The use of documentation to prove individuals have been vaccinated against Covid-19 to is being considered as a means to avoid certain restrictions on travel and other services. Stepping out of its lane a bit, the World Health Organization (WHO) is pouring cold water on the idea in part because individuals who do not have access to an authorized COVID-19 vaccine would be unfairly impeded in their freedom of movement if proof of vaccination status became a condition for entry to or exit from a country.

Vaccine Passports

A vaccine passport is a document (likely digital) that would be accepted as proof that the holder had been vaccinated against COVID-19.

img_4522-2

The idea behind a vaccine passport is that it would allow a person to resume activities that are now restricted because of the coronavirus pandemic. Regaining the ability to travel freely is getting the most attention, but that’s not the only proposed benefit. Advocates say they also could allow holders to eat in restaurants, enjoy a cocktail in a bar, see a movie, go to the gym and attend concerts, sporting events, and other events that involve close proximity with a lot of people.

Cyprus, Estonia, Poland, Seychelles, Georgia, Romania, Iceland, and Thailand are among a growing list of countries that have announced or are studying requiring proof of vaccination for international travelers to enter or be exempt from certain restrictions on entry.

Individual Airlines like American Airlines, the International Air Transportation Association, and other companies are developing vaccine passports as part of a mobile app. The app would show your vaccination status possibly through a photo of a vaccine certification document, a scannable barcode, or other digital record.

In an interim position paper dated February 5, 2021, the WHO expressed serious reservations about the use of “vaccine passports” due to scientific, ethical, legal and technological concerns. The WHO makes some valid points relating scientific and technological issues surrounding vaccine passports. Those concerns don’t seem to be insurmountable. The WHO’s ethical concerns with vaccine passports don’t seem to have as much validity.

Ethical Considerations

The WHO argues that vaccine passports will add to already existing inequalities in the distribution of vaccines and introduce new ones with the result that individuals who do not have access to an authorized COVID-19 vaccine would be unfairly impeded in their freedom of movement if proof of vaccination status became a condition for entry to or exit from a country.

The WHO is taking a “don’t chew gum unless you brought enough for everyone” approach. The problem with this approach is vaccine passports won’t create inequitable distribution or make it worse. While it is true that wealthier countries generally have greater access to vaccines and procure them in larger quantities than poorer countries, using vaccine passports for travel should have no effect on the equities of vaccine procurement and distribution by country.

covid_travler (1)
Reuters photo

The WHO suggests that benefitting travelers by adopting vaccine passports might even lead to inequitable distribution within each country. Somehow those wanting to travel might be put in line before others. People wanting to travel would want to get vaccinated and obtain the benefits of a vaccine passport. But that is good. Governments not individuals decide who has priority for being vaccinated.

After the high-risk groups get vaccinated, there is a danger that others will see little need to do so. In he U.S., large segments of the population, Republican men and minorities, have expressed substantial reservations about their willingness to get vaccinated. Apparently to avoid appearing at odds with his supporters, former President Trump told no one that he and the former First Lady were vaccinated in the White House. Overcoming vaccine hesitancy is crucial because herd immunity and its benefits require that about 75% of the population be vaccinated or receive immunity through surviving infection.

I have the feeling that there will come a time in the not too distant future when authorities will be begging people to get vaccinated. Some companies have to go to provide extra incentives to get employees to get vaccinated. As an example, American Airlines wants all of its 130,00 employees to be vaccinated, but has had to offer an extra vacation day and $50 in rewards in hopes of overcoming the reluctance of some employees.

The benefits of a vaccine passport may encourage some vaccine hesitant people to get vaccinated. That supports good public health.

Legal Considerations

Legal concerns relate to WHO International Health Regulations governing requiring proof of vaccination for outgoing or incoming international travelers.  Presently, yellow fever is the only disease that these regulations allow countires to require proof of before entering. WHO regulations, however, have not stopped governments and companies all over the world from giving Covid-19 vaccination passports serious consideration.

The WHO’s technological and scientific concerns are not as easily dismissed.

Technological Considerations

Although vaccination status can easily be captured via digital means, the ability to uniquely identify individuals and validate their vaccination status in a common system requires international cooperation, coordination across complex systems and widespread adoption of interoperability standards to support secure data access and exchange. The WHO assumes there will be one system. That would be ideal, but governments and companies are looking at coming up with their own systems individually as well.

4edf7f97e546b6e5fc956986673fbcf7-1
Yahoo photo

All systems that are developed to store, access and display information necessary for vaccine passports must be secure and reliable. Governments and businesses should be able to satisfy those requirements with effort. Fraudsters would be very interested in producing fake vaccine passports. While Covid-19 vaccine passports would be produced on a much larger scale, it appears these concerns have been addressed with non-digital yellow fever vaccine passports.

Scientific Considerations

The scientific considerations are the key to determining how useful vaccine passports would be. A number of scientific unknowns remain concerning the effectiveness of COVID-19 vaccines. The most important issue for vaccine passports is if a vaccinated person can infect others.

Studies have shown that vaccines are very good at preventing almost all serious cases of Covid-19 disease. That means people who have been vaccinated can still acquire a SARS-CoV-2 infection. Current evidence and assumptions based on experience with other vaccines supports the conclusion that Covid-19 vaccines prevent building up enough SARS-CoV-2 virus that a vaccinated person who has a SARS-CoV-2 would very likely be unable to infect others. Still, that conclusion remains unproven.

Final Thoughts

I think Covid-19 passports would be a very helpful in returning life to a semblance of normal by allowing travel and greater access to places like restaurants, theaters, and sporting events. It is almost a certainty that vaccinated individuals present much less of a risk of transmitting SARS-CoV-2. More work needs to be done to establish scientifically what the risk of transmission is, if any and the appropriate measures to mitigate that risk. Vaccine passports need to be developed that ensure that the necessary information can be shared securely and that the passports cannot be forged.

If vaccine passports can be developed that help people return to a normal life, that will be a huge boost to overcoming vaccine hesitancy and being able to reach a sufficiently high percentage of the population to achieve herd immunity. Reaching that goal is the whole purpose of the massive, world-wide struggle against the coronavirus pandemic.

What are your thoughts on Covid-19 vaccine passports? Thanks for reading.