From France to Germany, an image is already common in many European countries: customers showing the QR code of their COVID-19 certificate to be able to enter restaurants, cinemas, theaters and other closed spaces. A study published in the magazine The Lancet Public Health has concluded that COVID-19 certificates may increase the adoption of the coronavirus vaccine in countries with lower vaccine coverage.
Specifically, it is a model-based study, prepared by researchers at the Leverhulme Center for Demographic Sciences at the University of Oxford and reviewed by peers, according to which COVID certificates have caused an increase in vaccination 20 days earlier, with a lasting effect up to 40 days after its introduction in countries with vaccination coverage lower than the average of the countries analyzed.RELATED
This type of certification, also known as a “passport,” requires individuals to have a complete guideline test, a negative test, or a COVID-19 recovery certificate to access public venues and events. Many countries have introduced them or are considering introducing them, but so far it is not clear if the measure increases the adoption of the vaccine, as indicated by the magazine in a statement.
The study now published in The Lancet relates the passport data entered between April and September 2021 with the adoption of vaccination in six countries where they were legally required: Denmark, Israel, Italy, France, Germany and Switzerland. It uses a model to estimate what vaccine adoption would have been without certificates in each of the six countries, based on trends in 19 control countries without certificates, but otherwise similar (including Spain).
The authors estimate the number of additional doses per population attributable to this policy and also examine the impact of the measure on reported infections, as well as the differences in the effects by age groups and the influence of the application of COVID-19 certificates. in specific types of public places (eg nightclubs and large events alone).
In countries where vaccination coverage was previously lower, the introduction of passports is associated with a considerable rise in the number of additional doses per million people: 127,823 in France, 243,151 in Israel – a pioneer in this measure -, 64,952 in Switzerland and 66,382 in Italy.
In contrast, in Denmark and Germany, where average immunization rates were higher before certificates were required, there was no significant increase in vaccination. Denmark introduced them in April, when the global supply of vaccines was still limited despite the high demand and its main objective with this measure, the measure points out, was to increase testing before attending public places, rather than to encourage vaccination, “which highlights the multiple objectives or potential consequences of COVID-19 certificate policies.”
“Increasing vaccine adoption is crucial both to protect immunized individuals and to break the chains of infection in the community,” says study lead author Melinda Mills. “Our study is an important first empirical assessment of whether COVID-19 certificates can be part of this strategy. Overall, we see a significant increase (…) but the context of the adoption of existing vaccination, doubts, the levels of trust in the authorities and the trajectory of the pandemic were crucial for the impact. ”
When compared to control countries, the number of daily COVID-19 cases decreased after passport application in France, Germany, Italy and Switzerland, but grew in Israel and Denmark – many countries apply the measure in response to the spike in cases, making it difficult to assess the effect of certificates on reported infections, warns The Lancet-.
The increase in vaccination is greater in those under 30 years of age compared to older age groups. When passports were used to restrict only access to discos and big events in Switzerland, an increase in the adoption of vaccination was only seen in people under 20 years of age. When it was expanded to include all hospitality and entertainment venues, it also increased among 20-49 year olds.
The authors say this suggests that the measure may be useful in promoting vaccine adoption in certain groups, “but other factors, such as socioeconomic status and ethnicity, need to be investigated to fully understand who the certificates might be targeting.” . The study also has limitations such as the lack of access to detailed data on daily vaccine consumption by age.
The researchers also recall that the measure raises multiple ethical questions, such as the risk of exacerbating inequalities between certain groups that have less confidence in the authorities.
“We know that certain groups have lower vaccine adoption than others and it may be that COVID-19 certificates are a useful way to encourage vaccine-compliant groups. [debido a una menor percepción del riesgo], like young people and men, to get vaccinated, “says study co-author Tobias Rüttenauer of the University of Oxford.” However, certificates alone are not a magic bullet to improve vaccine adoption and should used in conjunction with other policies. Vaccination concerns due to lack of trust in authorities … can be more successfully addressed through other interventions, such as targeted vaccination initiatives and community dialogue to gain a better understanding of vaccines. “