Why “one size fits all” is not enough when designing COVID-19 immunity certificates for domestic use: a UK wide cross-sectional online survey

Abstract

The present study explored public willingness to use immunity certificates across six different domestic scenarios through a Cross–sectional online survey (534 UK residents over 18 years old). The primary outcome measure was willingness to use immunity certificates across three different domestic settings (1. Visiting the GP for a non urgent health issue, 2. Dining in a restaurant, and 2. Attending a performance in a theatre). For each setting two options, one prioritising convenience (option A) and the other privacy (option B), were offered. Our secondary outcome measures were computed indices from items adapted from the Health Belief Model, Attitudes towards sharing immunity status with service providers, Prior to COVID– 19 lifestyle. In addition, we recorded data about respondents socio– demographic characteristics. Respondents were more willing to use immunity certificates that prioritised convenience, rather than privacy, when visiting their GP (92%). However, privacy was more favourable (84%) in the other two settings (dining in a restaurant and going to a theatre) compared to convenience (39%). Personal beliefs about COVID–19 and immunity certificates were associated with variations in willingness to use these across all scenarios. No variations were observed across socio–demographics and lifestyle. The findings of this survey suggest that there is not one size fits all solution for designing immunity certificates. Immunity certificates are complex socio–technical systems, any attempt to implement these for domestic use should be tailored to different settings and user needs. The design of certification services requires a more evidence-based approach and further research is needed to understand how different settings, design elements (like convenience or privacy) and personal beliefs about the pandemic should inform their design.

Public views on the Covid‐19 immunity certificate: A scoping review

“…The varying acceptance rates may partly be attributed to differences in demographics, Covid‐19‐related concerns and ideological beliefs, as seen for other health‐related tracking policies 33 . 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 1 . Indeed, in different contexts, this certification implies different rights, restrictions and/or freedoms, based on presumed immunity‐ or infection‐based criteria.…”

“…33 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. 1 Indeed, in different contexts, this certification implies different rights, restrictions and/or freedoms, based on presumed immunity-or infection-based criteria. This may further explain retrieved differences in public views.…”

“…Since the start of the Covid‐19 vaccination campaigns, vaccine hesitancy has been recognized as one of the foremost barriers to their effectiveness. 1 , 2 , 3 As the Covid‐19 pandemic continues and global vaccination campaign does not seem to be enough to effectively control the virus, many countries proceed to (re)instituting lockdowns and other restrictive public health measures to manage the spread of the disease. 2 Governments are simultaneously struggling with ways to save people from some of these restrictions.…”

Using the Health Belief Model to design a questionnaire aimed at measuring people’s perceptions regarding COVID-19 immunity certificates

“…The survey items comprising the perceived barriers and perceived benefits of using immunity certificates displayed a low Cronbach’s alpha of 0.3691, 0.6045 and respectively 0.3276, hence these items were not aggregated into individual indices, but rather used on their own. Our analysis was an exploratory one, and the main of the survey was to explore willingness to use immunity certificates in different scenarios[16]. Further research should take a theoretical approach in creating survey items for applying the HBM to immunity certificates.…”

Individual factors influencing public’s perceptions about the importance of COVID-19 immunity certificates: a cross-sectional online questionnaire survey in the UK

“…Production of this knowledge is important to help us understand how perceptions around immunity certificates are influenced by individual characteristics and use this insight to inform policy making and implementation strategies for services around immunity certification, e.g. by helping identify those who are more in need of using immunity certificates [18,19].…”