Exemptions from COVID-19 Containment Measures for Vaccinated and Recently Recovered Individuals - RKI
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COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures COVID- CONTAINMENT MEASURES ANALYSIS, ISSUE & Exemptions from COVID-19 Containment Measures for Vaccinated and Recently Recovered Individuals Evidence-Based Public Health (ZIG 2) | Center for International Health Protection (ZIG) Robert Koch Institute
1 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
Exemptions from COVID-19 Containment Measures for Vaccinated and Recently Recovered Individuals
Robert Koch-Institute, 2021
Funding
This report was developed under the project Analysis of international epidemiological data and response
measures, a project funded by the German Federal Ministry of Health (BMG).
Authors
Thurid Bahr, ZIG 2
Kofi Abrokwa, ZIG 2
Nina Klein, ZIG 2
Johanna Hanefeld, ZIG
Charbel El-Bcheraoui, ZIG2
Acknowledgements
The authors gratefully acknowledge Luisa Denkel, Angela Fehr and the Public Health Intelligence team for
their valuable input and feedback on this report.
Suggested Citation
Bahr, T., Abrokwa, S. K., Klein, N., Hanefeld, J. and El-Bcheraoui, C., 2021. Exemptions from COVID-19
Containment Measures for Vaccinated and Recently Recovered Individuals in Bahrain, Chile, France,
Germany, Israel, the United Kingdom and the United States, February – May 2021. Report. COVID-19
Containment Measures Analysis, Issue 3, Robert Koch Institute, Berlin.
Disclaimer
The content of this report expresses the opinions of its authors and does not necessarily represent the views of
the Robert Koch Institute.2 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
Summary
This report describes the exemptions from COVID-19 containment measures for fully vaccinated and recently
recovered individuals in Bahrain, Chile, France, Germany, Israel, the United Kingdom and the United States.
The report also briefly discusses exemptions for individuals with negative COVID-19 tests. Weekly COVID-19
incidence has been decreasing in all countries but Bahrain. The available evidence on circulation of VOC indicates
that the vaccines used in the seven countries are mostly effective against VOC B.1.1.7, B.1.351 and P.1. However,
there is not sufficient evidence yet on the impact of VOC B.1.617 on vaccine effectiveness. Vaccine acceptance is
lower in France, Israel and the United States and higher in Germany and the United Kingdom. Bahrain, Israel
and the United States currently universally offer COVID-19 vaccinations. Chile, France, Germany and the United
Kingdom continue to expand vaccination rollout to progressively younger population groups. Nonetheless, full
vaccination coverage is relatively low in all seven countries. As of 9 May 2021, full vaccination was below 40% in
Germany, France, the United Kingdom, Bahrain, the United States and Chile. Israel had fully vaccinated 58.7%
of its population as of that date. Therefore, the vast majority of populations is currently not protected from
COVID-19 and continues to be able to transmit the virus, if infected.
The United States, Israel and the United Kingdom have progressively lifted containment measures. France and
Germany continue to maintain tighter containment measures. Bahrain presents a mix of loosening and
tightening of measures over time. Bahrain, Germany, Israel and the United States offer exemptions from COVID-
19 containment measures to individuals with a negative COVID-19 test, those who are recently recovered or those
who are fully vaccinated. Exemptions often regard access to leisure activities and easier international travel. Most
of the countries offer equal exceptions to recently recovered and fully vaccinated individuals. France and the
United Kingdom do not currently offer exemptions to COVID-19 containment measures. However, such
exemptions are under discussion in both countries.
Limited evidence from Germany suggests that exemptions for fully vaccinated and recently recovered individuals
do not incentivize non-vaccinated individuals to get vaccinated as soon as possible. In light of this evidence, it is
unclear if granting exemptions to COVID-19 containment measures may provide an incentive to currently
unvaccinated individuals to receive the vaccine.
Risks to COVID-19 containment posed by granting exemptions depend inter alia on the epidemiological context
and the extent of full vaccination coverage. In Bahrain and Germany, granting exemptions in a context of higher
incidence may potentially weaken the effect of containment measures in place. All countries granting exemptions
should invest in sustained risk communication and community engagement to stress the continued importance
of protective behaviors (mask-wearing, physical distancing, hand-washing, ventilation) to protect the non-
vaccinated population.3 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
Zusammenfassung
Dieser Bericht befasst sich mit der Lockerung von COVID-19-Eindämmungsmaßnahmen für vollständig
geimpfte und genesene Personen in Bahrain, Chile, Deutschland, Frankreich, Israel, dem Vereinigten
Königreich und den Vereinigten Staaten. Der Bericht befasst sich auch mit den Lockerungen für negativ getestete
Personen. Die wöchentliche COVID-19-Inzidenz ist zuletzt in allen Ländern außer Bahrain gesunken. Die
verfügbare Evidenz zeigt, dass die in den sieben Ländern verwendeten Impfstoffe wirksam gegen VOC B.1.1.7,
B.1.351 und P.1 sind. Die Auswirkungen von VOC B.1.617 auf die Impfstoffeffektivität sind noch nicht
ausreichend erforscht.
Die Impfakzeptanz ist in Frankreich, Israel und den USA geringer und in Deutschland und Großbritannien
höher. Bahrain, Israel und die USA machen derzeit ihren gesamten Bevölkerungen ein Impfangebot. Chile,
Frankreich, Deutschland und das Vereinigte Königreich weiten ihre Impfungen auf zunehmend jüngere
Bevölkerungsgruppen aus. Trotzdem ist die Durchimpfungsrate (2. Dosis) in allen sieben Ländern relativ gering.
Am 9. Mai 2021 lag diese in sechs von sieben Ländern unter 40%. Israel hatte zu diesem Zeitpunkt 58,7% seiner
Bevölkerung vollständig geimpft. Daher ist die überwiegende Mehrheit der Bevölkerungen derzeit nicht vor
COVID-19 geschützt und kann das Virus bei einer Infektion weiterhin übertragen.
Die Vereinigten Staaten, Israel und das Vereinigte Königreich haben ihre Eindämmungsmaßnahmen
schrittweise gelockert. Frankreich und Deutschland halten weiterhin strengere Eindämmungsmaßnahmen
aufrecht. In Bahrain wechseln sich inkrementelle Lockerungen und Verschärfungen über Zeit ab. Bahrain,
Deutschland, Israel und die Vereinigten Staaten haben ihre Maßnahmen für Personen mit negativem COVID-
19-Test, kürzlich Genesene oder vollständig Geimpfte gelockert. Die Lockerungen betreffen häufig den Zugang
zu Freizeitaktivitäten und Erleichterungen bei internationalen Reisen. Die meisten Länder unterschieden bei
den Lockerungen nicht zwischen kürzlich genesenen und vollständig geimpften Personen. Frankreich und das
Vereinigte Königreich lockern derzeit nicht ihre COVID-19-Eindämmungsmaßnahmen für ausgewählte
Personengruppen. Über derartige Ausnahmen wird jedoch aktuell in beiden Ländern beraten.
Eine Untersuchung aus Deutschland deutet darauf hin, dass Lockerungen für vollständig geimpfte und kürzlich
genesene Personen für nicht geimpfte Menschen keinen nennenswerten Anreiz darstellen, sich so schnell wie
möglich impfen zu lassen. Angesichts dessen ist unklar, ob Lockerungen einen Impfanreiz für aktuell nicht
geimpfte Personen bieten.
Die Risiken der Lockerungen für ausgewählte Personengruppen für die COVID-19-Eindämmung hängen unter
anderem von der epidemiologischen Lage und der Durchimpfungsrate ab. In Bahrain und Deutschland könnten
Lockerungen in einem Kontext höherer Inzidenz möglicherweise die Wirkung bestehender
Eindämmungsmaßnahmen schwächen. Alle Länder die Ausnahmen gewähren, sollten Risikokommunikation
und Community Engagement stärken, um die fortdauernde Bedeutung von Schutzmaßnahmen (AHA + L) für
den Schutz der nicht geimpften Bevölkerung hervorzuheben.4 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
1. Problem Statement
Weekly COVID-19 incidence per 100,000 population has been increasing in Bahrain since early April 2021 and
decreasing in Chile, France, Germany, Israel, the United Kingdom and the United States at least since late April
2021. Meanwhile, full vaccination coverage is below 40% in all countries save Israel. Several countries have begun
granting exemptions from COVID-19 containment measures to individuals with negative tests, those who are
recently recovered or those who are fully vaccinated. The types of granted exemptions pose differential risks for
COVID-19 transmission. Risks to COVID-19 containment posed by granting exemptions depend inter alia on
the epidemiological context and the extent of full vaccination coverage.i This report describes the exemptions
from COVID-19 containment measures for fully vaccinated, recently recovered and negatively tested individuals
that countries have recently implemented or are planning to implement. While the risk of transmission is
reduced in fully vaccinated individuals, in a context of continued heavy SARS-CoV-2 virus circulation and low
full vaccination coverage, it is important to analyze exemptions across countries to assess their potential to
weaken pandemic containment.
2. Epidemiological Comparison
2.1 Weekly new COVID-19 cases per 100,000 population in Bahrain, Chile, France, Germany, Israel, the United
Kingdom and the United States, February -May 2021: Weekly COVID-19 incidence per 100,000 population has
been increasing in Bahrain since early April 2021. In Germany, weekly COVID-19 incidence increased in early
April, but has begun to decrease slightly since late April 2021. Weekly COVID-19 incidence has been decreasing
in Chile, France, Israel, the United Kingdom and the United States since early April 2021. As of 9 May 2021,
COVID-19 incidence stands at 3.93 in Israel, 21.72 in the United Kingdom, 86.44 in the United States, 117.22 in
Germany, 183.28 in France, 191.19 in Chile and 591.16 per 100,000 population in Bahrain (Figure 1). 1
2.2 Variants of Concern: VOC B.1.1.7 is dominant (accounting for at least 50% of circulating variants) in France,
Germany, Israel, the United Kingdom, and the United States. ii In the United Kingdom, VOC P.1 has been
prevalent in 0.027% of cases between October 2020 and late April 2021. VOC B.1.617 was prevalent in 0.064%
of cases in the country between October 2020 and late April 2021, but Public Health England reports that variant-
associated cases have been increasing by 71% between mid- and late April 2021. iii In Germany, VOC P.1
comprises 0% of sequenced samples and B.1.351 0.7%.iv In France, P.1 comprises 0.3% of circulating variants in
the country as of late April. v B.1.1.7 comprises 22% of circulating variants in Chile as of April 2021. P.1 comprises
27% of circulating variants in Chile as of April 2021.vi P.1 comprises 5% of circulating variants in the United
States. B.1.617.1 and B.1.617.2 together comprise 0.7% of circulating variants in the country. vii No data on
circulating virus variants was available for Bahrain.2
1 In early April 2021, public holidays due to Easter celebrations were observed in a number of the seven countries. This
likely affected reported incidence.
2 Data quality on COVID-19 variants varies greatly across countries. See “Evidence Rating” in this report.COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures Figure 1: Weekly COVID-19 incidence, vaccination coverage and vaccine acceptance in Bahrain, Chile, France, Germany, Israel, the United Kingdom and the United States, weeks 5-2021 – 18-2021
COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures
3. Vaccination Coverage, Access, and Acceptance
3.1 Vaccination coverage in Bahrain, Chile, France, Germany, India, Israel, the United Kingdom and the United
States, February-May 2021: As of 9 May 2021, 44.8, 46, 46.9, 52.3 and 62.7 % of the population had received at
least one dose of a COVID-19 vaccine in Chile, the United States, Bahrain, the United Kingdom and Israel
respectively. By the same date, 26.4 and 32.6 % of the population in France and Germany had received at least
one dose. As of 9 May 2021, full vaccination coverage was at 9.4, 11.7, 26.3, 34, 34.2, 37.4 and 58.7 % in Germany,
France, the United Kingdom, Bahrain, the United States, Chile and Israel, respectively. Bahrain administers
vaccines by Oxford/AstraZeneca, Pfizer/BioNTech, Sinopharm/Beijing and Sputnik V. Chile administers
vaccines by Pfizer/BioNTech and Sinovac. France and Germany administer Oxford/AstraZeneca, Moderna,
Pfizer/BioNtech and Johnson&Johnson vaccines. France and Germany, as well as several other European
countries temporarily paused vaccinations with the Oxford/AstraZeneca vaccine in mid-March 2021, due to the
occurrence of rare blood clots in people vaccinated with the Oxford/AstraZeneca vaccine. viii Israel administers
vaccines by Moderna and Pfizer/BioNTech. The United Kingdom administers Oxford/AstraZeneca, Moderna
and Pfizer/BioNtech vaccines. The United States administer vaccines by Johnson&Johnson, Moderna and
Pfizer/BioNTech. Chile predominantly administers the Sinovac vaccine and a small share of Pfizer/BioNTech
vaccines. France and Germany predominantly administer the Pfizer/BioNTech vaccine, followed by the
Oxford/AstraZeneca vaccine and a smaller proportion of the Moderna vaccine. The United States predominantly
administer the Pfizer/BioNtech vaccine and the Moderna vaccine, as well as a small proportion of
Johnson&Johnson vaccines. In late April 2021, the United States paused vaccination with the Janssen vaccine to
investigate rare blood clots in people vaccinated with that vaccine. ix Information on administered vaccine types
for the remaining countries was not readily available at time of report writing (Figure 1).
3.2 Vaccination access in Bahrain, Chile, France, Germany, the United Kingdom and the United States, May
2021: Bahrain is currently offering a COVID-19 vaccination to its entire population.x Chile is vaccinating anyone
aged 38 years and older.xi Since 1 May 2021, France has been offering a vaccination to anyone aged 18 and over if
they present co-morbidities. The government estimates that it can universally offer a vaccination to the adult
population from 15 June 2021 onwardsxii. Since early April, Germany has begun providing COVID-19 vaccines
through general practices. xiii The country currently vaccinates anyone aged 60 and older, as well as specific
priority groups.xiv Germany estimates that it can universally offer a vaccination by the summer of 2021.xv By mid-
February 2021, Israel completed vaccination of priority groups and has moved to universally offer a COVID-19
vaccination to its entire population of 16 years and older. The United Kingdom is currently offering a vaccination
to anyone aged 40 and over, as well as specific priority groups.xvi In the United States, anyone aged 16 and over
can be vaccinated against COVID-1 since 19 April 20219.xvii
3.3 Vaccine acceptance in Chile, France, Germany, Israel, the United Kingdom and the United States, February
2020-April 2021: In France and Germany vaccine acceptance has overall been stable between February and April
2021, shifting from 40 to 39% and 59 to 61%, respectively. In Israel, vaccine acceptance decreased from 67 to
26% between February and March 2021. In the United Kingdom and the United States, vaccine acceptance
decreased from 77 to 66% between February and April 2021 (United Kingdom) and 48 to 39% between February
and March 2021 (United States). A journal article published in Vaccine in late 2020 reports 87% vaccine
acceptance in Chile for a nationally representative sample (Figure 1).3
3 Survey data for France, Germany, Israel, the United Kingdom and the United States builds on nationally representative
samples.1 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
4. COVID-19 Containment Measures and Exemptions
4.1 COVID-19 containment measures in Bahrain, Chile, France, Germany, Israel, the United Kingdom and the
United States, February-May 2021: Between February and May 2021, regulations on COVID-19 containment
measures varied significantly among the seven countries. International travel restrictions, restrictions on internal
movement, cancellation of public events and restrictions on public gathering were measures most strictly
maintained across all seven countries between February and March. Most countries tightened their measures
relating to school closures, workplace closures, public transportation and restrictions on internal movement from
the beginning of March. From the beginning of April to the beginning of May, there have been gradual relaxation
of measures including school closure, workplace closure, public transportation, stay-at-home restriction and
restriction on internal movement among all countries with the exception of Chile.4
Germany and Chile continue to maintain strict measures on school closures at all levels. Bahrain, Israel, United
Kingdom and USA relaxed school closure between April and May. France relaxed school closure in April but
tightened the measure again from beginning of May. France, Israel USA and United Kingdom have relaxed
workplace closure from the beginning of May. Germany relaxed workplace restrictions from the beginning of
March onwards.
Germany, Chile, France and the UK continue to have strict measures in place for the cancellation of public events
and together with the USA maintain strict measures for public gathering. Israel has relaxed restrictions on public
gatherings from the beginning of May and Bahrain tightened restriction on public gatherings starting April. Stay-
at-Home Requirements remain strict and unchanged for Chile, Germany, France and the United Kingdom. The
United States have relaxed stay-at-home requirement from the beginning of May.
Containment measures for use of public transport have remained unchanged for Germany, Chile, United
Kingdom and the USA since the beginning of February. From the beginning of April, Bahrain and France have
loosened regulations on public transportation and currently have no measures in place. Israel lifted these
measures completely in the beginning of May. Across the countries, there is a gradual loosening of restrictions
on internal movement from the beginning of March, except in Bahrain and France. Those countries tightened
their internal movement measures. The United Kingdom and the United States have started loosening measures
regarding internal movement from the beginning of April and beginning of May respectively. No country has
loosened international travel measures (Figure 2).
4 Due to the coding scheme applied by Our World in Data, the loosening and tightening of COVID-19 containment
measures at the sub-national level does not fully display in Figure 2. In the case of Chile, that means lifting of measures
in March 2021 is not displayed in the heatmap.COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures
1 February 2021 1 March 2021 1 April 2021 1 May 2021
School Closures Required (all levels) Recommended
Workplace Closures Required for some
Cancellation of Public Events Required cancellations Recommended cancellations Required cancellations
Restrictions on Public Gatherings < 10 people > 1000 people 100-1000 people
Bahrain
Stay-at-Home Requirements Recommended
Public Transport Closures No measures Recommended closing (or No measures
reduced volume)
Restrictions on Internal Movement No measures Recommend movement restriction
International Travel Controls Screening Quarantine from high-risk regions
School Closures Required (all levels)
Workplace Closures Required for all but key workers
Cancellation of Public Events Required cancellations
Restrictions on Public Gatherings < 10 people
Chile
Stay-at-Home Requirements Required (few exceptions)
Public Transport Closures Recommended closing (or
reduced volume)
Restrictions on Internal Movement Restrict movement
International Travel Controls Ban on high-risk regions
School Closures Required (some levels) Recommended Required (some levels)
Workplace Closures Required for some Required for all but key Required for some
workers
Cancellation of Public Events Required cancellations
Restrictions on Public Gatherings < 10 people
France
Stay-at-Home Requirements Required (except essentials)
Public Transport Closures No measures Required closing (or No measures
prohibiting most using it)
Restrictions on Internal Movement No measures Restrict movement
International Travel Controls Ban on high-risk regions Quarantine from high-risk regions Ban on high-risk regions
School Closures Required (all levels)
Workplace Closures Required for all but key workers Required for some
Germany
Cancellation of Public Events Required cancellations
Restrictions on Public Gatherings < 10 people
Stay-at-Home Requirements Required (except essentials)
Public Transport Closures Recommended closing (or
reduced volume)1 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
Restrictions on Internal Movement Recommend movement
restriction
International Travel Controls Ban on high-risk regions Quarantine from high-risk Ban on high-risk regions
regions
School Closures Required (some levels)
Workplace Closures Required for all but key workers Required for some Recommended
Cancellation of Public Events Required cancellations Recommended cancellations
Israel
Restrictions on Public Gatherings < 10 people 10 – 100 people
Stay-at-Home Requirements Required (except essentials) No measures
Public Transport Closures Recommended closing (or No measures
reduced volume)
Restrictions on Internal Movement Restrict movement No measures
International Travel Controls Total border closure
School Closures Required at all levels Required (some levels) Recommended
Workplace Closures Required for all but key workers Required for some
United Kingdom
Cancellation of Public Events Required cancellations
Restrictions on Public Gatherings < 10 people
Stay-at-Home Requirements Required (except essentials)
Public Transport Closures Recommended closing (or
reduced volume)
Restrictions on Internal Movement Restrict movement Recommended movement restrictions
International Travel Controls Ban on high-risk regions
School Closures Required (all levels) Required (some levels)
Workplace Closures Required for some Recommended
Cancellation of Public Events Required cancellations Recommended cancellations
United States
Restrictions on Public Gatherings < 10 people
Stay-at-Home Requirements Required (except essentials) Recommended
Public Transport Closures Recommended closing (or reduced volume)
Restrictions on Internal Movement Restrict movement Recommend movement
restrictions
International Travel Controls Ban on high-risk regions
Figure 2: Heatmap COVID-19 Containment Measures in Bahrain, Chile, France, Germany, Israel, the United Kingdom and the United States, 1 February – 1 May 2021xviiiCOVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures 4.2 Exemptions from COVID-19 containment measures for fully vaccinated, recently recovered and negatively tested individuals in Bahrain, Chile, France, Germany, the United Kingdom and the United States, February 2020-May 2021: The available data indicates that France and the United Kingdom are not granting any exemptions to COVID-19 containment measures for negatively tested, recently recovered or fully vaccinated individuals. However, both countries are discussing possible future exemptions for these groups. As a member state of the European Union, France is planning the implementation of the EU Digital Green Certificate. There was no data on exemptions from containment measures in Chile. The four remaining countries – Bahrain, Germany, Israel and the United States – are granting exemptions. Germany and Israel grant exemptions for three categories of individuals: negatively tested, recently recovered and fully vaccinated. Bahrain and the United States are only granting exemptions for recovered and fully vaccinated individuals. All four countries provide equal exemptions to recently recovered and fully vaccinated individuals. In the four countries, exemptions are granted for varying types of leisure activities and international travel (i.e., no obligation to quarantine or test after returning). Germany, Israel and the United States also granted exemptions for private gatherings. Additionally, Germany and Israel provide for exemptions in schools and work places. In the United States, recovered and fully vaccinated people can participate in outdoor activities without wearing masks. Furthermore, in German and Israel individuals with a negative test may participate in different types of leisure activities (Table 1). All countries but Chile introduced or will introduce certification schemes, including via apps, for COVID-19 vaccinations, recovery and/or testing. In February 2021, Israel and Bahrain launched a certification system – “Green Pass” and “BeAware Bahrain App” respectively for completed vaccinations and recovery from COVID- 19. Proof of vaccination can be provided via an app or as a paper certificate. In mid-March 2021, the European Commission also introduced a proposal for a “Digital Green Certificate” for EU member states that would serve to reinstate freedom of movement of EU citizens if they have been either vaccinated against COVID-19, can provide a current negative COVID-19 test result or have recovered from COVID-19. In line with this approach, France has launched the "TousAntiCovid Carnet"-app with test certificates and vaccination certificates available in digital and paper format to help the wider recovery of travel between EU countries. In Germany, users can currently share their test results via the Corona-Warn-App. The United Kingdom is discussing plans for vaccination certificates while the US is using recovery certificates (Table 1).
COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures
Table 1: Exemptions from COVID-19 Containment Measures for individuals with a negative COVID-19 test, recently recovered and fully vaccinated individuals in Bahrain, France,
Germany, Israel, the United Kingdom and the United States, May 2021. Legend: red = no exemptions, green = exemptions, orange = under discussion, planned or experimental use, grey =
no data
Exemptions
Schools Workplaces Leisure Public Public and Stay-at- Public Internal International Face Physical Certificat
Events Private Home Transport Movement Travel Coverings Distancing es and
Gatherings Restrictions Apps
Negative No data No data No data No data No data No data No data No data Exemptionsxix No data No data No data
Test
Recovered No data No data Exemptions No data No data No data No data No data No data No data No data BeAware
xx
App
Bahrain
Fully No data No data Exemptions No data No data No data No data No data Exemptions No data No data BeAware
xxi xxii
Vaccinated App and
Green
Shield-
extension
Negative No data No data No data No data No data No data No data No data No data No data No data No data
Test
Recovered No data No data No data No data No data No data No data No data No data No data No data No data
Chile
Fully No data No data No data No data No data No data No data No data No data No data No data No data
Vaccinated
Negative No data No data No data No data No data No data No data No data No data No data No data TousAnti
France
Test Covid
App xxiii1 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
Exemptions
Schools Workplaces Leisure Public Public and Stay-at- Public Internal International Face Physical Certificat
Events Private Home Transport Movement Travel Coverings Distancing es and
Gatherings Restrictions Apps
Recovered No No No No No No No No No No No No data
exemptio exemptions exemptions exemptions exemptions exemptions exemptions exemptions exemptions exemptions exemptions
nsxxiv xxv xxvi xxvii xxviii xxix xxx xxxi xxxii xxxiii xxxiv
Fully No No Under No No No No No Experimental No No TousAnti
Vaccinated exemptio exemptions discussion exemptions exemptions exemptionsxl exemptionsxli exemptionsxlii usexliii exemptions exemptions Covid
nsxxxv xxxvi xxxvii xxxviii xxxix xliv xlv
App and
Certificat
exlvi
Negative Exemptio Exemptions Exemptions No No No No No No No No Corona-
Test nsxlvii xlviii xlix
exemptionsl exemptionsli exemptions exemptions exemptionsliv exemptionslv exemptionslvi exemptions Warn-
lii liii lvii
Applviii
Recovered Exemptio Exemptions Exemptions No Exemptions Exemptions No No Exemptions No No Planned:
nslix lx lxi
exemptions lxiii lxiv
exemptions exemptions lxvii
exemptions exemptions EU
lxii lxv lxvi lxviii lxix
Digital
Germany
Green
Certificat
elxx
Fully Exemptio Exemptions Exemptions No Exemptions Exemptions No No Exemptions No No Planned:
Vaccinated nslxxi lxxii lxxiii
exemptions lxxv lxxvi
exemptions exemptions lxxix
exemptions exemptions EU
lxxiv lxxvii lxxviii lxxx lxxxi
Digital
Green
Certificat
elxxxii
Negative Exemptio No data Exemptions Exemptions No No data No data No No data No data No data Certificat
Test nslxxxiii exemptions exemptions e and
“Green
Pass”lxxxiv
Israel
Recovered Exemptio Exemptions Exemptions Exemptions No No data No data No Exemptions No data No data Certificat
ns exemptions exemptions e of
recovery
(digital or2 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
Exemptions
Schools Workplaces Leisure Public Public and Stay-at- Public Internal International Face Physical Certificat
Events Private Home Transport Movement Travel Coverings Distancing es and
Gatherings Restrictions Apps
hard
copy)lxxxv
Fully Exemptio Exemptions Exemptions Exemptions No data No data No data No Exemptions No data No data “Green
Vaccinated ns exemptions Pass” and
certificate
lxxxvi
Negative No No No No Trial eventsxci No No No No No No No data
Test exemptio exemptions exemptions exemptionsxc exemptions exemptions exemptions exemptionsxcv exemptions exemptions
nslxxxvii lxxxviii lxxxix xcii xciii xciv xcvi xcvii
Recovered No No No No No No No No No No No No data
United Kingdom
exemptio exemptions exemptionsc exemptionsci exemptionscii exemptions exemptions exemptionscv exemptionscvi exemptions exemptions
nsxcviii xcix ciii civ cvii cviii
Fully No No No No No No No No No No No Planned:
Vaccinated exemptio exemptions exemptions exemptions exemptions exemptions exemptions exemptions exemptions exemptions exemptions vaccinatio
nscix cx cxi cxii cxiii cxiv cxv cxvi cxvii cxviii cxix
n
certificate
cxx
Negative No data No data No data No data No data No data No data Exemptionsc Exemptionsc No No data No data
Test xxiv xxiv exemptions.c
xxiv
Recovered No data No data No data No data No data No data Exemptions No data Exemptions No No data Recovery
United States
cxxi
exemptions. certificate
cxxii cxxiii
Fully No No No ExemptionsF ExemptionsFe ExemptionsF No data ExemptionsFe ExemptionsFe No ExemptionsF No data
Vaccinated exemptio exemptionsF exemptionsF ehler! hler! Textmarke nicht ehler! Textmarke hler! Textmarke hler! Textmarke nicht
exemptions ehler! Textmarke
cxxiv
nsFehler! ehler! Textmarke ehler! Textmarke
Textmarke definiert. nicht definiert. nicht definiert. definiert. nicht definiert.
Textmarke nicht nicht definiert. nicht definiert.
nicht
definiert.
definiert.COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures 5. Synthesis Weekly COVID-19 incidence has been decreasing in all countries included in this analysis but Bahrain. The available evidence on circulation of VOC indicates that the vaccines used in the seven countries are mostly effective against VOC B.1.1.7, B.1.351 and P.1.cxxv However, there is not sufficient evidence yet on the impact of VOC B.1.617 on vaccine effectiveness. Vaccine acceptance is lower in France, Israel and the United States and higher in Germany and the United Kingdom. Bahrain, Israel and the United States currently universally offer COVID-19 vaccinations. Chile, France, Germany and the United Kingdom continue to expand vaccination rollout to progressively younger population groups. Nonetheless, one-dose and full vaccination coverage is relatively low in all seven countries. As of 9 May 2021, at least 44.8% of the population had received at least one dose of a COVID-19 vaccine in Chile, the United States, Bahrain, the United Kingdom and Israel. By the same date, at least 26.4% of the population in France and Germany had received at least one dose. As of 9 May 2021, full vaccination was below 40% in Germany, France, the United Kingdom, Bahrain, the United States and Chile, with full vaccination coverage in Germany as low as 9.4%. Israel had fully vaccinated 58.7% of its population as of that date. Therefore, the vast majority of populations is currently not protected from COVID-19 and continues to be able to transmit the virus, if infected. The United States, Israel and the United Kingdom have progressively lifted containment measures. France and Germany continue to maintain tighter containment measures. Bahrain presents a mix of loosening and tightening of measures over time. France and the United Kingdom do not currently offer exemptions to COVID- 19 containment measures to recently recovered or vaccinated individuals. However, such exemptions are under discussion in both countries. In the remaining countries, exemptions often regard access to leisure activities and easier international travel. Most of the countries offer equal exceptions to recently recovered and fully vaccinated individuals. The majority of the countries also provide apps to digitally certify test results and vaccination status. The available data indicates that at least two countries that grant exceptions continue to demand mask wearing (the United States and Germany). Survey research conducted in Germany in early May 2021 found that exemptions for fully vaccinated and recently recovered individuals do not incentivize non-vaccinated individuals to get vaccinated as soon as possible. On the other hand, the same research also did not find any evidence of intended undesirable behavior in response to exemptions, such as non-vaccinated individuals intentionally becoming infected with COVID to achieve “recovered”-status and gain exemptions. The survey also found that non-vaccinated individuals did not wish to abolish vaccine access prioritization if privileges to vaccinated and recovered individuals were granted.cxxvi In light of this evidence, it is unclear if granting exemptions from COVID-19 containment measures may provide an incentive to currently unvaccinated individuals to receive the vaccine. Risks to COVID-19 containment posed by granting exemptions depend inter alia on the epidemiological context and the extent of full vaccination coverage. In Bahrain and Germany, incidence is currently very high and somewhat high while full vaccination coverage is high and low, respectively and exemptions are granted. This potentially weakens containment measures in both countries. Irrespective of incidence, since six out of seven countries continue to have relatively lower full vaccination coverage, all countries granting exemptions should invest in sustained risk communication and community engagement to stress the continued importance of protective behaviors (mask-wearing, physical distancing, hand-washing, ventilation) to protect the non-vaccinated population.cxxvii
1 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
6. Evidence Rating
The evidence presented in this report analyzes exemptions from COVID-19 containment measures for fully
vaccinated, recently recovered and negatively tested individuals. The evidence presented in this report builds on
data in the public domain from Our World in Data that was used to calculate weekly COVID-19 incidence and
vaccination coverage. Our World in Data builds on epidemiological data from the Center for Systems Science
and Engineering at Johns Hopkins University, the European Centre for Disease Prevention and Control and
government sources. Data on prevalence of COVID-19 virus variants stems from analyses conducted by the
Public Health Intelligence Unit at Robert Koch Institute and government sources. Data on vaccine acceptance
stems from the Imperial College London/YouGov COVID-19 Behaviour Tacker. Data on COVID-19 containment
measures stems from the Oxford COVID-19 government response tracker. Data on national exemptions to
COVID-19 containment measures for fully vaccinated, recently recovered or negatively tested individuals stems
from government sources and is occasionally supplemented with media reports.
Data on COVID-19 incidence and vaccination coverage was available for all countries. Data on VOC circulation
was available for six out of seven countries. The representativeness and validity of data on VOC is limited for
Chile and Israel, good for France and Germany and very good for the United Kingdom. The representativeness
and validity of VOC data for the United States could not be evaluated. Continuous data on vaccine acceptance
over time was available for five out of seven countries. Data on vaccine types administered was available for four
out of seven countries. Data on COVID-19 containment measures was available for all countries. Due to the
coding scheme applied by the Oxford COVID-19 government response tracker, containment policies at the sub-
national level may not be fully represented in the tracker’s data. Evidence on exemptions from COVID-19
containment measures was complete for two out of seven countries, five out of seven countries had at least some
missing data.COVID-19 Containment Measures, Issue 3 | Exemptions from COVID-19 Containment Measures
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v ZIG 1-PHI “Erlass 1849_36: Update Virusvarianten in ausgewählten Ländern” of 28 April 2021.
vi Ibid.
vii Centers for Disease Control and Prevention, “Variant Proportions”. Available at https://covid.cdc.gov/covid-data-
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xvii Centers for Disease Control and Prevention (28 April 2021). “Key Things to Know About COVID-19 Vaccines”. Available
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xviii Roser, M. Ritchie, H., Ortiz-Ospina, E. and Hasell, J. (2020). "Coronavirus Pandemic (COVID-19)". Available at
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xix The National Medical Task Force for combatting the Coronavirus (COVID-19) (6 May 2021). “Passenger arrival
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xx Bahrain Ministry of Health (6 May 2021). “The National Coronavirus Taskforce (COVID-19) reiterates importance of
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xxi Ibid.3 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
xxii The National Medical Task Force for combatting the Coronavirus (COVID-19) (6 May 2021). “Passenger arrival
procedures through all ports have been updated”. Available at https://healthalert.gov.bh/en/article/the-national-medical-
task-force-for-combatting-the-coronavirus-covid-19-06-05-2021, accessed 10 May 2021.
xxiii Ministère des Solidarités et de la Santé (19 April 2021). “Des certificats de tests et des attestations de vaccination pour
sécuriser les déplacements à l’intérieur de l’Union européenne”. Available at https://solidarites-
sante.gouv.fr/actualites/presse/communiques-de-presse/article/des-certificats-de-tests-et-des-attestations-de-vaccination-
pour-securiser-les, accessed 5 May 2021.
xxiv Ibid.
xxv Ibid.
xxvi Ibid.
xxvii Ibid.
xxviii Ibid.
xxix Ibid.
xxx Ibid.
xxxi Ibid.
xxxii Ibid.
xxxiii Ibid.
xxxiv Ibid.
xxxv Ibid.
xxxvi Ibid.
xxxvii Les Echos/Godeluck, S. (3 May 2021). “Covid : les attestations certifiées de vaccination sont arrivées“. Available at
https://www.lesechos.fr/economie-france/social/covid-les-attestations-certifiees-de-vaccination-sont-arrivees-1311883,
accessed 10 May 2021.
xxxviii Ibid.
xxxix Ibid.
xl Ibid.
xli Ibid.
xlii Ibid.
xliii Ibid.
xliv Ibid.
xlv Ibid.
xlvi Ibid.
xlvii Senatsverwaltung für Bildung, Jugend und Familie Berlin. „Einfach Testen“. Available at
https://www.berlin.de/sen/bjf/corona/tests/#schultest9a, accessed at 04 May 2021.
xlviii Der Regierende Bürgermeister von Berlin – Senatskanzlei. „Informationen zum Coronavirus (Covid-19)“. Available at
https://www.berlin.de/corona/massnahmen/, accessed at 04 May 2021.
xlix Ibid.
l Ibid.
li Ibid.
lii Ibid.
liii Ibid.
liv Ibid.
lv Ibid.
lvi Ibid.
lvii Ibid.
lviii Die Bundesregierung. „Integration von Schnelltests in die Corona-Warn-App“. Available at
https://www.bundesregierung.de/breg-de/suche/corona-warn-app-schnelltests-1902350, accessed 12 May 2021.
lix Bundesregierung (04 May 2021). „Verordnung zur Regelung von Erleichterungen und Ausnahmen von
Schutzmaßnahmen zur Verhinderung der Verbreitung von COVID-19“. Available at
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Impfung.pdf?__blob=publicationFile&v=7, accessed at 10 May 2021.
lx Ibid.
lxi Ibid.
lxii Ibid.
lxiii Ibid.
lxiv Ibid.
lxv Ibid.
lxvi Ibid.
lxvii Ibid.4 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
lxviii Ibid.
lxix Ibid.
lxx European Commission. “COVID-19: Digital green certificates”. Available at https://ec.europa.eu/info/live-work-travel-
eu/coronavirus-response/safe-covid-19-vaccines-europeans/covid-19-digital-green-certificates_en, accessed 29 April 2021.
lxxi Bundesregierung (04 May 2021). „Verordnung zur Regelung von Erleichterungen und Ausnahmen von
Schutzmaßnahmen zur Verhinderung der Verbreitung von COVID-19“. Available at
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Impfung.pdf?__blob=publicationFile&v=7, accessed at 10 May 2021.
lxxii Ibid.
lxxiii Ibid.
lxxiv Ibid.
lxxv Ibid.
lxxvi Ibid.
lxxvii Ibid.
lxxviii Ibid.
lxxix Ibid.
lxxx Ibid.
lxxxi Ibid.
lxxxii European Commission. “COVID-19: Digital green certificates”. Available at https://ec.europa.eu/info/live-work-travel-
eu/coronavirus-response/safe-covid-19-vaccines-europeans/covid-19-digital-green-certificates_en, accessed 29 April 2021.
lxxxiii Times of Israel/Staff, Toi (5 May 2021). “Israel to extend Green Pass for the vaccinated and recovered until end of
2021”. Available at https://www.timesofisrael.com/israel-to-extend-green-pass-for-the-vaccinated-and-recovered-
until-end-of-2021/, accessed 06 May 2021.
lxxxiv Israel Ministry of Health. “What is a Green Pass?”. Available at https://corona.health.gov.il/en/directives/green-pass-
info/, accessed 11 May 2021.
lxxxv Israel Ministry of Health. “What is a Certificate of Recovery?”. Available at
https://corona.health.gov.il/en/directives/corona-recovered-patients/, accessed 04 May 2021.
lxxxvi Israel Ministry of Health. “What is a Green Pass?”. Available at https://corona.health.gov.il/en/directives/green-pass-
info/, accessed 11 May 2021.
lxxxvii Senatsverwaltung für Bildung, Jugend und Familie Berlin. „Einfach Testen“. Available at
https://www.berlin.de/sen/bjf/corona/tests/#schultest9a, accessed at 04 May 2021.
lxxxviii GOV.UK. „Guidance: (COVID-19) Coronavirus restrictions: what you can and cannot do”. Available at
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d896-44c1-a611-e3109cce8eae#april-whats-changed, accessed 04 May 2021.
lxxxix Ibid.
xc Ibid.
xci GOV.UK. (19 April 2021) “Information on the Events Research Programme”. Available at
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larger-audiences-to-attend-sport-theatre-and-gigs-safely-this-summer/guidance-on-the-events-research-
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xciii Ibid.
xciv Ibid.
xcv Ibid.
xcvi Ibid.
xcvii Ibid.
xcviii Ibid.
xcix Ibid.
c Ibid.
ci Ibid.
cii Ibid.
ciii Ibid.
civ Ibid.
cv Ibid.
cvi Ibid.
cvii Ibid.5 COVID-19 Containment Measures Analysis, Issue 3 | Exemptions from COVID-19 Containment Measures
cviii Ibid.
cix Ibid.
cx Ibid.
cxi Ibid.
cxii Ibid.
cxiii Ibid.
cxiv Ibid.
cxv Ibid.
cxvi Ibid.
cxvii Ibid.
cxviii Ibid.
cxix Ibid.
cxx UK Parliament. “Covid 19 Vaccine Certification – Inquiry”. Available at
https://committees.parliament.uk/work/1104/covid-19-vaccine-certification/, accessed 28 April 2021.
cxxi Centers for Disease and Control Prevention (27 April 2021). “Domestic Travel During COVID-19”. Available at
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cxxii Centers for Disease and Control Prevention (27 April 2021). “International Travel During COVID-19”. Available at
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cxxiii Centers for Disease and Control Prevention (7 May 2021). “Requirement for Proof of Negative COVID-19 Test or
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cxxiv Centers for Disease and Control Prevention (2 April 2021). “Travel”. https://www.cdc.gov/coronavirus/2019-
ncov/travelers/index.html, accessed 11 May 2021.
cxxv WHO (25 April 2021). “Weekly Epidemiological Update”. Available at
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erfurt.de/cosmo2020/web/summary/42/, accessed 12 May 2021.
cxxvii Harder T., Koch J., Vygen-Bonnet S., Scholz S., Pilic A., Reda S., Wichmann O. (2021). „Wie gut schützt die COVID-19-
Impfung vor SARS-CoV-2-Infektionen und SARS-CoV-2-Transmission? – Systematischer Review und Evidenzsynthese”.
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