Papers Please-Predictive Factors of National and International Attitudes Toward Immunity and Vaccination Passports: Online Representative Surveys

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 whatMethods: 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 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

Citizens' Perception of COVID-19 Passport Usefulness: A Cross Sectional Study.

This paper assesses the influence on people's perception of the utility of the immunity passport (IP) program by sociodemographic factors, infectivity status, and the objective of its use. The material of this paper is a cross-sectional survey of 400 residents in Spain. The relation between utility perception and input variables is fitted with ordinary least squares (OLS) regression and linear quantile regression (LQR). The principal explanatory variable of usefulness perception is being vaccinated, especially when the objective of the IP is regulating mobility. The OLS estimate of the coefficient regression is (cr) = 0.415 (p = 0.001). We also found a positive and significant influence of that factor in all LQRs (cr = 0.652, p = 0.0026 at level (τ) = 0.75; cr = 0.482, p = 0.0047 at τ = 0.5 and cr = 0.201, p = 0.0385 at τ = 0.25). When the objective of the IP is regulating leisure, being vaccinated is relevant only to explain the central measures of usefulness perception. If the IP is used to regulate traveling, variables related to interviewees' infectivity have greater relevance than sociodemographic factors. When its objective is ruling assembly, the more important variables than being vaccinated are gender and age. To create an effective implementation of the IP, it is advisable to have a general agreement among the population on its convenience. Therefore, the findings in this study have important implications for public health decision-makers.

Detecting SARS-CoV-2 neutralizing immunity: highlighting the potential of split nanoluciferase technology.

The coronavirus disease 2019 (COVID-19) pandemic has progressed over 2 years since its onset causing significant health concerns all over the world and is currently curtailed by mass vaccination. Immunity acquired against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be following either infection or vaccination. However, one can never be sure whether the acquired immunity is adequate to protect the individual from subsequent infection because of three important factors: individual variations in humoral response dynamics, waning of protective antibodies over time, and the emergence of immune escape mutants. Therefore, a test that can accurately differentiate the protected from the vulnerable is the need of the hour. The plaque reduction neutralization assay is the conventional gold standard test for estimating the titers of neutralizing antibodies that confer protection. However, it has got several drawbacks, which hinder the practical application of this test for wide-scale usage. Hence, various tests have been developed to detect protective immunity against SARS-CoV-2 that directly or indirectly assess the presence of neutralizing antibodies to SARS-CoV-2 in a lower biosafety setting. In this review, the pros and cons of the currently available assays are elaborated in detail and special focus is put on the scope of the novel split nanoluciferase technology for detecting SARS-CoV-2 neutralizing antibodies.

Papers Please - Predictive Factors of National and International Attitudes Toward Immunity and Vaccination Passports: Online Representative Surveys.

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.

Immunity Passport Ledger: Digital Certificates Implemented on a Permissioned Blockchain

The global outbreak of Coronavirus (SARS-CoV-2) which in 2020 reached pandemic scale, has been a central topic of debate in our society. Concerns over the ease of transmission of the infection led to the imposition of measures restricting freedom such as curfews, lockdown, general confinement, and closure of trade. Technology was one of the tools used to resist to the spread of the disease using applications that, on one hand, track contacts to warn users that were close to someone infected and, on the other hand, provide immunity digital certification. Despite the relevance of these options, end users have no confidence, transparency, and responsibility that the registration and use of their health data are ethical, secure, anonymous, and available through verifiable credentials and, most importantly, is being used for its main purpose. Consequently, a solution based on a distributed ledger technology, such as blockchain, is introduced to assure the trustworthiness and integrity of user’s data. Since the proposed application embraced user privacy, we conducted a comparative study between permissioned blockchains, that includes an authorization ion layer and ensures that certain actions can only be performed by identifiable participants. We concluded that Hyperledger Fabric was an option that fulfilled all the requirements to develop a platform for the immunity passport ledger. Its modularity and versatility accommodates the needs that were initially proposed for the development of a proof of concept. The work leads us to propose that further research be conducted regarding scalability and performance evaluation. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Immunity Passports and Entrepreneurial Opportunities in the COVID-19 Era

The recent pandemic of COVID-19 has brought forth the notion of Immunity Passports and has sparked up a heated debate about the socioeconomic necessity behind their use versus the moral, ethical and social implications that may arise from a possible widespread implementation thereof. Despite this animated controversy, this paper aims at pinpointing the future perspectives on the scientific and economical level as well as the entrepreneurial opportunities that the adoption of Immunity Passports may create. After a clear definition of the term, a short description of the current state-of-the-art in terms of their development and a clear separation of the facts from fictitious assumptions about their potential medical outcomes, the paper concentrates on providing a general outlook on the opportunities that may arise from the creation of such biodiagnostic tools along with analysis of strengths, weaknesses, opportunities, threats (SWOT). Special emphasis is also given on two critical economic sectors that may serve as exemplifications par excellence on the entrepreneurial opportunities and the innovative disruption that Immunity Passports may bring about. Implications are discussed. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Ethical Attitudes toward COVID-19 Passports: Evidences from Spain.

A so-called COVID-19 passport or Immunity passport (IP) has been proposed to facilitate the mobility of individuals while the SARS-CoV-2 pandemic persists. A COVID-19 passport can play a key role in the control of the pandemic, specifically in areas with a high density of population, and the help of smart city technology could be very useful to successfully implement IPs. This research studies the impact of ethical judgments on user attitudes toward using vaccine passports based on a Multidimensional Ethics Scale (MES) that contains five ethical constructs: moral equity, relativism, egoism, utilitarianism, and contractualism. Regression analysis shows that MES satisfactorily explains attitude (R2 = 87.82%, p < 0.001) and that a positive evaluation in moral equity, egoism and utilitarianism is significant (p < 0.001). The objective of the passport (variable leisure) shows a significant negative moderating effect on moral equity (coefficient = -0.147, p = 0.0302) and a positive one on relativism (coefficient = 0.158, p = 0.0287). Adjustment by means of fsQCA shows that five ethical constructs satisfactorily explain both favorable and unfavorable attitudes toward IPs. Solutions explaining acceptance attain an overall consistency (cons) = 0.871 and coverage (cov) = 0.980. In the case of resistance, we found that cons = 0.979 and cov = 0.775. However, that influence is asymmetrical. To have a positive attitude toward the passport, it is a sufficient condition to attain a positive evaluation on a single ethical factor. On the other hand, when explaining resistance, and with the exception of the recipe ~utilitarianism (cons = 0.911 and cov = 0.859), explanatory prime implications require the interaction of at least two variables. Likewise, the context in which the passport is required is significant to explain rejection.

Behavioural responses to Covid-19 health certification: a rapid review.

BACKGROUND: Covid-status certification - certificates for those who test negative for the SARS-CoV-2 virus, test positive for antibodies, or who have been vaccinated against SARS-CoV-2 - has been proposed to enable safer access to a range of activities. Realising these benefits will depend in part upon the behavioural and social impacts of certification. The aim of this rapid review was to describe public attitudes towards certification, and its possible impact on uptake of testing and vaccination, protective behaviours, and crime. METHOD: A search was undertaken in peer-reviewed databases, pre-print databases, and the grey literature, from 2000 to December 2020. Studies were included if they measured attitudes towards or behavioural consequences of health certificates based on one of three indices of Covid-19 status: test-negative result for current infectiousness, test-positive for antibodies conferring natural immunity, or vaccination(s) conferring immunity. RESULTS: Thirty-three papers met the inclusion criteria, only three of which were rated as low risk of bias. Public attitudes were generally favourable towards the use of immunity certificates for international travel, but unfavourable towards their use for access to work and other activities. A significant minority was strongly opposed to the use of certificates of immunity for any purpose. The limited evidence suggested that intention to get vaccinated varied with the activity enabled by certification or vaccination (e.g., international travel). Where vaccination is seen as compulsory this could lead to unwillingness to accept a subsequent vaccination. There was some evidence that restricting access to settings and activities to those with antibody test certificates may lead to deliberate exposure to infection in a minority. Behaviours that reduce transmission may decrease upon health certificates based on any of the three indices of Covid-19 status, including physical distancing and handwashing. CONCLUSIONS: The limited evidence suggests that health certification in relation to COVID-19 - outside of the context of international travel - has the potential for harm as well as benefit. Realising the benefits while minimising the harms will require real-time evaluations allowing modifications to maximise the potential contribution of certification to enable safer access to a range of activities.

The Welfare Cost of Vaccine Misallocation, Delays and Nationalism.

I calibrate an eco-epidemiological age-structured Susceptible-Infected-Recovered (SIR) model of the B.1.1.7 covid variant on the eve of the vaccination campaign in France, under a stop-and-go lockdown policy. Three-quarters of the welfare benefit of the vaccine can be achieved with a speed of 100,000 full vaccination per day. A 1-week delay in the vaccination campaign raises the death toll by approximately 2500, and it reduces wealth by 8 billion euros. Because of the large heterogeneity of the rates of hospitalization and mortality across age classes, it is critically important for the number of lives saved and for the economy to vaccinate older people first. Any departure from this policy has a welfare cost. Prioritizing the allocation of vaccines to the most vulnerable people save 70,000 seniors, but it also increases the death toll of younger people by 14,000. Vaccine nationalism is modeled by assuming two identical Frances, one with a vaccine production capacity and the other without it. If the production country vaccinates its entire population before exporting to the other, the global death toll would be increased by 20 %. I also measure the welfare impact of the strong French anti-vax movement, and of the prohibition of an immunity passport.

COVID-19 Pandemic: A Compressive Review on Gender, Herd Immunity, and Physiological Mechanisms.

BACKGROUND: Researchers and scientists experienced the spread and aid recovery of the COVID-19 pandemic with a condition of great uncertainty. With limited understanding of SARS-CoV-2, current attempts at controlling its spread are focused on the suppressing approach (to reduce a sustained endogenous transmission) and the mitigating approach (to reduce the growth rate of the epidemic). On the one hand, while there has been no firm explanation, many governments have considered immunity passport and herd immunity for paths out of restrictive physical distancing measures imposed to control the spread of SARS-CoV-2 but were not successful. PURPOSE OF REVIEW: Herein, we attempted to systematize the lessons and shreds of evidence related to the spectrum of illness, the physiological mechanisms of host susceptibility, herd immunity, immunity passport, gender disparities, and severe challenges and uncertainties posed by the COVID-19 pandemic. We hope that the insights provided in this review will help raise the effectiveness of the treatment policies and preventive measures required to end the pandemic. RECENT FINDINGS: The use of immunity passports is suggested to certify an individual at low risk of acquiring or transmitting SARS-CoV-2. But, an individual might nevertheless carry the virus at similar levels and for a similar duration to those previously uninfected, with an unchanged potential for transmission. Vaccine-induced herd immunity is a complex issue inherent to a vaccine and the population receiving the vaccine. The central epidemiological questions about are as follows: what proportion of the population should be vaccinated to meet elimination (in a local program), eradication (in a global program) or a defined level of control? How is this affected by demographic factors (such as gender)? What is the best age at which to immunize? Besides, although age-dependent mortality risk is estimated to be higher for men and older people, such interpretation across gender, age groups, and countries, however, must be accepted with caution at present. SUMMARY: COVID-19 has taught us that health is the basis of global wealth and international solidarity is an essential response and a superior approach to isolationism. Hence, we must be clear about what the alternatives are when evaluating the merits of different ways of tackling this pandemic both in the short term as well as in the long term.

High incidence of false-positive results of IgG antibody against SARS-CoV-2 with rapid immunochromatographic antibody test due to human common cold coronavirus infection.

We experienced a 72-year-old man who developed laboratory-confirmed human coronavirus HKU1 pneumonia. PCR testing for SARS-CoV-2 from a nasopharyngeal specimen was negative twice, and rapid immunochromatographic antibody test (RIAT) using a commercially available kit for IgM and IgG against SARS-CoV-2 showed him turning positive for IgG against SARS-CoV-2. We then performed RIAT in stored serum samples from other patients who suffered laboratory-confirmed human common cold coronaviruses (n = 6) and viruses other than coronavirus (influenza virus, n = 3; rhinovirus, n = 3; metapneumovirus, n = 1; adenovirus, n = 1) admitted until January 2019. Including the present case, four of 7 (57%) showed false-positive RIAT results due to human common cold coronaviruses infection. Two of the 4 patients showed initial negative to subsequent positive RIAT results, indicating seroconversion. RIAT was positive for IgG and IgM in viruses other than coronavirus in 2 (25.0%) and 1 (12.5%) patient. Because of high incidence of false positive RIAT results, cross antigenicity between human common cold coronaviruses and SARS-CoV-2 can be considered. Results of RIAT should be interpreted in light of epidemics of human common cold coronaviruses infection. Prevalence of past SARS-CoV-2 infection may be overestimated due to high incidence of false-positive RIAT results.