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Factors associated with the opposition to COVID-19 vaccination certificates: A multi-country observational study from Asia

Kc S 1 , Faradiba D 1 , Sittimart M 2 , Isaranuwatchai W 3 , Ananthakrishnan A 1 , Rachatan C 1 Show all authors , Dabak S 1 , Shafie AA 4 , Guerrero AM 5 , Suwantika A 6 , Kang G 7 , Ahn J 8 , Hsu LY 9 , Mayxay M 10 , Howard N 11 , Wattanasri P 12 , Nakamura R 13 , George TK 14 , Teerawattananon Y 15

Affiliations 

  • 1 Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
  • 2 Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand. Electronic address: manit.s@hitap.net
  • 3 Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand; Institute of Health Policy, Management and Evaluation, St. Michael's Hospital, University of Toronto, 30 Bond St Toronto, ON M5B 1W8, Canada
  • 4 School of Pharmaceutical Sciences, 11800, Universiti Sains Malaysia, Pulau Pinang, Malaysia
  • 5 Health Technology Assessment Unit, Department of Health, Manila, 1003, Philippines
  • 6 Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang Km. 21 Jatinangor, Sumedang, 45363, West Java, Indonesia
  • 7 Division of Gastrointestinal Sciences, The Christian Medical College (CMC), IDA Scudder Rd, Vellore, Tamil Nadu, 632004, India
  • 8 Department of Health Convergence, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
  • 9 Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS), 12 Science Drive 2, #10-01, 117549, Singapore
  • 10 Department of Medicine, University of Health Sciences, Samsenthai Road P.O. Box 7444, Vientiane, Laos; Lao-Oxford-Mahosot Hospital-Welcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vietiane, Laos; Centre for Tropical Medicine and Global Health, University of Oxford, United Kingdom
  • 11 Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS), 12 Science Drive 2, #10-01, 117549, Singapore; London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
  • 12 Department of Disease Control, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand
  • 13 Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Faculty Building II, 2-1, Naka, Kunitachi, 186 - 8601, Japan
  • 14 Department of General Internal Medicine, The Christian Medical College (CMC), IDA Scudder Rd, Vellore, Tamil Nadu, 632004, India
  • 15 Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000, Thailand; Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore (NUS), 12 Science Drive 2, #10-01, 117549, Singapore
Travel Med Infect Dis, 2022;48:102358.
PMID: 35595199 DOI: 10.1016/j.tmaid.2022.102358

Abstract

BACKGROUND: There are ongoing calls to harmonise and increase the use of COVID-19 vaccination certificates (CVCs) in Asia. Identifying groups in Asian societies who oppose CVCs and understanding their reasons can help formulate an effective CVCs policy in the region. However, no formal studies have explored this issue in Asia.

METHOD: The COVID-19 Vaccination Policy Research and Decision-Support Initiative in Asia (CORESIA) was established to address policy questions related to CVCs. An online cross-sectional survey was conducted from June to October 2021 in nine Asian countries. Multivariable logistical regression analyses were performed to identify potential opposers of CVCs.

RESULTS: Six groups were identified as potential opposers of CVCs: (i) unvaccinated (Odd Ratio (OR): 2.01, 95% Confidence Interval (CI): 1.65-2.46); vaccine hesitant and those without access to COVID-19 vaccines; (ii) those not wanting existing NPIs to continue (OR: 2.97, 95% CI: 2.51-3.53); (iii) those with low level of trust in governments (OR: 1.25, 95% CI: 1.02-2.52); (iv) those without travel plans (OR: 1.58, 95% CI: 1.31-1.90); (v) those expecting no financial gains from CVCs (OR: 2.35, 95% CI: 1.98-2.78); and (vi) those disagreeing to use CVCs for employment, education, events, hospitality, and domestic travel.

CONCLUSIONS: Addressing recurring public health bottlenecks such as vaccine hesitancy and equitable access, adherence to policies, public trust, and changing the narrative from 'societal-benefit' to 'personal-benefit' may be necessary and may help increase wider adoption of CVCs in Asia.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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