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A call for caution regarding infection-acquired COVID-19 immunity: The potentially unintended effects of "immunity passports" and how to mitigate them.

ABSTRACT: Research suggests that emerging information about infection-acquired COVID-19 immunity should be interpreted with caution. The introduction of "immunity passports" that would enable people who have recovered from COVID-19 to travel freely and return to work may therefore have detrimental consequences if not managed carefully. In two studies, we examined how perceived (suspected or imagined) recovery from COVID-19, and the concept of immunity passports, influence people's intentions to engage in behaviors aimed to reduce the spread of COVID-19. We also consider ways to lessen potential negative effects. In Study 1 (N = 1604), participants asked to imagine that they had recovered from COVID-19 reported lower social distancing intentions compared to a control condition. Participants who suspected (versus imagined) that they had recovered from past infection did not report lower preventative intentions compared to the control condition, even at high levels of certainty of past infection. In Study 2 (N = 1732), introducing the idea of immunity passports also reduced social distancing intentions compared to a control condition. The latter effect was, however, attenuated when cautious information about the equivocal science on COVID-19 was also presented to participants. Participants who suspected that they had COVID-19 in the past (compared to the control condition) revealed a similar pattern of results, but only at higher levels of certainty of past infection. Caution regarding infection-acquired COVID-19 immunity and immunity passports will be crucial in the COVID-19 response. Implications for premature pandemic announcements, as well as their potential remedies, are discussed.

SUBMITTER: Green R

PROVIDER: S-EPMC8237004 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceDiscovery of effective vaccines and increased confidence that infection confers extended protection against coronavirus disease (COVID-19) have renewed discussion of using immunity certificates or 'passports' to selectively reduce ongoing public health restrictions.ObjectiveTo determine public views regarding government and private conferral of immunity privileges.Design and settingNational on-line survey fielded in June 2020. Participants were randomly asked about either government 'passports' or private 'certificates' for COVID-19 immunity.ParticipantsAdults from a standing panel maintained for academic research, selected to approximate national demographics.Main outcomes/measuresLevel of support/opposition to immunity privileges, and whether views vary based on: government vs. private adoption; demographics; political affiliation or views; or various COVID19-related attitudes and experiences.ResultsOf 1315 respondents, 45.2% supported immunity privileges, with slightly more favoring private certificates than government passports (48.1% vs 42.6%, p = 0.04). Support was greater for using passports or certificates to enable returns to high-risk jobs or attendance at large recreational events than for returning to work generally. Levels of support did not vary significantly according to age groups, socioeconomic or employment status, urbanicity, political affiliation or views, or whether the respondent had chronic disease(s). However, estimates from adjusted analyses showed less support among women (odds ratio, 0.64; 95% confidence interval, 0.51 to 0.80), and among Hispanics (0.56; 0.40 to 0.78) and other minorities (0.58; 0.40 to 0.85) compared with whites, but not among blacks (0.83; 0.60 to 1.15). Support was much higher among those who personally wanted a passport or certificate (75.6% vs 24.4%) and much lower among those who believed this would harm the social fabric of their community (22.9% vs 77.1%).Conclusions and relevancePublic views are divided on both government or private uses of immunity certificates, but, prior to any efforts to politicize the issues, these views did not vary along usual political lines or by characteristics that indicate individual vulnerability to infection. Social consensus on the desirability of an immunity privileges programs may be difficult to achieve.

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A call for caution regarding infection-acquired COVID-19 immunity: The potentially unintended effects of "immunity passports" and how to mitigate them.

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