The effect of COVID certificates on vaccine uptake, health outcomes, and the economy

• Published in: Nature communications Vol. 13; no. 1; pp. 3942 - 13
• Main Authors: Oliu-Barton, Miquel, Pradelski, Bary S. R., Woloszko, Nicolas, Guetta-Jeanrenaud, Lionel, Aghion, Philippe, Artus, Patrick, Fontanet, Arnaud, Martin, Philippe, Wolff, Guntram B.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 08.07.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/326/596/4130; 692/700/1538; 692/700/478/174; 706/689/159; Certificates; Communicable Disease Control; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 vaccines; Diffusion theory; Ecology, environment; Economics and Finance; France - epidemiology; Germany - epidemiology; Health; Humanities and Social Sciences; Humans; Italy - epidemiology; Life Sciences; multidisciplinary; Outcome Assessment, Health Care; Pandemics; Pandemics - prevention & control; Science; Science (multidisciplinary); Vaccination; Vaccines; France; Italy; Germany; Economics; SARS-CoV-2; Health policy; Epidemiology
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-022-31394-1

In the COVID-19 pandemic many countries required COVID certificates, proving vaccination, recovery, or a recent negative test, to access public and private venues. We estimate their effect on vaccine uptake for France, Germany, and Italy using counterfactuals constructed via innovation diffusion theory. The announcement of COVID certificates during summer 2021 were associated – although causality cannot be directly inferred – with increased vaccine uptake in France of 13.0 (95% CI 9.7–14.9) percentage points (p.p.) of the total population until the end of the year, in Germany 6.2 (2.6–6.9) p.p., and in Italy 9.7 (5.4–12.3) p.p. Based on these estimates, an additional 3979 (3453–4298) deaths in France, 1133 (−312–1358) in Germany, and 1331 (502–1794) in Italy were averted; and gross domestic product (GDP) losses of €6.0 (5.9–6.1) billion in France, €1.4 (1.3–1.5) billion in Germany, and €2.1 (2.0–2.2) billion in Italy were prevented. Notably, in France, the application of COVID certificates averted high intensive care unit occupancy levels where prior lockdowns were instated. Many countries introduced COVID certificates that were required to access public venues. Here, the authors analyse data from France, Germany, and Italy, and estimate that these policies led to increased vaccine uptake of 6-13 percentage points with subsequent beneficial impacts on health and economic outcomes.