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Jab passports a fab way of boosting uptake, say Oxford researchers

Requiring a certificate of vaccination for admission to public events leads to increasing numbers of people getting inoculated against Covid, study finds

19 December 2021 - 00:01
Vaccination rates increase among under-20s when nightclubs and large events start requiring a vaccine certificate for entry, an Oxford University study has found.
Vaccination rates increase among under-20s when nightclubs and large events start requiring a vaccine certificate for entry, an Oxford University study has found.

Introducing vaccine certificates to control entry into public venues increases vaccine uptake, according to the world’s first large-scale study into the impact of a certificate system.

The Oxford University study in six countries reported an increase in the number of people receiving vaccinations 20 days before the certification system commenced and up to 40 days thereafter.

The results were published this week in The Lancet Public Health journal as South Africans remain in the dark whether or when the government will introduce vaccine mandates in SA. 

The types of venues in which a certificate requirement was introduced determined which age groups experienced higher numbers of vaccines, said Oxford sociology professor Melinda Mills, the study's lead author.

“Increase in uptake was most pronounced in people under 30. When restrictions were applied to only nightclubs and large events, the largest increases were among under-20s,” she said.

When restrictions were expanded to include all hospitality and leisure settings, uptake also increased among 20 to 49-year-olds. 

Apart from helping to curb the spread of the virus, said the authors, “Covid vaccine certification could also help increase uptake in vaccine-complacent groups, like younger people”.

They said implementation should be considered in the context of circumstances such as vaccination coverage, vaccine hesitancy, levels of trust in authorities and the pandemic trajectory.

The study was done in Denmark, Israel, Italy, France, Germany, Switzerland.

According to Mills, “as mass vaccination programmes continue to play a central role in protecting public health in this pandemic, increasing vaccine uptake is crucial both to protect the individuals immunised and break chains of infection in the community. Our study is an important first empirical assessment of whether certification can form part of this strategy.”

In countries where vaccine coverage was previously low, “introduction of certification was associated with a significant increase in the number of additional vaccine doses per million people”.


614%: Fortnightly increase in Covid cases, as of Thursday

99%: Highest fortnightly increase during third wave

130%: Highest fortnightly increase during second wave

134%: Highest fortnightly increase during first wave

Co-author Tobias Rüttenauer said it is important to remember, however, that certification “alone is not a silver bullet for improving vaccine uptake and must be used alongside other policies”.

Rosemary Anderson, chair of the Federated Hospitality Association of SA, called for rapid government decisions on where vaccinations will be mandatory.

“A number of countries have already set out which sectors are required to be vaccinated to protect the public they serve and themselves,” she said.

Certification would open up music and sporting events, and Anderson said this would “go a long way in the recovery efforts of the hospitality and tourism industry”.

With no indication yet about the composition and timeline for a task team to look into mandatory vaccines in certain public spaces and workplaces, health department spokesperson Foster Mohale said: “Our role is to enable organisations that wish to verify the vaccination status of their customers or employees to do so with a certificate as a verifiable document.

“This was used in Bafana vs Ethiopia and during the MTN Cup finals. We don’t decide who must impose compulsory vaccination.”

Business for SA (B4SA) said the department of employment and labour had published a health and safety directive in June which effectively allows employers to introduce a mandatory vaccination policy provided certain conditions are met. 

“The complex issue of implementing mandatory vaccinations is becoming a heated topic in SA,” the B4SA said.

“While these mandates are only expected to be implemented in the new year, several corporates have already taken steps to introduce mandatory policies.

“Old Mutual recently joined the growing list of employers and entities — which includes Discovery, Life Healthcare, Curro, MTN, Sanlam and various universities — that intend to implement mandatory vaccinations in the workplace with effect from January 2022.

“It appears that many employers are considering this option in light of the poor uptake of vaccinations among the South African population and the understanding and hope that if the majority of the population is vaccinated, the economy can start with the recovery process.”

Hlonipha Mokoena, a professor of history at the Wits Institute for Social and Economic Research, said in the South African context certificates “may introduce more problems than they solve”.

She also foresees “several constitutional and legal challenges” in the vaccine certification debate and said: “From a cultural or psychological perspective, the debates are once again revealing the basic failure of projection and scenario modelling.

“Human beings are turning out not to be as rational or risk-averse as we have assumed, and this is going to eventually limit the types of interventions that governments can use to limit the spread of the virus.”


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