Covid passports could increase vaccine uptake, study suggests
Coronavirus passports could lead to increased uptake of vaccines, especially among young people, a study suggests.
Research by the University of Oxford found Covid-19 certification led to increased jab uptake 20 days before and 40 days after introduction in countries with lower-than-average vaccination coverage. Increase in vaccine uptake was most pronounced in people under 30. The modelling analysis was published in The Lancet Public Health.
Coronavirus passports require people to have proof of either complete vaccination, a negative test or a Covid-19 recovery certificate to access public venues and events, such as restaurants or concerts. As well as helping to prevent the spread of coronavirus in public venues, it has been suggested they may encourage more unvaccinated people to get vaccinated, particularly those who perceive their own risk of hospitalisation or death from Covid-19 as low.
Prof Melinda Mills, the director of the Leverhulme Centre for Demographic Science at the University of Oxford and the study’s lead author, said: “As mass vaccination programmes continue to play a central role in protecting public health in this pandemic, increasing vaccine uptake is crucial both to protect the individuals immunised and break chains of infection in the community.
“Our study is an important first empirical assessment of whether Covid-19 certification can form part of this strategy. Overall, we observed a significant uptick in anticipation of restrictions coming into place about 20 days before introduction, which lasted up to 40 days after, but the context of existing vaccination uptake, vaccine hesitancy, levels of trust in authorities, and pandemic trajectory was crucial to the impact.”
Many countries have either introduced or are considering introduction of Covid-19 certification, but whether this public health intervention increases vaccine uptake is unclear. From Wednesday, NHS Covid passes showing full vaccination or a recent negative test will be required in England for entry to indoor venues containing more than 500 people, unseated outdoor venues with more than 4,000 people, and any venue with more than 10,000 people, subject to a vote on Tuesday.
Some survey-based evidence has suggested that people reported they would be less likely to get vaccinated if Covid passports were introduced, while some countries have reported increases in uptake after the introduction of Covid-19 certification.
In the study, researchers linked data on Covid certification introduced between April and September this year to vaccination uptake in six countries where certification was legally required – Denmark, Israel, Italy, France, Germany and Switzerland.
The study used modelling to estimate what vaccine uptake would have been without Covid-19 certification in all six countries, based on vaccination uptake trends from 19 otherwise similar control countries without certification.
In countries where vaccine coverage was previously low, introduction of vaccine passports was associated with a significant increase in the number of additional vaccine doses per million people – 127,823 in France, 243,151 in Israel, 64,952 in Switzerland and 66,382 in Italy, according to the study.
Researchers found that in Denmark and Germany, where there were higher average vaccination rates, there was no significant increase in vaccination after the introduction of certification.
The study’s co-author Dr Tobias Ruttenauer, from the University of Oxford, said: “We know that certain groups have lower vaccine uptake than others and it may be that Covid-19 certification is a useful way to encourage vaccine-complacent groups, such as young people and men, to get vaccinated.
“However, Covid-19 certification alone is not a silver bullet for improving vaccine uptake and must be used alongside other policies. Vaccine hesitancy due to lack of trust in authorities, which is common among some minority-ethnic and lower socioeconomic groups, may be addressed more successfully through other interventions, such as targeted vaccine drives and community dialogue to generate more understanding about Covid-19 vaccines.”
The authors said there were limitations to their study. There was no data available to examine vaccine uptake by sociodemographic, gender and ethnic groups. They also emphasised that Covid-19 certification policies across the six countries were different for various reasons, and acknowledged that the causes of vaccine hesitancy are diverse across different countries, which may limit the generalisability of their findings.
The authors also raised several issues linked with Covid passports that policymakers should consider, including the risk of exacerbating inequalities among communities with lower uptake, generating inequality in access to public spaces where Covid-19 vaccine rollout is staggered by age, entrenching digital divides if passports are electronic, and data privacy concerns.