European countries that introduced Covid passes increased uptake for vaccines and improved public health and economic performance, potentially helping to avert lockdowns, according to a new study.
Covid certificates in France, Germany and Italy increased the vaccination rate in those countries by 13, 6.2 and 9.7 percentage points respectively, researchers at Bruegel and the French Council of Economic Analysis said in a paper published on Tuesday. The effect was also “sizeable” among older population groups, they wrote.
The certificates also helped stem thousands of hospital admissions and deaths, they estimated, lowering intensive care unit occupancy in France and helping to avoid further lockdowns. In Germany, vaccine uptake was low until more stringent rules on certificates were introduced in November, including compulsory Covid passes in workplaces. In Italy, ICU pressure remained low throughout the study period.
The study estimated that, without the policy interventions, by the end of 2021 gross domestic product in France, Germany and Italy would have been €6bn, €1.4bn and €2.1bn lower respectively.
Covid certification passes to prove vaccination, recovery from the virus or a recent negative test have been gradually introduced in a number of countries since last year, with the aim of broadening vaccine coverage as much as possible. Previous versions of the certificates, for example in Italy, granted access to all venues with proof of a negative Covid test, though rules have recently been tightened, especially for older citizens, to further reduce the proportion of unvaccinated citizens.
Covid-19 vaccine certificates are not technically vaccine mandates, which make vaccination compulsory, as is the case in certain nations such as France and Italy for healthcare workers. The rollout of vaccine mandates and Covid passes and has been controversial, though the study suggests their impact has been positive.
“The extensive use of Covid-19 certificates is a measured tool to control the pandemic and avoid outright vaccine mandates or renewed lockdowns,” said Miquel Oliu-Barton, one of the principal investigators on the study, a Bruegel researcher and an associate professor in mathematics and economics at Paris-Dauphine university. “In many countries, it has led to an increased vaccine uptake, and to less severe health outcomes, and economic losses.”
The World Health Organization has said vaccine mandates should be used as a “last resort”.
He said the researchers had focused the study on those three countries as they had introduced Covid certificates at around the same time, between July and August last year, to regulate entry to public venues. They also have comparable vaccine supply, economies, health systems and demographics.
Some countries are tightening the rules: France approved a law on Sunday that will bar unvaccinated individuals from accessing bars, restaurants and other venues. Previously, the unvaccinated citizens could attend such venues with proof of a recent negative test. Italy introduced a similar “super green pass” requiring proof of vaccination this month.
Oliu-Barton added the results of the study, which has not yet been peer reviewed, were not necessarily applicable to other countries. Decisions by governments should also weigh additional factors, including supply of Covid tests and vaccines, levels of political trust in their countries and access for marginalised groups so that such schemes did not “threaten social cohesion or exacerbate existing inequities”.
“Covid certificates appear to be an attractive, more inclusive alternative to vaccine mandates, focusing on the added benefits of getting vaccinated or tested rather than punitive measures of not doing so,” he added, noting they could play a key role in increasing and maintaining vaccine protection in the face of Omicron.