Among all the methods used to minimize the impact of the coronavirus, including masking and social distancing, the COVID-19 vaccine is perhaps the most successful, having prevented millions of hospitalizations and deaths since it was first administered at the end of 2020. Despite the vaccine's high efficacy rate, approximately 22 percent of U.S. citizens remain unvaccinated.

According to research recently published in Management Science by Idris Adjerid, associate professor in the Department of Business Information Technology at Pamplin College of Business, anxiety over the amount of personal information an individual is required to share when receiving the COVID-19 vaccine could be partially to blame for vaccine hesitancy in the U.S., particularly among minority groups or those with privacy concerns.

Adjerid has been a faculty member and researcher in the department since 2018. His primary area of research — economics on privacy — centers around different aspects of legal requirements on consumer behavior, privacy protections, the value of data to companies, and different aspects of privacy regulations.

Out of this research, Adjerid became concerned with the way certain privacy regulations were impacting the uptake of the COVID-19 vaccine. “There was a lot of hesitation around the vaccine, concerns that were impacting how frequently people got the vaccine,” he said. “That was the background motivation for what started the paper.”

Adjerid’s paper focuses on two types of privacy regulations that directly impacted COVID-19 vaccine uptake in the U.S. “We want to understand the interplay between these two types of laws,” he said. “One increases privacy concerns while the other one decreases them. We then try to understand which of these policy approaches is optimal from a vaccine uptake perspective.”

The first regulation the paper explores is a mandate that individuals show some type of personal identification, such as a driver’s license, when they arrive for their vaccine. This information is then stored in a state immunization registry system.

While the purpose of storing personal information is to help improve public health programs, Adjerid’s paper warns that these identification requirements may prevent minorities and those in underserved communities from participating in the vaccination efforts.

“Identification requirements may disadvantage people of color, minorities, and poorer communities where identification is not as common, where there are these kinds of barriers to people having IDs,” Adjerid said. He also pointed out how this can also be applied to other contexts such as voting, where minorities without valid forms of ID have been barred from participating in the voting process, thus resulting in a lower voter turnout.

Pamplin College of Business professor Idris Adjerid recently published his research, Privacy Regulation and Barriers to Public Health, in the journal Management Science. Virginia Tech photo
Pamplin College of Business professor Idris Adjerid recently published his research, Privacy Regulation and Barriers to Public Health, in the journal Management Science. Virginia Tech photo

Immigration communities are especially affected by identification requirements because of the fear that the personal data stored in immunization registries could be shared with governmental entities such as Immigration Customs Enforcement (ICE). “There’s a concern that data which has people’s addresses in it can be used for immigration enforcement,” says Adjerid.

According to Adjerid’s findings, states with vaccine identification requirements that also have ICE detention centers decreased vaccination rates by an additional .66 percent, demonstrating how privacy concerns surrounding these identification requirements are likely the cause of these lower vaccination rates. 

“Many of these people need the vaccine because many of them are frontline workers, but a lot of them have immigration concerns. Some are here illegally making it very difficult for them to get IDs. There are dimensions around these identification requirements that increase privacy concerns.”

These identification requirements, along with the storing and sharing of that data, have caused privacy concerns for the general public as well. For many, there is concern over what information is shared with the government and what the government might do with that information.

“They may want to go and get the COVID-19 vaccine, or any vaccine, but they are not comfortable showing their ID and sharing that information with the state because this information is verified and then stored in a state registry of who got vaccinated and who didn’t.”

With an average population of over four million people in states with identification requirements, Adjerid’s research found that identification requirements decreased the state’s vaccination rate by 4.87 percent, resulting in an average of 215,557 fewer vaccinations per state, demonstrating how this type of regulation negatively impacted vaccine uptake in the U.S.

While the results of Adjerid’s study highlight the negative consequences of identification requirements on Covid-19 vaccine rates, the second type of regulation offers a more optimistic view of how adopting certain digital protections can help offset the negative outcome of ID requirements.

Known as anonymity protections, Adjerid states that by allowing individuals to remove personal information from these registries, vaccination uptake can be improved while addressing the need for privacy.

“On one hand you have a requirement to show an ID and then store that information, while on the other hand, you have states that give you the option to anonymize that data in the records so you can choose to store that information without having your identity stored in that system,” he said.

Adjerid’s findings contribute to more than just privacy regulations surrounding the COVID-19 vaccine, particularly in policy making, “I think the paper itself has pretty significant policy implications, obviously for COVID-19, but also more broadly in terms of how we think about public health and privacy concerns,” he said.

“Whether it be the vaccine or some other health service that’s good societally for people to have, we may want to consider that if we have these requirements they may have some benefits, but there may also be these unintended consequences that may deter people away from something that we as a society may want them to do.”

Adjerid’s research doesn’t discount the importance of identification requirements for improving public health programs to help make decisions around policy, rather, it shows how adopting certain protections, such as anonymity protections, can help improve things like vaccine rates by easing privacy concerns.

“A lot of the factors that impact vaccine hesitancy are very hard to change," he explained. "They are cultural or they’re systemic. These are very difficult to change, so in that sense, there’s not much a policymaker can do to encourage somebody to take a vaccine if they have barriers stemming from those systemic differences.

“However, something like a privacy concern might be something that, if you tweak the policy, if you pick the right balance of requirements or protections, you can have a lot of the benefits you want while still avoiding this harmful decline in desirable public health.”

Written by Shea Walters

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