Coronavirus (COVID-19) vaccine certification: evidence paper

8. Conclusion

To continue to manage the epidemic at this point in time requires additional measures to be put in place to help reduce infection and subsequent hospitalisations as we move into the winter season. Vaccine certification could assist as a package of measures along with other non-pharmaceutical interventions (NPIs). Vaccine certification is a far less restrictive measure than re-introducing capacity limits on venues, early closure times or complete closure of events.

Vaccines help prevent transmission as vaccinated people are less likely to catch the virus and only infected people can infect others. Vaccinated people who catch the virus are less likely to become seriously ill than unvaccinated people. However people infected with the Delta variant who are fully vaccinated can contract symptomatic breakthrough infections and transmit the virus onwards. There is insufficient data to conclude whether people who have symptomatic infections are as infectious as unvaccinated people, or whether fully vaccinated people with asymptomatic breakthrough infections can transmit SARS-CoV-2. The impact of vaccine waning on transmission is not yet clear.

Vaccination certification reduces the likelihood of infected people being present at events. Evidence from the UK Events Research Programme (section 5.5) together with evidence on the science of transmission (section 3.1) suggests that mitigation measures to reduce the risk of transmission should be considered and implemented as a part of a package, certification alone is not enough.

Different countries introduced their certification schemes with varying aims depending on the current state of the epidemic and the level of vaccination in place at the time of introduction. The main difference of the certification system proposed for Scotland compared to other European countries is that it takes into account vaccination status only, not testing results, or previous infection. The proposed vaccination certification scheme in Scotland is also narrower in scope compared to most comparator countries and the level of vaccination within the Scottish population is also higher than was the case in most other comparator countries when they introduced their certification schemes.

Some initial increase in vaccine uptake was noted in Scotland when the scheme was initially announced but given these differences and the variety of schemes in place elsewhere it is difficult to draw clear trends and conclusions between implementation of vaccine certificates and vaccine uptake. Certification is unlikely to convince the most vaccine hesitant to be vaccinated, however, it may convince those who are currently indifferent.

It is acknowledged that the COVID-19 Status Certification system is likely to increase administrative costs for the businesses it affects, and that these businesses have already been badly affected by the pandemic. The extent of additional cost depends in part on how it is introduced. However, if COVID-19 cases keep rising, the alternative would be to require those businesses to close which would exacerbate economic harm. The COVID-19 Status Certification system allows higher risk settings to remain open safely and to continue to trade and may therefore provide a more sustainable basis for these businesses to continue to operate safely in the long run.

The Scottish Government is putting in place monitoring and evaluation to assess the extent that the COVID-19 Status Certification system achieves its four objectives. This will enable us to keep the evidence base up to date and to respond to new findings.