Paul M Garrett, Joshua P White, Simon Dennis, Stephan Lewandowsky, Cheng-Ta Yang, Yasmina Okan, Andrew Perfors, Daniel R Little, Anastasia Kozyreva, Philipp Lorenz-Spreen, Takashi Kusumi, and Yoshihisa Kashima
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 these 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 toward the introduction of immunity passports in six countries, and determine what social, personal, and contextual factors predicted their support. Methods: We collected 13,678 participants through online representative sampling across six countries—Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom—during 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, being the highest in Germany (775/1507 participants, 51.43%) and the United Kingdom (759/1484, 51.15%); followed by Taiwan (2841/5989, 47.44%), Australia (963/2086, 46.16%), and Spain (693/1491, 46.48%); and was the lowest in Japan (241/1081, 22.94%). Bayesian generalized linear mixed effects modeling was used to assess predictive factors for immunity passport support across countries. International results showed neoliberal worldviews (odds ratio [OR] 1.17, 95% CI 1.13-1.22), personal concern (OR 1.07, 95% CI 1.00-1.16), perceived virus severity (OR 1.07, 95% CI 1.01-1.14), the fairness of immunity passports (OR 2.51, 95% CI 2.36-2.66), liking immunity passports (OR 2.77, 95% CI 2.61-2.94), and a willingness to become infected to gain an immunity passport (OR 1.6, 95% CI 1.51-1.68) were all predictive factors of immunity passport support. By contrast, gender (woman; OR 0.9, 95% CI 0.82-0.98), immunity passport concern (OR 0.61, 95% CI 0.57-0.65), and risk of harm to society (OR 0.71, 95% CI 0.67-0.76) predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries and results were modeled separately to provide national accounts of these data. Conclusions: Our research suggests that support for immunity passports is predicted by the personal benefits and societal risks they confer. These findings generalized across six countries and may also prove informative for the introduction of vaccination passports, helping policymakers to introduce effective COVID-19 passport policies in these six countries and around the world. Data collection in Australia was supported by anonymous philanthropic funding to the Peter Doherty Institute for Infection and Immunity to SD. Data collection in Germany was funded by the planning grant of the Volkswagen Foundation to RH, SL, and SH (Initiative “Artificial Intelligence and the Society of the Future”). SL was supported by a Research Award from the Humboldt Foundation in Germany while this research was conducted. SL also received funding from the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement 964728 (JITSUVAX). Data collection in Taiwan was supported by the National Cheng Kung University and Ministry of Science and Technology (MOST 110-2321-B-006-004 and MOST 108-2321-B-006-022-MY2) to CTY. Data collection in the United Kingdom was supported by the Elizabeth Blackwell Institute, University of Bristol, with funding from the University’s Alumni and Friends fund. Data collection in Spain was supported by funding from Leeds University Business School, University of Leeds to YO, who was in part supported by a Population Research Fellowship awarded by Cancer Research UK (C57775/A22182). Data collection in Japan was supported by funding from the School of Psychological Sciences, the University of Melbourne, and provided to YK.