some debate among the public. This debate might be a hindrance to the effective realization of this policy. This study aimed to systematically review published research evaluating public feeling of the Covid-19 immunity certificate policy measure and to find which factors might influence its acceptance.

METHODS

We followed the scoping review methods manual by the Joanna Briggs Institute. We included studies with no time limits that presented novel data, and no exclusions have been made based on study design. We excluded articles that presented just expert opinions.

RESULTS

We found and reviewed 17 articles. The included studies were conducted in two main countries (the United Kingdom and Switzerland), with the rest from Israel, Italy, Spain, Germany, Australia, Taiwan and China. Both qualitative and quantitative studies were included, and nonrepresentative samples were mostly used to explore the public feeling about the Covid-19 immunity certification. The included studies showed that public views on immunity certification are quite contradictory and influenced by age, gender, ethnicity, political orientation and attitudes towards Covid-19 vaccination. The topic more often addressed by the included studies was the public's views on the positive and negative implications of the Covid-19 immunity certificate in terms of ethical, legal and behavioural consequences of this measure.

CONCLUSION

The varying acceptance rates are notable and may partly be linked to differences in demographics, Covid-19 concerns and ideological beliefs, as seen in other health-related tracking policies. Moreover, dominant factors behind the (un)success of this policy are complex and entangled with the cultural and political dimensions rather than being just technical. For this reason, it is important to expand psychosocial research to better understand the concerns behind health certifications and allow planning of culturally based and ethically sound suitable strategies. This would be very relevant to increasing public approval and compliance with this public health measure.

PATIENT OR PUBLIC CONTRIBUTION

This does not apply to our work as it was a review paper.

Public Perceptions of Harms and Benefit of COVID-19 Immunity Certificate: A Cross-Sectional Study in the Italian Setting

A cross-sectional survey between 29 January 2022 and 3 February 2022 was conducted to understand the public rationale for accepting or rejecting the use of COVID-19 immunity certificates and to identify the psychosocial factors that mostly predict the positive/negative individuals' perceptions of this measure. One thousand twenty-two Italian adults were recruited by a professional panel provider by employing a stratified sampling strategy controlled for gender, age, geographical area of residence, size of the urban centre of residence, employment, and wage. Eight Welch's ANOVAs were then carried out to compare the perception of benefits and the perception of harms among different population groups. Multiple linear regression was carried out to measure the explained variance of benefits perception and harms perception by age, trust in institutions, and concern for health emergencies. The results shows that age, trust in institution, and concern for the COVID-19 emergency explain more variance of perceived benefits than of perceived harms of COVID-19 immunity certificates but the opposite regarding political orientation which explains perceived harms better than perceived benefits. The need for policy improvements is pressing because a large share of the world's population remains unvaccinated. Moreover, our results can serve as vital information for similar health crises that may occur in the future. In addition, our results are expected to offer useful insights into public feelings around the use of digital health information tools.

Conflicting attitudes: Analyzing social media data to understand the early discourse on COVID-19 passports

In several countries, vaccine passports are being encouraged to hasten the return to some form of normalcy amidst the COVID-19 pandemic. Vaccine passport is a digital or paper document that may serve as proof of the COVID-19 vaccine, thereby allowing entry to public venues, sporting events, air travel, and unrestricted access to other facilities. This study explores how the COVID-19 passport is being discussed and perceived on Twitter and the prominent entities involved in the early discourse on the issue. Twitter messages were theoretically analyzed for Health Belief Model (HBM) and Theory of Planned Behavior (TPB) variables, as well as message source, engagement, and attitudes towards vaccination certificates. Using quantitative content analysis, tweets were coded on nine dimensions: account type, tweeter profile, tweet content, tweet modality, attitude, self-efficacy, perceived barriers, benefits, and action cues. Most of the tweets originated from personal accounts, followed by media organizations, media-related personalities, politicians, and the travel industry. A significant number of tweets were from male Twitter users. Our analysis revealed that most tweeters had a favorable attitude towards the COVID-19 passports. Unfavorable attitudes toward the COVID-19 passport were based on reasons such as a lack of common standard or consensus, and personal freedoms & human rights. Tweets highlighting the benefits of COVID-19 passports cited travel as the primary reason. Based on a combination of technical, legal, and ethical practices, our study offers a set of vital recommendations for governments, health organizations, and businesses that may help stimulate the acceptance of vaccine passports.