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What do we know about vaccine passports?

This article was published on
April 16, 2021

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A “vaccine passport” is a proof that someone has been vaccinated against COVID-19. Currently, vaccine passports are being debated in the public health community for their many pros and cons. Vaccine passports are also being used, or planned to be used, in different ways across and within countries globally, which is a trend that is likely to continue.

A “vaccine passport” is a proof that someone has been vaccinated against COVID-19. Currently, vaccine passports are being debated in the public health community for their many pros and cons. Vaccine passports are also being used, or planned to be used, in different ways across and within countries globally, which is a trend that is likely to continue.

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What our experts say

A vaccine passport is proof that someone has been vaccinated against COVID-19. The “passport” could be in the form of a smartphone app or a written certificate, but is typically digital. Just like a national passport, a vaccine passport would allow an individual entrance somewhere such as a restaurant, concert, or a country that demands proof of vaccination. A vaccination passport is technically different from the vaccination cards that individuals are provided after getting vaccination given that those could be forged easily. 

There is currently significant debate in the public health community regarding whether or not we should use vaccine passports. Those in favor claim that it will incentivize individuals to get vaccinated, make crowded places safer, and safely allow a sense of normalcy for some. Those against it claim that vaccine passports could violate individuals’ privacy and personal freedom, and that it could create a discriminatory system in which individuals who haven’t been able to obtain a vaccine would be systematically left out of a return to normal life, disproportionately limiting the movement of individuals from lower-middle income countries and marginalized groups. 

Mandates on and uses of vaccine passports are already differing by country and are likely to continue to vary. In Britain, they’ve started a COVID-19 “certificate system” that is in a pilot phase. In Israel, residents are required to show an electronic “Green Pass” to enter places such as concerts, restaurants, and gyms. In addition, they are considering requiring foreign visitors to take blood tests in order to prove their vaccination statuses. The Chinese government announced that it will only admit travelers who can prove they received Chinese-made vaccines. 

The European Union has approved of the idea of an electronic vaccine passport set to be ready by June; however, each member country will be able to decide whether to individually implement the vaccine passport and how. For instance, Estonia is planning to start issuing digital certificates in the form of a QR code, showing proof of vaccination by the end of April. In the U.S., the federal government has said it will not require digital vaccine passports at a federal level. However, a growing number of businesses say they will require vaccination proof for service or entry. The African Union and Africa CDC are currently developing a “My Covid Pass” to allow safe travel across the continent. 

While across countries, and even within countries, uses of vaccine passports are currently varying, there are efforts underway to standardize applications and uses. The World Health Organization, for instance, has convened a “smart vaccination certificate” working group to develop international standards.

Context and background

Legally, governments have power to validate and monitor vaccination statuses while requiring proof of vaccination for access to certain privileges, given that international law poses few restrictions on digital health passports. The International Health Regulations, signed by 196 countries, grant wide discretion to exercise public health powers based in evidence. Industry also faces few restrictions for developing digital health passports for businesses to use, and many industry players are rushing to work on different platforms. 

While the first vaccine was not created until the late 1700s, the idea of a health passport has been around for approximately 600 years, when it became popular in Europe following the Black Death in the 14th century. Vaccine passports have also been successfully used in the past; for instance, the U.S. has successfully used vaccine passports to control smallpox outbreaks, and yellow fever cards—approved by the World Health Organization—are required to enter certain countries.

Resources

  1. Digital Health Passes in the Age of COVID-19: Are “Vaccine Passports” Lawful and Ethical? (The Journal of the American Medical Association)
  2. Incentivizing Vaccination Uptake: The “Green Pass” Proposal in Israel (Journal of the American Medical Association)
  3. Covid-19 vaccine passports will harm sustainable development (The British Medical Journal Opinion)
  4. “Vaccine Passport” Certification — Policy and Ethical Considerations (The New England Journal of Medicine)
  5. Covid passports: What are different countries planning? (BBC News)
  6. Covid-19 Vaccine Passports Are Coming. What Will That Mean? (WIRED Magazine)
  7. There's a lot of debate about vaccine passports right now. What are they, and how would they work? (CNN)
  8. What Are the Roadblocks to a ‘Vaccine Passport’? (The New York Times)
  9. COVID-19 Health Passports: What’s Old Is New Again (Science Health Institute)
  10. The U.S. Has Had 'Vaccine Passports' Before—And They Worked (TIME Magazine)
  11. The Vaccine Passport Debate Actually Began In 1897 Over A Plague Vaccine (NPR)
  12. Waldemar Mordecai Haffkine, CIE (1860-1930): prophylactic vaccination against cholera and bubonic plague in British India (Journal of Medical Biography)

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