Original article
Vol. 150 No. 4748 (2020)
Perceptions of immunity and vaccination certificates among the general population: a nested study within a serosurvey of anti-SARS-CoV-2 antibodies (SEROCoV-POP)
Summary
At a time when COVID-19 immunity certificates are debated and vaccination certificates might potentially be made available if an effective vaccine is established, we conducted a study to elucidate public opinion on this issue. Our objective was to determine social and individual perceptions of COVID-19 immunity certificates through a population-based study.
A nested survey within the SEROCoV-POP study, a population-based serosurvey of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland, was conducted with a self-administered questionnaire. The questionnaire was proposed to 1520 SEROCoV-POP participants. Measures included percentage of participants agreeing or disagreeing with statements on immunity and vaccination certificates. Stratification by age, gender, education and work status was used to examine socio-demographic variations.
Of the 1520 SEROCoV-POP participants, 1425 completed the questionnaire (response rate 93%; mean age ± standard deviation 52 ± 15.1 years; 51.9% women). About 80% of participants agreed that knowing one’s serology status would lead to a change in one’s behaviour. In the event that the presence of antibodies correlated with immunity, 60% of participants reported that certificates should be offered to the general population. The results showed variations in perceptions of certificates depending on the context (73% agreed on certificates’ utility for travel, 72% for entering a country, and 32% for the right to work). Provided an effective vaccine was available, 55% of participants agreed that vaccination should be mandatory and 49% agreed that a vaccination certificate should be mandatory. About 68% reported a potential risk of discrimination and 28% a risk of deliberate infection. Differences were seen with age, gender and education level.
This study shows that the general adult population in Geneva, Switzerland can envisage scenarios where COVID-19 immunity, and eventually vaccination, certificates would be useful. Seroprevalence estimates of anti-SARS-CoV-2 antibodies remain low to date, and the interpretability of serological testing and immunity remains undefined. However, the information from this study is important, especially the differences based on context and the socio-demographic variations, and should be taken into account if COVID-19-related certificates are to be implemented.
References
- OECD. Evaluating the initial impact of COVID-19 containment measures on economic activity. OECD. Published June 2020. Available from: http://www.oecd.org/coronavirus/policy-responses/evaluating-the-initial-impact-of-covid-19-containment-measures-on-economic-activity-b1f6b68b/ [accessed 2020 July 18].
- Goldstein D. Research Shows Students Falling Months Behind During Virus Disruptions. The New York Times 2020 June 5. Available from: https://www.nytimes.com/2020/06/05/us/coronavirus-education-lost-learning.html [accessed 2020 July 21].
- Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health. 2020;8(7):e901–8. doi:.https://doi.org/10.1016/S2214-109X(20)30229-1
- Miller J. Armed with Roche antibody test, Germany faces immunity passport dilemma. Reuters. Published 2020 May 4. Available from: https://www.reuters.com/article/health-coronavirus-germany-antibodies-idUSL1N2CM0WB [accessed 2020 July 20].
- Proctor K, Devlin H. Coronavirus UK: health passports “possible in months.” The Guardian 2020 May 4. Available from: https://www.theguardian.com/politics/2020/may/03/coronavirus-health-passports-for-uk-possible-in-months [accessed 2020 July 20].
- Laing A. Chile plans “release certificates” for recovered coronavirus patients. Reuters. Published 2020 April 9. Available from: https://www.reuters.com/article/us-health-coronavirus-chile-recovered-idUSKCN21R3EC [accessed 2020 July 20].
- Stringhini S, Wisniak A, Piumatti G, Azman AS, Lauer SA, Baysson H, et al. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): a population-based study. Lancet. 2020;396(10247):313–9. doi:.https://doi.org/10.1016/S0140-6736(20)31304-0
- Havers FP, Reed C, Lim T, Montgomery JM, Klena JD, Hall AJ, et al. Seroprevalence of Antibodies to SARS-CoV-2 in 10 Sites in the United States, March 23-May 12, 2020. JAMA Intern Med. 2020;(July 21). Online ahead of print. doi:.https://doi.org/10.1001/jamainternmed.2020.4130
- World Health Organization. “Immunity passports” in the context of COVID-19. “Immunity passports” in the context of COVID-19. Published 2020 April 24. Available from: https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19 [accessed 2020 July 18].
- National COVID-19 Science Task Force (NCS-TF). Ethical, legal, and social issues associated with “serological passports.” April 2020. https://ncs-tf.ch/en/policy-briefs.
- Persad G, Emanuel EJ. The Ethics of COVID-19 Immunity-Based Licenses (“Immunity Passports”). JAMA. 2020;323(22):2241–2. doi:.https://doi.org/10.1001/jama.2020.8102
- Hall MA, Studdert DM. Privileges and Immunity Certification During the COVID-19 Pandemic. JAMA. 2020;323(22):2243–4. doi:.https://doi.org/10.1001/jama.2020.7712
- de Mestral C, Stringhini S, Guessous I, Jornayvaz FR. Thirteen-year trends in the prevalence of diabetes in an urban region of Switzerland: a population-based study. Diabet Med. 2020;37(8):1374–8. doi:.https://doi.org/10.1111/dme.14206
- Kofler N, Baylis F. Ten reasons why immunity passports are a bad idea. Nature. 2020;581(7809):379–81. doi:.https://doi.org/10.1038/d41586-020-01451-0
- Childress JF, Faden RR, Gaare RD, Gostin LO, Kahn J, Bonnie RJ, et al. Public health ethics: mapping the terrain. J Law Med Ethics. 2002;30(2):170–8. doi:.https://doi.org/10.1111/j.1748-720X.2002.tb00384.x
- Phelan AL. COVID-19 immunity passports and vaccination certificates: scientific, equitable, and legal challenges. Lancet. 2020;395(10237):1595–8. doi:.https://doi.org/10.1016/S0140-6736(20)31034-5
- Wright L, Steptoe A, Fancourt D. Are we all in this together? Longitudinal assessment of cumulative adversities by socioeconomic position in the first 3 weeks of lockdown in the UK. J Epidemiol Community Health. 2020;74(9):683–8. doi:.https://doi.org/10.1136/jech-2020-214475