‘A can of worms’: Experts weigh in on the vaccine passport debate

There is no international consensus on how, or why, vaccine passports should be used but many countries are exploring the idea.

A vaccine passport can broadly be defined as a piece of documentation proving someone has been inoculated against a virus [File: Jens Schlueter/AFP]

London, United Kingdom – From Israel to Iceland, several governments around the world are adopting so-called coronavirus vaccine passports as they bid to safely reopen borders, unfreeze economies from costly lockdowns and restore a semblance of normality to social life.

Supporters of the vaguely-defined certificates argue they have a critical role to play in ending restrictions imposed to curtail the spread of the pandemic, at least in countries with widescale access to vaccines.

Documents showing proof of inoculation against COVID-19 could mean sweeping travel bans and strict stay-at-home orders are able to be lifted, for instance, freeing millions and kickstarting commerce.

But sceptics say they present insurmountable scientific, legal, and ethical issues – at least for now – and should not be used either within individual countries or as a tool to unlock international travel.

As the debate continues, Al Jazeera asked five United Kingdom-based experts for their opinions.

Here is what they had to say …

Al Jazeera: Do current scientific understanding of COVID-19 and existing vaccines support the use of vaccine passports?

Sarah Chan, a bioethicist at Edinburgh University: One of the main problems with vaccine passports as they are currently proposed is that they focus on the individual’s vaccination status as a binary indicator of risk, to self and others: Vaccinated equals “safe”, unvaccinated equals “unsafe”.

It is true that vaccination provides some protection against catching COVID, but it is not 100 percent effective in 100 percent of individuals; and, what is more important, we do not have enough evidence to say that vaccination prevents people from transmitting the disease to others.

So, while vaccination certainly reduces risk, both to the individual and across the population, issuing “passports” that divide us up into such black-and-white, binary categories and controlling what we can do and where we can go on that basis does not seem to be justified. In fact, giving people a passport that says they are “safe” might actually produce a false sense of security that could result in further spread of disease.

The rollout of COVID-19 vaccines has raised hopes of an end to the pandemic, but there are pressing concerns that doses are not being shared equitably and are instead being hoarded by rich countries at the expense of poorer nations [File: Francis Mascarenhas/Reuters]

Dave Archard, chair of the Nuffield Council on Bioethics: At the moment, there is insufficient evidence that the existing approved vaccines significantly reduce transmission, as opposed to susceptibility to serious illness, and it is [reduced] transmissibility that the passport assumes is given by the vaccine. Moreover, we do not know enough yet about the length of any immunity or resistance to the new variants.

Danny Altmann, professor of immunology at Imperial College London: If one takes the broadest possible view at a global health level, perhaps yes – people who have had two doses of a licensed, tested vaccine, on average, are less likely to have and transmit COVID than others.

Therefore, if we regulate our air travel/care-home staff/sports events et cetera in this light, we will tend to be safer. This is a bit like the long history of needing yellow fever vaccines for many countries. Enforcing this keeps yellow fever down.

Al Jazeera: What are the biggest issues and risks – legal, ethical, and otherwise – with the use of vaccine passports?

Ana Beduschi, an associate professor of law at the University of Exeter: Digital health passports pose essential questions for the protection of data privacy and human rights, given that they use sensitive personal health information to create a new distinction between individuals based on their health status, which can be used to determine the degree of freedoms individuals may enjoy.

If digital health passports start to be required as proof of COVID-19 health status to access public and private spaces, some people could move freely – that would be the case of those who would have tested negative for COVID-19 or would have been vaccinated.

By contrast, those who cannot access or afford COVID-19 tests or vaccines would not be able to prove their health status. Their freedoms would therefore be de-facto restricted.

Imagine, for example, the case of a pregnant woman who cannot be vaccinated and cannot afford to pay for private COVID-19 tests – she may be excluded from a variety of places and activities. Decades of progress on women’s rights could be reversed if governments do not think it through before providing guidelines for implementing digital health passports.

A sticker in a vaccination certificate confirms the reception of a dose of the Pfizer-BioNTech COVID-19 vaccine ‘Comirnaty’ at the Bavarian Red Cross vaccination centre, in Pfaffenhofen an der Ilm, Germany [File: Andreas Gebert/Reuters]

Melinda Mills, director of the University of Oxford’s Leverhulme Centre for Demographic Science: Underpinning any introduction of a vaccine passport or certificate would need a clarification of the uses and who will be excluded if and when they are introduced.

We need to ask whether it is something just for international travel, attending a sports event, eating in a restaurant or as a condition of employment. It carries the risk that they could be used to unjustly discriminate in hiring or access to certain places or services.

Additional concerns are whether vaccination data could be used for other unintended reasons. Importantly, they will need to ensure individuals do not get blocked from essential services or exacerbate inequalities.

Altmann: [It is] an enormous can of worms and enormously open to fraud and misbehaviour … [There is also] great potential to create a tiered society of vaccinated, and unvaccinated.

Al Jazeera: Would the introduction of vaccine passports exacerbate existing inequalities? 

Chan: I think there is definitely a concerning possibility that vaccine passports will worsen social inequalities. For example, if vaccination rates are lower amongst disadvantaged communities, then further limiting people’s access to society based on who has or has not been vaccinated will entrench and exacerbate this disadvantage.

Furthermore, for people and groups who may have doubts about the vaccination, for whatever reason, using passports as a form effectively of coercion is liable to amplify mistrust and increase, rather than diminish, resistance. The question of vaccination is already highly politicised – we have seen, with interventions such as mask-wearing and even compliance with lockdown restrictions themselves – how public health behaviours can rapidly become aligned with ideological differences, and how these differences are amplified and polarised further by the nature of discussion, especially on social media.

Vaccine passports, by splitting the population into the dos and don’ts, the wills and won’ts, is likely to lead to even greater polarisation and create deeper social divisions. At a time when collective action and solidarity are more important than ever, that is the last thing we need.

The introduction of vaccine passports could have adverse effects for minority communities already disproportionately affected by the COVID-19 pandemic, experts have warned [File: John Sibley/Reuters]

Archard: It may very well do so. We know that the pandemic has disproportionately adversely affected particular communities and social groups who are already disadvantaged, those, for instance, from Black, Asian and minority ethnic (BAME) communities. Access to the vaccine and to the likely digital technology that might be used – smartphones, most obviously – is unequal and disadvantages these groups. At its worst, a vaccine passport would stigmatise and leave behind those who cannot access them.

Al Jazeera: What benefits could the introduction of COVID-19 vaccine passports bring about?

Mills: If introduced with clarity, they could allow more efficient international travel and economies to open up. However, if it was introduced, it would need an expiry date and even the potential to be revoked if emerging variants compromise existing vaccines.

Archard: Most obviously, the benefits of vaccine passports are the restoration to some in society of those liberties – work, social contact, travel – currently denied to them; an assurance of greater public safety and protection against the harms of the virus; and the economic gains of allowing some to return to work.

COVID-19 lockdowns have had a major economic effect, with many commercial activities grinding to a halt [File: Nacho Doce/Reuters]

Altmann: If done in a strong, robust, intelligent way and in the context of universal access to vaccines, it [the introduction of vaccine passports] really can safely reopen our society. But the challenges to doing this well are huge.

Chan: Some form of vaccination certification could be used to reduce risk and increase safety for those in high-exposure roles, such as health and social care, public transport or education. However, the framing of “passports” focuses on [an] individual’s rights and what the individual is entitled to do, rather than on keeping others safe and on the collective benefits of vaccination as a public health measure. And I think this is the wrong focus.

Al Jazeera: Israel has recently rolled out its version of a vaccine passport/certificate as part of a bid to reopen the country’s economy. What do you make of this approach, and do you see other countries following suit?

Altmann: I think it can work well there [in Israel] for several reasons. It is a sophisticated, medicalised society where the Pfizer vaccine and uniform testing have been massively applied. Also, as witnessed in their very successful test and trace [system], it is a society where there is acceptance of high-tech ID systems in a way that is less tolerated in a place like the UK.

Chan: One of the key questions here is about resources and opportunity costs. Israel is pursuing a strategy of rapid, population-wide vaccine rollout to get as much of the population vaccinated as soon as possible, as is, to some extent, the UK.

In such a situation, the utility of vaccine passports within the country may be limited, meaning that introducing such a scheme would be a waste of resources. Consider that our aim is to roll out the vaccine quickly, to get to the point where enough of the population is vaccinated to prevent the disease from spreading; based on current figures we are doing very well towards that. But once enough of the population is vaccinated, it will be even less useful to force everyone to carry proof of their individual vaccination status.

This being the case, for the government to throw money at commissioning a passporting scheme that, if all goes well, will be obsolete within the year, would be a waste of resources and distract attention from other, more effective ways of addressing the pandemic and its broader effects.

Israel has rolled out a government-validated certificate, known as a ‘Green Pass’, which allows people to prove they have been vaccinated against or recovered from COVID-19 and hence have presumed immunity [File: Amir Cohen/Reuters]

Archard: Israel has used the vaccine passport as a means of effectively mandating vaccination and doing so has risks and costs, such as eroding trust and being counterproductive – those who see a vaccine as being forced upon them may well be more unwilling to have it.

Not everyone in Israel has the same access to the vaccine and the government has been criticised for its treatment in this regard of Palestinians. The government’s claim that those who do not have the vaccine “will be left behind” is also troubling. Other countries may introduce vaccine certificates, but not take the same measures or [have the same] attitude as Israel.

Source: Al Jazeera