Rapid-antigen testing for SARS-CoV-2 in Germany: Citizens’ selective granting of freedoms for negatively tested, vaccinated, recovered, and other citizens

Pandemic management of SARS-CoV-2 has involved temporary freedom restrictions to curb the spread of infection. In this study, citizens are asked for whom they would grant freedoms and it is examined how their granting is influenced by risk perceptions, and to what extent granting and individuals' test intentions are related to an understanding of test performance.When large-scale rapid-antigen testing was introduced as a means for pandemic management, we conducted a longitudinal study (March to May 2021) with a representative panel of German citizens who are online (N=4,991). We assessed granting of freedoms to participate in various activities (e.g., visiting restaurants) depending on health status (negative rapid antigen test, vaccinated, recovered from COVID-19, or neither), and respondents’ understanding of the performance of rapid antigen tests. An experiment with the panel (N=1,660, May 2021) investigated how information from a national health authority on the societal benefit of regular testing and on test performance relate to respondents’ test comprehension and freedom granting.Granting for tested and vaccinated people was associated with their perceived infectivity. Substantial freedoms were only granted for negatively tested and vaccinated citizens, until in May 2021 recovered people were roughly put on par with those groups. Restricting activities for other citizens who fulfilled none of these criteria remained highly accepted. Providing evidence-based information improved comprehension of test performance over a control group without information and decreased granting for negatively tested groups. Adding societal benefit information mediated this decrease in granting. Respondents testing intentions were not affected by the provided information. Citizens were uncertain about both infectivity risks and test properties. Presenting them with performance information improved understanding of test performance and reduced freedom granting for negatively tested people. Evidence-based information has the potential to inform a critical acceptance of targeted granting of freedoms as a measure of pandemic management.