JMIR Publications

ABSTRACT

Background:

In response to the COVID-19 pandemic, countries are introducing digital passports that allow citizens to return to normal activities if they were previously infected with (immunity passport) or vaccinated against (vaccination passport) SARS-CoV-2. To be effective, policy decision makers must know whether immunity and vaccination passports will be widely accepted by the public, and under what conditions? This study focuses attention on immunity passports, as these may prove useful in countries both with and without an existing COVID-19 vaccination program, however, our general findings also extend to vaccination passports.

Objective:

We aimed to assess attitudes towards the introduction of immunity passports in six countries, and determine what social, personal, and contextual factors predicted their support.

Methods:

We collected online representative samples across six countries – Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom – from April to May of the 2020 COVID-19 pandemic, and assessed attitudes and support for the introduction of immunity passports.

Results:

Immunity passport support was moderate-to-low, ranging from 51% in the UK and Germany, 47% in Australia and Spain, 46% in Taiwan, and 22% in Japan. Bayesian generalized linear mixed effects modelling controlling assessed predictive factors for immunity passport support across countries. International results showed neoliberal world views, personal concern and perceived virus severity, the fairness of immunity passports, and willingness to become infected to gain an immunity passport, were all predictive factors of immunity passport support. By contrast, gender (woman), immunity passport concern, and risk of harm to society predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries and results were modelled separately to provide national accounts of these data.

Conclusions:

Our research suggests that support for immunity passports is predicted by the personal benefits and social risks they confer. These findings generalized across six countries and may also prove informative for the introduction of vaccination passports, helping policy makers to introduce effective COVID-19 passport policies in these six countries and around the world.