The promise and perils of vaccine passports

THE RACE to vaccinate against covid-19 is on. More than 50 countries have given more than 68m jabs. That is not much of a dent in the global population of more than 7bn, but it is enough to invigorate a debate about whether people who have been vaccinated should be permitted to move around more freely.

To allow this, those who have been vaccinated need to be able to prove it. And thus has begun a discussion about whether certificates of immunity—or vaccination passports—should be introduced. Some tourism-dependent countries, such as the Seychelles, have already opened to people who have received a covid-19 jab. Opinions differ about how welcome the wider adoption of such a thing would be. Some think it is a quick route back to normal life. Others worry that it will be unfair and divisive.

Although to some vaccination passports may seem radical, they are not without precedent. By 1922, many schools in America required that children get smallpox vaccinations as a condition of attendance. And the “yellow card” is an international certificate created almost 100 years ago to record inoculations against cholera, yellow fever, typhus and smallpox. To this day, many countries require a yellow-fever certificate as a pre-condition of entry.

Britain’s health secretary has said he isn’t attracted to the idea, while the prime minister of Greece, Kyriakos Mitsotakis, wants an EU-wide certificate for travel. His interest is likely to have been spurred by his country’s reliance on tourism. Over in America, President Joe Biden has asked for an evaluation of vaccination passports. Around the world a variety of private efforts are under way to create digital versions.

One reason for caution is that it remains unclear how much protection vaccines offer against transmission. They will clearly save lives and prevent severe illness, but some of those who receive a jab may still be able to catch and pass on the disease. Still, vaccines will probably reduce transmission significantly, and as evidence that it does so emerges, the pressure to allow the vaccinated to resume their normal lives, including travel, will grow.

Even assuming vaccinations help only a bit, some believe vaccine passports are inevitable. Arthur Caplan, a professor of bioethics at New York University’s Grossman School of Medicine, believes they are also desirable. He notes that health-care workers in nursing homes and hospitals will be required to be inoculated against covid-19, and to have proof of it. Hospital workers in many places are already required to get flu vaccines, or the hepatitis B jab, in order to protect the vulnerable patients who cannot be vaccinated, such as the immunocompromised, cancer sufferers and newborns.

Beyond this, some businesses, such as cruise ships, airlines and restaurants, will be completely hamstrung this year without vaccination passports. And many employers are already showing signs of interest in keeping tabs on those among their staff who have been jabbed. Qantas, an Australian airline, has talked since last year about making it compulsory for passengers to prove they are vaccinated against covid-19 before they board flights.

Governments seem unlikely to refuse entry completely to people without certificates of immunity, but they are likely to impose additional conditions, such as a recent negative covid test, and even quarantine in a hotel. Other airlines, including United, Etihad and Emirates, are looking at health passports that would record tests or immunisations.

But private companies, like airlines, have a lot more freedom to impose restrictions on customers, or employees, as long as they are not discriminatory. Governments face more challenges. Prioritising who gets the vaccine first, ensuring it reaches everyone reasonably equitably and reassuring the vaccine-sceptical are all politically tricky—particularly if a jab provides benefits, such as freedom of movement or more secure employment, that others do not get. Then there is the question about how to treat people who have natural immunity from an infection with covid-19. As no one knows how long protection from the virus will last, vaccine passports may expire.

Passports are also likely to create a generational divide. Most countries are vaccinating the old first. Many young people have had to restrict their lives a great deal in the past year, largely to protect their elders. It could seem particularly unfair if old folks can swan off to Ibiza this summer, while the young are stuck at home or in quarantine. Those who cannot be vaccinated for health reasons, such those who have serious allergies, may feel aggrieved at their relative confinement, too. Last, if passports come into wide use, some may feel forced to get a jab, and that their freedom of choice has been compromised.

Even so, in one recent study, more than two-thirds of British people said they would accept them. That is a surprisingly high proportion. People in other countries may well follow suit, whatever their philosophical misgivings. The reason for this might be quite simple. Tight lockdowns are so difficult to tolerate, and so economically costly, that even a slightly cracked door looks like a bright ray of hope.

Correction (February 4th 2021): An earlier version of this piece stated that immunocompromised patients could not be vaccinated against covid. This is not the case. Apologies.

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