Papers please: Factors affecting national and international COVID-19 immunity and vaccination passport uptake as determined by representative national surveys

Public Preferences for Introducing a COVID-19 Certificate: A Discrete Choice Experiment in the Netherlands

OBJECTIVE

Here we investigate public preferences for coronavirus disease 2019 (COVID-19) certificates in the Netherlands, and whether these preferences differ between subgroups in the population.

METHODS

A survey including a discrete choice experiment was administered to 1500 members of the adult population of the Netherlands. Each participant was asked to choose between hypothetical COVID-19 certificates that differed in seven attributes: the starting date, and whether the certificate allowed gathering with multiple people, shopping without appointment, visiting bars and restaurants, visiting cinemas and theatres, attending events, and practising indoor sports. Latent class models (LCMs) were used to determine the attribute relative importance and predicted acceptance rate of hypothetical certificates.

RESULTS

Three classes of preference patterns were identified in the LCM. One class a priori opposed a certificate (only two attributes influencing preferences), another class was relatively neutral and included all attributes in their decision making, and the final class was positive towards a certificate. Respondents aged > 65 years and those who plan to get vaccinated were more likely to belong to the latter two classes. Being allowed to shop without appointment and to visit bars and restaurants was most important to all respondents, increasing predicted acceptance rate by 12 percentage points.

CONCLUSIONS

Preferences for introduction of a COVID-19 certificate are mixed. A certificate that allows for shopping without appointment and visiting bars and restaurants is likely to increase acceptance. The support of younger citizens and those who plan to get vaccinated seems most sensitive to the specific freedoms granted by a COVID-19 certificate.

Nationalism, conspiracy theories and vaccine mandates: Exploring the statism determinants for attitudes to COVID-19 control in China

Introduction

China's loosening its COVID-19 controls highlighted its insufficiency in vaccination protection. Mandatory vaccination might be necessary if the gap cannot be filled over a short time. However, few studies have explored how Chinese people view the COVID-19 vaccine mandates, let alone placing such views in the country's highly politicized context.

Material and methods

The current study utilizes data from a national survey adopting quota sampling to analyze the Chinese public's medical and non-medical considerations when judging compulsory COVID-19 vaccination (n = 1,523). The survey was conducted between 1 and 8 April 2021. All adults aged 18 years and older were eligible to take part. The survey included sociodemographic details, perceived susceptibility to infection, perceived vaccine benefit, attitudes to vaccination policies, nationalism, beliefs in various conspiracy theories and science literacy. Multiple regression analyses were done to examine factors associated with the attitude to COVID-19 vaccine mandates.

Results

The study reveals that personal risk and benefit perceptions did not dominate the Chinese public's attitude toward vaccination mandates. Instead, nationalism was relatively strongly associated with their willingness to accept mandatory vaccination. Contrary to studies in the West, various conspiracy beliefs and conspiratorial thinking were robustly related to the support for mandatory vacciniation. Science literacy didn't link to the attitude to vaccination mandates. It only had a weak moderating effect on the influence of conspiratorial thinking on attitudes to the vaccination policies.

Conclusions

The results indicated that Chinese people's attitude to the COVID-19 vaccination policy is highly politicized and influenced by conspiracy theories. Given the potentially massive impacts of the COVID-19 infection, we need to educate the Chinese public with more medically valuable and relevant information to help them make sound decisions regarding vaccination. Meanwhile, we can adopt nationalistic tones to improve the persuasion effect, but misinformation during the process must be overcome.

COVID-19, travel restrictions and environmental consequences

The component of human life that has been most significantly altered by the COVID-19 epidemic is travel. Due to the upheaval produced by the pandemic breakout, countries are becoming increasingly avaricious and are scrambling to stockpile vaccines. The world has been locked down to reduce/control the pandemic outbreak, driving countries to shut their doors to other people from countries. The recent pandemic has had a short-term, positive effect on the environment, but travel restrictions have caused problems for the common person and are expected to deteriorate more soon, necessitating longer quarantines, vaccination requirements, vaccine passports, and immunization certificates required by countries for safe travel. Thus, this study has three objectives. First, we investigate the impact of COVID-19 on travel and the environment, as well as the role that tourists play in the transmission of the virus. Second, we examine how countries are handling COVID-19 vaccines. Finally, we pinpoint differences in vaccination coverage.

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.

Citizens’ Perception of COVID-19 Passport Usefulness: A Cross Sectional Study

This paper assesses the influence on people’s perception of the utility of the immunity passport (IP) program by sociodemographic factors, infectivity status, and the objective of its use. The material of this paper is a cross-sectional survey of 400 residents in Spain. The relation between utility perception and input variables is fitted with ordinary least squares (OLS) regression and linear quantile regression (LQR). The principal explanatory variable of usefulness perception is being vaccinated, especially when the objective of the IP is regulating mobility. The OLS estimate of the coefficient regression is (cr) = 0.415 (p = 0.001). We also found a positive and significant influence of that factor in all LQRs (cr = 0.652, p = 0.0026 at level (τ) = 0.75; cr = 0.482, p = 0.0047 at τ = 0.5 and cr = 0.201, p = 0.0385 at τ = 0.25). When the objective of the IP is regulating leisure, being vaccinated is relevant only to explain the central measures of usefulness perception. If the IP is used to regulate traveling, variables related to interviewees’ infectivity have greater relevance than sociodemographic factors. When its objective is ruling assembly, the more important variables than being vaccinated are gender and age. To create an effective implementation of the IP, it is advisable to have a general agreement among the population on its convenience. Therefore, the findings in this study have important implications for public health decision-makers.