Background Globally, COVID-19 vaccines have proven to be instrumental for promoting population health by curbing the transmission of SARS-CoV-2 and achieving herd immunity. Vaccine certificates have emerged as a promising solution for encouraging vaccination and facilitating the safe reopening of society, however, they remain controversial due to criticisms of infringing upon individual rights of bodily autonomy. While there is extensive literature describing the ethical, legal, and public health implications of vaccine certificates, there is currently a gap in knowledge about the impact of vaccine certificates on vaccine uptake during the COVID-19 pandemic. Objectives The objectives of this scoping review are to (i) evaluate the impact of vaccine certificates on the rates of COVID-19 vaccine uptake across several countries and (ii) describe the myriad intrinsic and extrinsic barriers or facilitators that moderate this relationship. Methods We conducted a scoping review based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched three bibliographic databases (APA PsychInfo, Embase Classic + Embase, OVID-Medline) and preprint severs on May 17, 2022. Two reviewers independently screened the studies based on pre-specified eligibility criteria and performed data extraction for pre-specified themes. Results Thirteen studies met the inclusion criteria. The majority documented that vaccine certificates significantly increased the rates of COVID-19 vaccine uptake (n=9), motivated by factors such as travel/employer requirements, influence from the government/peers, and trust in the safety, efficacy, and science behind COVID-19 vaccines. Three studies had non-significant or mixed findings. Only one study found a significant decrease in COVID-19 vaccine uptake, motivated by pervasive distrust in the QR code-based system of digital vaccine certificates in Russia. Conclusion Our findings provide valuable insights into the consequences of vaccine certificates on vaccine uptake at a global scale, which can be used to guide future implementation of vaccine certificates in a more acceptable, feasible, and sustainable manner.

Introduction Vaccine certificates have been implemented worldwide, aiming to promote vaccination rates and to reduce the spread of COVID-19. However, they are not without controversy and have been criticized for infringing upon medical autonomy and individual rights. Methods We administered a national web-based survey exploring public attitudes towards vaccine mandates, vaccine acceptance, and demographic variables. We conducted a multivariate linear regression which revealed key social and demographic factors that were predictive of vaccine certificate acceptance in Canada. Results Self-reported minority status (p<0.001), rurality (p<0.001), political ideology (p<0.001), age (p<0.001), having children under 18 in the household (p<0.001), education (p=0.014), and income status (p=0.034) were significant predictors of attitudes towards COVID-19 vaccines and mandates. We found that the most common reasons for COVID-19 vaccination included personal health and safety, protecting others, and travel/work requirements. In contrast, the most common reasons for refusing COVID19 vaccination include perceived violations of personal freedoms, health and safety concerns, and a lack of perceived threat of COVID-19. Conclusion The present findings are valuable for their ability to inform the implementation of vaccine certificate which may require targeted communication between public health agencies and under-vaccinated populations.

Vaccine certificates have been implemented worldwide, aiming to promote vaccination rates and to reduce the spread of COVID-19. However, their use during the COVID-19 pandemic was controversial and has been criticized for infringing upon medical autonomy and individual rights. We administered a national online survey exploring social and demographic factors predicting the degree of public approval of vaccine certificates in Canada. We conducted a multivariate linear regression which revealed which factors were predictive of vaccine certificate acceptance in Canada. Self-reported minority status ( p < .001), rurality ( p < .001), political ideology ( p < .001), age ( p < .001), having children under 18 in the household ( p < .001), education ( p = .014), and income status ( p = .034) were significant predictors of attitudes toward COVID-19 vaccine certificates. We observed the lowest vaccine-certificate approval among participants who: self-identify as a visible minority; live in rural areas; are politically conservative; are 18–34 years of age; have children under age 18 living in the household; have completed an apprenticeship or trades education; and those with an annual income between $100,000–$159,999. The present findings are valuable for their ability to inform the implementation of vaccine certificates during future pandemic scenarios which may require targeted communication between public health agencies and under-vaccinated populations.