Are vaccine passports key to eradicating COVID-19?

The UK government are considering vaccine passports. Are they the silver bullet we’ve been waiting for, or are they exclusionary?

“Vaccination passports” – now there’s a phrase we never thought we would utter this time last year. Yet 12 months, three lockdowns, and a fledgling vaccination system later, the media has been awash with debate and concern. 

The conversation continues even today, as the UK Prime Minister, Boris Johnson, announced in a COVID-19 briefing that vaccination passports may be an “important step forward” in fighting the pandemic.

“What are the pitfalls against this measure?”

The move has prompted thousands to flock to Twitter under the #NoVaccinePassportsAnywhere hashtag (enter at your peril), where critics claim vaccine passports will restrict freedom of movement based on their medical records.

As a COVID-19 survivor, it would all be easy to wave off the scheme as a viable defence strategy in our fight against COVID-19. COVID-19 is a nasty blighter and the vaccines work. But in the context of vaccine passports, to what extent are vaccination passports a human rights issue, and what are the pitfalls against this measure?

Will vaccine passports springboard us back to normality?

Governments worldwide contend that vaccine passports are a fundamental step towards reenabling travel and springboarding, in my opinion, vastly neglected public venues back onto the economic chalkboard. Better still, vaccine passports come with little compromise to personal safety and public health.

Nevertheless, vaccine passports do not come without ethical challenges. Many have highlighted how governments and organisations could use vaccination data to discriminate against particular groups, and there are also fears over the appropriate sharing of sensitive medical data. 

“Supporting countries advocate vaccine passports that motivate individuals and populations towards global immunity.”

The prospect of a vaccine passport is hardly new; as a matter of fact, they exist in many forms. Most travellers are accustomed to the fact that to enter certain countries, they must prove they are vaccinated against yellow fever.  

Far from incentivising infection, supporting countries advocate vaccine passports that motivate individuals and populations towards global immunity.

Some countries, such as Israel, have already adopted a mandatory Green Pass scheme, allowing people who have either recovered from or been vaccinated against COVID-19 to access public venues legally. 

The liberty question

Historically speaking, the balance between population health and civil liberties has always been a tricky one to muster. For the longest time, lockdown became the sure-fire means of eliminating infection, an alternative to the passport scheme. Many countries across the world have succeeded in eradicating COVID-19 through this measure when appropriately implemented. 

“People don’t obey laws perceived as unjust.”

Still, here in the UK, lockdown regulations and what they have meant for the British people were translucent at best. Plus, it is not always seen as fair, and generally speaking, people don’t obey laws perceived as unjust.

One only has to look at the case of Neil Ferguson, whose model motivated lockdown; he resigned from his role as UK government adviser after breaking lockdown guidelines. He confessed that he “acted in the belief that I was immune.”

“Businesses have no business delving into potentially sensitive medical records just for the sake of flashing a vaccination passport.”

On an idealistic level, vaccination passports may provide a brief panacea for the economic handicaps brought on by a (medically necessary) series of lockdowns. There could also be undeniable collective health, economic, and social benefits.

Be that as it may, I seriously question the standpoint that vaccination passports could be used in settings where medical records are irrelevant. It varies from case to case, but I agree with the UK Cinema Organisation on this point; trite as it is to say, businesses have no business delving into potentially sensitive medical records just for the sake of flashing a vaccination passport.

The evidence is still in formation

This leads me to question the extent to which vaccination passports measure individual immunity, particularly against mutations and variants. Moreover, will these passports confer a lack of infectiousness? 

While I cannot pretend to be a scientist, I must say that the statistics do indeed paint positive pictures for both the AstraZeneca and the PziferNTech vaccines: 67% reduced transmission with AZ, 85% prevention of severe infection after 2nd dose with PNT.

Studies across the world have illustrated clear as day that vaccines, in themselves, are a huge pathing stone back to normality.  

Still, join this up with vaccine passports and the devil may indeed be in the detail.  There is every chance that on a medical level, vaccine passports may stifle the transmission of COVID-19. Israel’s Green Pass scheme may indeed be proving successful in many degrees, but we are still gathering data to determine the efficiency.

The evidence is growing, and we’re not sure the direction it is taking just yet.

“In some cases, major cities are trialling alternate schemes.”

In some cases, major cities are trialing alternate schemes. Liverpool, for instance, is piloting the UK’s first non-socially distanced event and Barcelona hosted a Love of Lesbian gig to thousands after music-goers received COVID-19 negative tests.

Time will give us a bigger picture.

Where are the volunteers?

Another part of me is curious about why we do not have these answers. A year has passed since the world declared a global pandemic and COVID-19 is a huge priority for many countries.

Here in the UK alone, tens of thousands of young people aged 20 – 30 consented and volunteered to be deliberately infected with COVID-19 with the intent of measuring vaccine efficiency and disease transmission post-vaccination.  

Vaccination and natural immunity reduce the risk of reinfection and transmission. Reduction does not mean eradication or elimination of risk. Still, a reduction is better than nothing and the potential findings are significant. So, why have these schemes gone under the radar?

Passport vaccines and digital privacy

Digital privacy is another ethical question for the vaccine passport scheme. In the UK, I imagine most vaccine passports would be digital.  If that is the case, anyone wishing to use the vaccine passport scheme would need to access private medical records. How would this be shielded from abuse?  Also, in terms of the global picture, how would this translate for an individual entering the UK on business from a low-income or middle-income country? Would the standards for ‘infectivity’ and ‘immunity’ stay the same?

We must work alongside nations in an interoperable manner to standardise and safeguard the scheme. Access to the technology to support vaccination passports must be universal. Still, there are limited foolproof systems to prevent data mismanagement or abuse.

The poverty divide

In some settings, vaccine passports could inadvertently exacerbate social inequalities and health divides. The vaccine rollout in the UK, while efficient, is a salient example of this. This is because allocation has been split into categories. Yet, for some, the rollout can be a bit of a postcode lottery.

Another issue with vaccine passports is the availability of vaccines. People facing vaccination access problems will undoubtedly struggle to acquire authentic documentation. Plus, it’s worth remembering that current vaccine uptake remains highest in income-rich nations. 25% of the world’s population may not receive their first vaccine dose until at least 2022. 

“The world is on the brink of a catastrophic moral failure”

This led the Director-General of the World Health Organisation to believe some nations – including the UK – are stockpiling doses, putting poorer countries at a distinct disadvantage.

He said: “More than 39 million doses of vaccine have now been administered in at least 49 higher-income countries. Just 25 doses have been given in one lowest-income country.

“Not 25 million. Not 25 thousand. Just 25.

“The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries…this is wrong.”

Conclusion

Please make no mistake where I stand on vaccination. The benefits are undeniable. However, I fear inequality, and in my opinion, the vaccination passport scheme is a bear trap for potential discrimination.  

Asking people for their medical records for non-medical related activities is wholly inappropriate.  While there is strong evidence vaccines do work in the fight, restricting and curtailing freedoms may prompt those who cannot take the vaccine to believe they are being deliberately excluded. This feels counter-intuitive. 

“Far too many people worldwide are unable to access their first dose for this to succeed.”

Furthermore, even if vaccination passports were a viable weapon against COVID-19, I suspect vaccine unavailability will leave poorer nations at a disadvantage. Far too many people worldwide are unable to access their first dose for this to succeed. 

In the end, I think that if vaccine passport standards are to be successful, they need to be translatable, safeguarded for privacy, and equipped alongside vaccines – if people want them.

April Ryan

Tweet to @April_L_Ryan

Featured image courtesy of Lukas via Unsplash. Image license can be found here. No changes were made to this image.