Five Things to Know About Vaccine Passports

After a long year under various stages of lockdown to slow the spread of the Covid-19 virus, with borders closed, travel restricted, and trips and parties and meals and meetings and events canceled, vaccinations are offering the world a potential return to normalcy. As the world waits to achieve herd immunity, governments and businesses are increasingly looking for ways to tell who has been inoculated from those who have not. This pursuit has stirred up discussions of what most governments and media outlets are calling “vaccine passports.”

What is a “vaccine passport?”

“Vaccine passports are essentially a verified way of showing that people have received immunizations,” explains Peter Chin-Hong, an infectious disease specialist at University of California, San Francisco. The passports are a modern twist on classic vaccine cards. People who have needed to show proof of a yellow fever or cholera vaccination to travel to parts of the world know the drill: A vaccine passport would be a digital or paper document showing that the bearer had received a Covid-19 vaccination or, in some cases, has antibodies to the virus or recently tested negative. Those with the passports could travel to certain states and countries, likely without quarantining or testing.

What states and countries are considering vaccine passports?

As the world watches, states like Hawaii and New York. and countries including Saudi Arabia, Denmark, Sweden, Hungary, Poland and Australia are already experimenting with some version of a vaccine passport, or they are in the planning stages of doing so, David Studdert, professor of Medicine and Law at Stanford University, told public radio show Take Two. Additionally, 27 member states of the European Union are considering some form of a vaccine-certification system to allow easier cross-border travel in the EU in the form of a Digital Green Certificate. While domestic travel has its own app-based monitoring system, China has rolled out a digital passport for international travel. Other countries are using vaccine passports as a way to open their doors for tourists. Belize has already said it would welcome vaccinated travelers without testing or quarantine and Iceland, Georgia, the Seychelles and Lebanon have opened borders to vaccinated U.S. travelers. “It’s an increasing number of random countries, but no coordinated effort,” says Chin-Hong.

What are the benefits of vaccine passports?

These moves could be a lifeline for the struggling tourism industry, which is estimating more than $1 trillion in losses due to Covid-19. Tourism and travel have taken such huge hits due to the coronavirus that it’s no surprise that the airline industry is rallying behind the vaccine passport idea. The International Air Transport Association, which represents 290 airlines worldwide, is already testing its own app-based IATA Travel Pass, which stores passport, vaccination and travel records as well as Covid-19 test results. IBM has also come up with the Digital Health Pass, called Excelsior Pass. It’s a blockchain-based app designed to protect privacy while making it easy to flash vaccination records or test results. It’s currently being tested by the state of New York with hopes for a bigger rollout soon.

However, vaccine passports aren’t just being proposed for travel. They may be used as a green light for the vaccinated to attend concerts or go to see a favorite team play, while the unvaccinated are kept out. Israel, the country with the fastest vaccination rollout, has already created a “green pass” that gives special privileges and access to its vaccinated citizens. “They have opened up certain activities to people who've been vaccinated versus people who have not been vaccinated using a QR code,” explains Chin-Hong. “And people in the U.S., for example, are looking at this model.”

As more venues open up to people with proof of vaccination, health experts hope that the lure of a vaccine passport could result in more people stepping forward to get vaccinated. That could be an important way for the U.S. to fight vaccine hesitancy. Thirty percent of all American adults will choose to not get a Covid-19 vaccine, according to a recent NPR/PBS NewsHour/Marist poll. Those numbers may change if vaccine passports open doors and borders.

Vaccinations and the vaccine passports may even become mandatory. “We've been hearing about workplaces that are introducing ideas that they make it mandatory,” says Chin-Hong. “And we have some school districts rumbling about making movements towards that.” Of course, the current crop of Covid vaccines are not currently authorized for use in children under the age of 16, but may be by September.

What are the drawbacks?

Mandates on vaccinations and vaccine passports aren’t without controversy, of course. Legislation has been introduced in several states, including Montana and Iowa, to ban discrimination based on vaccination status for employment or enrollment in schools.

While vaccine passports sound like one way to open the world back up, some health experts don’t see vaccination as a green light for travel just yet. “A vaccine passport is not a free pass to not use protection or to let your guard down,” says Chin-Hong. “Given that no vaccine is 100 percent effective, while Covid is going around [a vaccine] just becomes one important strategy in which we can protect ourselves, but it's not the only measure.” Chin-Hong also thinks it’s strange that the U.S. would require proof of vaccinations that have been cleared by the FDA “for emergency use” only, even though full clearance might come soon.

Last month, the World Health Organization released a statement urging countries away from vaccine passports, pointing out that “there are still critical unknowns regarding the efficacy of vaccination in reducing transmission” and citing the “limited availability of vaccines.” Globally, some countries have stockpiles of vaccines, while others struggle to vaccinate their frontline workers and people with a higher risk from Covid. Even in the U.S., which has been inoculating around three million people a day, as global health management researcher Yara M. Asi points out in a piece for The Conversation, vaccine distribution hasn’t exactly been equitable. Black Americans have been receiving vaccinations at half the rate of white Americans, a disparity that is even more marked for Hispanic Americans. Requiring vaccination to travel just adds to that inequity.

Additionally, any app that stores health records will run into privacy and fraud concerns. Plus, while vaccination records for yellow fever and the like were kept on physical cards, these days it is more likely that a vaccine passport would be stored as a QR code or some other digital proof kept on a smartphone. While Israelis have the option of a digital or paper green pass, the risk of fraud or counterfeit vaccination forms is leading many countries to think digital. For instance, England is considering an app-based passport, and, according to Chin-Hong, much of the vaccine passport conversation in the U.S. has revolved around apps. While handy for some, many people around the world do not have internet access, let alone smartphones. It’s this reliance on digital technology that is making some people nervous about requiring proof of vaccination for travel, or even work or school. “I think it's really problematic if not all people have equal access to a particular intervention,” says Chin-Hong.

How likely is it that the U.S. will implement a vaccine passport?

Despite those concerns, it’s likely some form of vaccine passport is coming. One of President Joe Biden’s early executive orders directed government agencies to “assess the feasibility” of digitizing Covid-19 vaccination records, most likely in some sort of public-private partnership. Coordinating those efforts and ensuring users’ medical records and vaccine certifications are kept secure and also accessible will prove a major challenge.

People are so eager to travel again, though, that they may be willing to jump those hurdles. A recent study from travel news site The Vacationer found that a whopping 73.6 percent of Americans surveyed would use a Covid health passport or app just to be able to hop on an international flight again.