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Institute of Biomedical Ethics and History of Medicine (IBME)

New publication by Giovanni Spitale, Nikola Biller-Andorno and Federico Germani: «Concerns Around Opposition to the Green Pass in Italy: Social Listening Analysis by Using a Mixed Methods Approach»

Giovanni Spitale, Federico Germani and Nikola Biller-Andorno published a new article in the Journal of Medical Internet Research (JMIR)Concerns Around Opposition to the Green Pass in Italy: Social Listening Analysis by Using a Mixed Methods Approach.

The software developed for this study is freely available (CC-BY-SA) via Zenodo.


The recent introduction of COVID-19 certificates in several countries, including the introduction of the European green pass, has been met with protests and concerns by a fraction of the population. In Italy, the green pass has been used as a nudging measure to incentivize vaccinations because a valid green pass is needed to enter restaurants, bars, museums, or stadiums. As of December 2021, a valid green pass can be obtained by being fully vaccinated with an approved vaccine, recovered from COVID-19, or tested. However, a green pass obtained with a test has a short validity (48 hours for the rapid test, 72 hours for the polymerase chain reaction test) and does not allow access to several indoor public places.

This study aims to understand and describe the concerns of individuals opposed to the green pass in Italy, the main arguments of their discussions, and their characterization.

We collected data from Telegram chats and analyzed the arguments and concerns that were raised by the users by using a mixed methods approach.

Most individuals opposing the green pass share antivaccine views, but doubts and concerns about vaccines are generally not among the arguments raised to oppose the green pass. Instead, the discussion revolves around the legal aspects and the definition of personal freedom. We explain the differences and similarities between antivaccine and anti–green pass discourses, and we discuss the ethical ramifications of our research, focusing on the use of Telegram chats as a social listening tool for public health.

A large portion of individuals opposed to the green pass share antivaccine views. We suggest public health and political institutions to provide a legal explanation and a context for the use of the green pass, as well as to continue focusing on vaccine communication to inform vaccine-hesitant individuals. Further work is needed to define a consensual ethical framework for social listening for public health.