Why “one size fits all” is not enough when designing immunity certificates for domestic use: a UK wide cross-sectional online survey

Abstract

Copyright 2021 The Author(s). Objectives: The present study explored public’s willingness to use COVID-19 immunity certificates across six different domestic scenarios. Design: Cross-sectional online survey. Setting: UK representative survey conducted on the 3rd of August 2021. Participants: 534 UK residents over 18 years old. Interventions: Participants replied to the same set of questions. Primary and secondary outcome measures: The primary outcome measure was willingness to use immunity certificates across three different domestic settings (1. Visiting the GP for a non- urgent health issue, 2. Dining in a restaurant, and 3. Attending a performance in a theatre). For each setting two options, one prioritising convenience (option A) and the other privacy (option B), were offered. Our secondary outcome measures were computed indices from items adapted from the Health Belief Model; Attitudes towards sharing immunity status with service providers; Prior characteristics. Results: Respondents were more willing to use immunity certificates that prioritised convenience, rather than privacy, when visiting their GP (92%). However, privacy was more favorable (84%) in the other two settings (dining in a restaurant and going to a theatre) compared to convenience (39%). Personal beliefs about COVID-19 and immunity certificates were associated with variations in willingness to use these across all scenarios. No variations were observed across socio-demographics and lifestyle. Conclusions: The findings of this survey suggest that there is not one size fits all solution for designing immunity certificates. Immunity certificates are complex socio-technical systems, any attempt to implement these for domestic use should be tailored to different settings and user needs. The design of certification services requires a more evidence-based approach and further research is needed to understand how different settings, design elements (like convenience or privacy) and personal beliefs about the pandemic should inform their design.