Perceptions of immunity and vaccination certificates among the general population in Geneva, Switzerland
Authors: Nehme Mayssam , Baysson Helene , Pullen Nick , Wisniak Ania , Pennacchio Francesco , Zaballa MarÍa-Eugenia , Fargnoli Vanessa , Trono Didier , Kaiser Laurent , Hurst Samia , Burton-Jeangros Claudine , Stringhini Silvia ,   Specchio-COVID19 study group, Guessous Idris 
Published: June 2021

As of June 2021, the European Union (EU) and Switzerland have published information about the introduction of COVID certificates in order to facilitate the safe free movement of their citizens. With implementation underway, little is known about the public perception of such certificates with potential differences in acceptability among individuals.

In March 2021, a self-administered online questionnaire was proposed to all individuals 18 years and older participating in the longitudinal follow-up of population-based seroprevalence studies in Geneva, Switzerland. The questionnaire covered aspects of individual and collective benefits, while allowing participants to select contexts in which vaccination certificates should be presented. Results were presented as the proportion of individuals agreeing or disagreeing with the implementation of vaccination certificates, selecting specific contexts where certificates should be presented, and agreeing or disagreeing with the potential risks related to certificates. Logistic regression was used to calculate odds ratios for factors associated with certificate non-acceptance.

Overall, 4,056 individuals completed the questionnaire (response rate 77.6%; mean age 53.3 ± standard deviation 14.4 years; 56.1% were women). About 61.0% of participants agreed or strongly agreed that a vaccination certificate was necessary in certain contexts; and 21.6% believed there was no context where vaccination certificates should be presented. Contexts where a majority of participants perceived a vaccination certificate should be presented included jobs where others would be at risk of COVID-related complications (60.7%), jobs where employees would be at risk of getting infected (58.7%), or to be exempt from quarantine when traveling abroad (56.1%). Contexts where fewer individuals perceived the need for vaccination certificates to be presented were participation in large gatherings (36.9%), access to social venues (35.5%), or sharing the same workspace (21.5%). Younger age, an absence of willingness to get vaccinated, and an absence of belief in vaccination as an important step in surmounting the pandemic were factors associated with certificate non-acceptance.

This large population-based study showed that the general adult population in Geneva, Switzerland, agreed with the implementation of vaccination certificates in work-related and travel-related contexts. However, this solution was perceived as unnecessary for access to large gatherings or social venues, or to share the same workspace. Differences were seen with gender, age, education, socio-economic status, and vaccination willingness and perception, highlighting the importance of taking personal and sociodemographic variations into consideration when predicting acceptance of such certificates.