What is the public perception surrounding COVID immunity certificates?

Immunity certificates are a controversial topic. While some individuals view them as necessary in order to protect others against the coronavirus disease 2019 (COVID-19) and prevent another surge in cases, others view them as an intrusion on their privacy and discriminatory against those who cannot be vaccinated.

As false news around vaccination and COVID-19 continues to spread, these views can become more and more confusing and intertwined. In a recent study published on the preprint server medRxiv*, researchers from Brunel University London investigate views on immunity certificates and how they interact with other opinions on the pandemic.

Study: Individual factors influencing public's perceptions about the importance of COVID-19 immunity certificates: a cross-sectional online questionnaire survey in the UK. Image Credit: millering / Shutterstock.com

About the study

The researchers obtained cross-sectional data from an online anonymous questionnaire survey. After excluding participants who failed attention checks and a duplicate responder, a total of 534 unique respondents were used for the current study. All study participants were 18 years or older, and demographically representative of the United Kingdom in terms of their age, gender, and ethnicity.

All study participants measured the perceived importance of vaccination, willingness to share immunity status, lifestyle, and socio-demographic characteristics through six questions that inquire about each immunity certificate. The respondents were asked to reply to each question with ‘strongly disagree’, ‘somewhat disagree’, ‘neither agree nor disagree’, ‘somewhat agree’ or ‘strongly agree.’

The six questions included in the current study were:

  • ‘I feel that without ‘A’ I won’t be able to return to my workplace’.
  • ‘I feel that without ‘A’ my chances of getting a job will be affected’
  • ‘I feel that without ‘A’ I won’t be able to book face-to-face appointments with my GP/dentist’
  • ‘I feel that without ‘A’ I won’t be able to go to the theatre/movies/sports events’
  • ‘I feel that without ‘A’ I won’t be able to travel internationally
  • ‘I feel that without ‘A’ I will not enjoy the same liberties I did before the pandemic’

Study findings

In general, the respondents felt that returning to their workspace and getting a job would not be greatly affected; however, the other four questions showed much higher responses for ‘somewhat agree’ and ‘strongly agree.’ The responses were indexed by rating responses from one to five and taking the average.

The respondents’ personal beliefs about COVID-19 were measured using tactics adapted from previous studies including perceived risk of contracting the virus and the severity of the consequences if an individual did contract the virus. Generally, individuals showed good internal consistency for these factors, with a Cronbach’s Alpha score of 0.7 or higher.

Normally, the scientists would examine views on vaccination; however, at the time of the study, 75% of the adult population were vaccinated. Therefore, the researchers questioned individuals on the feelings of vaccine effectiveness, worries about non-U.K. approved vaccines, as well as a feeling of safety around vaccinated people.

Questions were also asked to determine the lifestyle of individuals pre-COVID, including frequency of social activities, travel and time spent in public or visiting a healthcare facility, as well as their willingness to share their immunity status to use certain facilities such as their physician’s office, travel, and nightlife. Finally, questions were asked around feelings of hopelessness, mental wellbeing, and net income compared to before the pandemic.

The researchers employed a multiple stepwise linear regression analysis to examine the results, wherein the methods allow for regression a number of times, each time removing the weakest correlation. Moreover, the researchers examined certificate severity, as defined as the respondents’ perceived importance of immunity certificates, as the dependents variables, and the answers to the questions as independent variables. Stepwise regression analysis was also used to examine vaccination views, risk index, and mental wellbeing during the pandemic.

To this end, those who perceived themselves as more at risk of severe consequences if they contracted the virus were more likely to view immunity certificates as positive. Those who felt safer if vaccinated also viewed immunity certificates as important.

Self-employed or employed individuals, as well as those who had received an increase in income after the outbreak, were more likely to perceive these certificates as compared to those who were not employed. Furthermore, employed individuals were more likely to see these certificates as less important than retired or unemployed individuals.

The authors highlight that individuals who are more vulnerable respond more positively to immunity certificates, as did individuals who had received immunity due to vaccination rather than infection. No demographic factors appeared to affect the respondents’ views.

The current study’s findings could be highly beneficial to public health policymakers by helping them identify which individuals are more likely to support the use of immunity certificates, and which individuals to appeal to in order to encourage/discourage their use.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information

Journal reference:
Sam Hancock

Written by

Sam Hancock

Sam completed his MSci in Genetics at the University of Nottingham in 2019, fuelled initially by an interest in genetic ageing. As part of his degree, he also investigated the role of rnh genes in originless replication in archaea.

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