Coronavirus (COVID-19) vaccine certification: evidence paper update

This paper summarises the range of evidence available on vaccination certification schemes. Evidence is drawn from clinical and scientific literature, from public opinion and from international experience.

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8. Public attitudes and societal impacts of vaccination.

A key objective of the certification scheme is to encourage vaccine take-up. For some vaccine hesitant people vaccine passports are perceived to be a reason why they would get vaccinated in the future. However, for others, vaccine passports were seen as coercive measures to control the population and violate privacy[158] [159].

A UK based online study, conducted in August[160] highlights that the interaction between individual characteristics, domestic settings, and types of immunity certificate design can affect willingness to use certificates. For example, participants' responses showed high willingness to use immunity certificates when visiting their GP for a non-urgent health matter (in a hypothetical scenario) compared to the other settings (dinning in a restaurant and going to the theatre). Research on the impact of COVID vaccine certificates is evolving[161] and more evidence will become available.

Research into public attitudes carried out by YouGov for the Scottish Government, on 5/6 October 2021, found that 74% of respondents agree[162] that the certification scheme has advantages, in particular encouraging people to get vaccinated (52% agree), making venues and events safer places to visit (49% agree), and in helping to prevent businesses having to close (44% agree). The most commonly selected disadvantage of the scheme (62% agree) is that people who are vaccinated can still be carrying the virus, followed by it will be difficult for venues and events to check (47%).

Further polling carried out by YouGov for the Scottish Government on 2-4 November[163] ( See Annex C for further details on methodology and sample) found that awareness of the vaccine certification scheme in Scotland and Covid Status app are high, with a steady level of support for the scheme and majority recognition of the beneficial nature of the scheme for businesses.

Awareness of the vaccine certification scheme in Scotland is near universal at 93%, compared with 89% in early October and 84% towards the end of September. Awareness of the Covid status app is also high, at 80%, with one in three (36%) having downloaded it already – at 58% among those who have been to an eligible venue/event in the past week (although small base (n= 85) must be noted.

Overall support for the scheme is 59%, with around a quarter (24%) opposing it and 13% neither supporting nor opposing (similar levels to when asked towards the end of October).

Among the one in ten (n=85) who had been to an eligible venue or event in the past week, just over half (54%) showed their certificate, whether asked to or not (up from 36% two weeks before). A third (34%) – weren't asked to show their certificate and didn't show it, compared with 50% two weeks before. Enforcement was introduced in the middle of this two week period which is likely to have had some impact.

Three in five (60%) recognise that the scheme is designed to help rather than hinder eligible businesses/events. Nevertheless, the proportion who would like to see the scheme rolled out to other types of events and venues remains lower at 45%, and one in three (33%) agree that it will encourage more people to go to these venues/events, down from 38% four weeks before. Disagreement with these statements is at 29% and 28% respectively, with the remainder neither agreeing nor disagreeing.

COVID-19 has had a disproportionate impact on the health of people living with a range of conditions: 93% of people who died from COVID-19 up until April 2021 had at least one pre-existing condition. Understanding attitudes and beliefs regarding vaccination among those who are at increased risk is important. Interviews[164] were conducted with people on the Scottish Government's highest risk list[165] who receive advice and support about being at highest risk from COVID-19. Findings indicated that some participants do feel more confident in managing risk after vaccination and have started to 'get back to normal'. However, many participants were still concerned about the behaviour of others (as also highlighted in survey research in July 2021[166]) and this was cited as something which prevented them from being able to feel confident to engage with others and access a range of venues and settings. Many were choosing to avoid places where they believed that risk to be highest, especially bars and restaurants.

If the policy objectives of certification to reduce the risk of transmission and to increase vaccine uptake are achieved, this could positively affect those who are at a higher risk of poorer health outcomes if they contract the virus. However more research should be undertaken. The addition of testing as well as vaccination may provide more higher confidence that there is lower risk of transmission from vaccinated individuals who may currently be infected.

As an alternative to or along with vaccination LFTs can also be used as the basis of certification. Further opinion polling carried out by YouGov for the Scottish Government, on 5-6 October, indicated that almost nine in ten are aware that everyone can now access testing. 41% have ordered or collected self-administered LFD tests, an increase since late August (35%). Of those who have ordered or collected tests[167], nine in ten have used them.

To fully assess the societal and equality aspects of any changes to the existing vaccination certification scheme a further Equality Impact Assessment (EQIA) will be produced in due course which will contain detailed evidence of the impact on different diversity groups. This will also assesses the impact of the policy on the Scottish Government's obligations under the Public Sector Equality Duty (PSED) to advance equality of opportunity, eliminate unlawful discrimination and to foster good community relations. An updated Children's Rights and Wellbeing Impact Assessment (CRWIA) to analyse the potential impact, both positive and negative, of the domestic use of Covid Status Certification on the promotion of children's rights and wellbeing will also be produced.



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