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. 2023 Sep 20:68:1605812.
doi: 10.3389/ijph.2023.1605812. eCollection 2023.

Interplay of Digital Proximity App Use and SARS-CoV-2 Vaccine Uptake in Switzerland: Analysis of Two Population-Based Cohort Studies

Paola Daniore  1   2 , André Moser  3 , Marc Höglinger  4 , Nicole Probst Hensch  5   6 , Medea Imboden  5   6 , Thomas Vermes  5   6 , Dirk Keidel  5   6 , Murielle Bochud  7 , Natalia Ortega Herrero  8   9 , Stéphanie Baggio  8   9 , Patricia Chocano-Bedoya  8   9 , Nicolas Rodondi  8   10 , Stefano Tancredi  9 , Cornelia Wagner  9 , Stéphane Cullati  9   11 , Silvia Stringhini  12   13 , Semira Gonseth Nusslé  7 , Caroline Veys-Takeuchi  7 , Claire Zuppinger  7 , Erika Harju  14   15   16 , Gisela Michel  14 , Irène Frank  15 , Christian R Kahlert  17   18 , Emiliano Albanese  19 , Luca Crivelli  19   20 , Sara Levati  20 , Rebecca Amati  19 , Marco Kaufmann  21 , Marco Geigges  21 , Tala Ballouz  21 , Anja Frei  21 , Jan Fehr  21   22 , Viktor von Wyl  1   2   22
Affiliations

Interplay of Digital Proximity App Use and SARS-CoV-2 Vaccine Uptake in Switzerland: Analysis of Two Population-Based Cohort Studies

Paola Daniore et al. Int J Public Health. .

Abstract

Objectives: Our study aims to evaluate developments in vaccine uptake and digital proximity tracing app use in a localized context of the SARS-CoV-2 pandemic. Methods: We report findings from two population-based longitudinal cohorts in Switzerland from January to December 2021. Failure time analyses and Cox proportional hazards regression models were conducted to assess vaccine uptake and digital proximity tracing app (SwissCovid) uninstalling outcomes. Results: We observed a dichotomy of individuals who did not use the SwissCovid app and did not get vaccinated, and who used the SwissCovid app and got vaccinated during the study period. Increased vaccine uptake was observed with SwissCovid app use (aHR, 1.51; 95% CI: 1.40-1.62 [CI-DFU]; aHR, 1.79; 95% CI: 1.62-1.99 [CSM]) compared to SwissCovid app non-use. Decreased SwissCovid uninstallation risk was observed for participants who got vaccinated (aHR, 0.55; 95% CI: 0.38-0.81 [CI-DFU]; aHR, 0.45; 95% CI: 0.27-0.78 [CSM]) compared to participants who did not get vaccinated. Conclusion: In evolving epidemic contexts, these findings underscore the need for communication strategies as well as flexible digital proximity tracing app adjustments that accommodate different preventive measures and their anticipated interactions.

Keywords: COVID-19; digital proximity tracing; public health; public health measures; vaccination.

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Conflict of interest statement

The authors declare that they do not have any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
National SwissCovid app use and vaccine uptake data during study period. Switzerland, January to December 2021.
FIGURE 2
FIGURE 2
Cumulative hazard curves of vaccine uptake outcomes based on SwissCovid app use. Panel (A) curves are from Corona Immunitas Digital Follow Up eCohort study, while Panel (B) curves are from the COVID-19 Social Monitor study. p-values are retrieved from log-rank tests. Switzerland, January to December 2021.
FIGURE 3
FIGURE 3
Cumulative hazards curve of SwissCovid app uninstalling based on vaccine uptake. Panel (A) curves are from Corona Immunitas Digital Follow Up eCohort study, while Panel (B) curves are from the COVID-19 Social Monitor study. p-values are retrieved from log-rank tests. Switzerland, January to December 2021.
FIGURE 4
FIGURE 4
Multivariable Cox proportional hazards regressions and adjusted hazard ratios of vaccine uptake. Panel (A) represents the multivariable Cox proportional hazards regression analysis for the Corona Immunitas Digital Follow Up eCohort study, while Panel (B) represents the multivariable analysis for the COVID-19 Social Monitor study. Adjusted hazard ratios (aHR) are presented on the right of each panel for event of interest (i.e., vaccine uptake) for the groups with the covariate of interest in comparison to the group without the covariate of interest (e.g., app users vs. nonapp user). For example, in Panel (A) the aHR for app users compared to app non-users was 1.51 (95% CI: 1.40–1.62). A detailed description of the choice for each variable of interest in the multivariable Cox regressions can be found in Supplementary Table S1. More information with effect sizes of each variable of interest and reference categories can be found in Supplementary Table S4. Switzerland, January to December 2021.
FIGURE 5
FIGURE 5
Multivariable Cox proportional hazards regressions and adjusted hazard ratios of SwissCovid app uninstalling. Panel (A) represents the multivariable Cox proportional hazards regression analysis for Corona Immunitas Digital Follow Up eCohort study, while Panel (B) represents the multivariable Cox proportional hazards regression analysis for COVID-19 Social Monitor study. Adjusted hazard ratios (aHRs) are presented on the right of each panel for the event of interest (i.e., SwissCovid app uninstalling) for the groups with the covariate of interest in comparison to the group without the covariate of interest (e.g., vaccinated vs. not vaccinated). For example, in Panel (A) the aHR for participants who received their first vaccine dose in comparison to participants who did not receive their first vaccine dose was 0.55 (95% CI: 0.38–0.81). A detailed description of the choice for each variable of interest in the multivariable Cox regressions can be found in Supplementary Table S1. More information with effect sizes of each variable of interest and reference categories can be found in Supplementary Table S5. Switzerland, January to December 2021.
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