Vaccine passports

There are a multitude of ethical issues for consideration. The lessons of the mortality rate of the pandemic haunts everyone.

by Victor Cherubim   

As countries around the globe ramp up vaccine roll out and some are having to pursue a vigorous “vaccination persuasion” effort in line to balance early social mixing, the hope is that travel could start again soon with vaccinations.

Most people would like to think COVID-19 as a one-off event in history that will be paid off over a couple of generations, or sooner. Yet others are rather sceptical. 

Some people, in fact some governments think that Immunity Passports – a universal document - to show proof of vaccination(s) - would be an ideal way to reopen not only travel, but countries and back to work.

Governments know that people have money and until they spend it, the economy will be in a slump. People on the other hand want to spend their cash but not to splash it about for fear of not being trapped again.

The attraction to Vaccination Passports  

Vaccination Passports introduction is being considered by several countries including UK, Denmark, Estonia, Italy, Chile, and Canada, but they are not rushing headlong to issue this authorisation either in the form of a document or otherwise, for many understandable safe reasons. Israel, however, has gone ahead and issued their own “Green Document” the Immunity Passport, ahead of others. 

We know that Health Certification Vaccination for public health purposes is already in use worldwide, especially for the management of Yellow Fever, but there is hesitancy in issue for Coronavirus. 

Vaccination Passports, we are told could take different forms, such as Smart Phone application (APPs), Wrist hand band identification, or even a Certificate to be used to confirm international travel, stating a particular individual is at low risk of acquiring COVID-19 or transmitting it, without testing each individual traveller on arrival or quarantine. This Immunity Passport could also be used during lockdowns permitting workers to return to work, or even care for those at risk to supplement Test and Trace.

Whether this strategy should be pursued depends on both scientific evidence and ethical reasoning. Regarding scientific evidence, it is the degree of immunity and the duration of this immunity, that is the main concern. The doubt is whether it is a short-lived immune response or whether it is an “antibody response “which may persist for many years, is still unclear.

Beyond scientific evidence -the ethical view

In the absence of an immunological correlation of protection there is concern. All we know from Science is that Vaccine induced immunity can produce some protection. But it is too early for researchers to assume a more predictable pattern and duration of immunity over the years with just two doses of vaccine. 

As far as the ethical issue of immunity, this becomes one of timely access to vaccination for everyone or much of the population.

Some have argued that Vaccine Passports are unethical and impractical due to the uncertainties relating to COVID-19 immunity, testing, tracing, and the doubtful economic benefits and particularly the risk of discrimination.

There are also practical problems, the vulnerable and the poor or poorer nations may be left out or behind, or that people in richer nations could face losing their jobs or be barred from essential shopping, if they cannot produce proof of vaccination. 

There are a multitude of ethical issues for consideration. The lessons of the mortality rate of the pandemic haunts everyone.

Further, removing civil liberties of a people is considered unjustified. We know many black and ethnic minority population of UK have yet to make up their minds on vaccination. The Queen too has spoken on the take up of vaccination by the undecided. 

This trepidation has been due to many reasons not least as vaccination up to now is by free choice. Black and Ethnic minorities may have their own reasons, some due to their residential status as migrants, some being illegal in residence, some for ethical or health concerns.

Behavioural scientists are worried granting a portion of the population more freedoms ahead of others during lockdown before everyone gets a chance to be vaccinated, is wrong. They state this would seriously undermine civil liberties, which unlike many Asian nations matters, much more in the so-called West. Whether we in the East accept it, is yet another matter. 

Then there are those who cannot be vaccinated due to underlying health conditions. They may be exempt, with a notification on their Certificate   that they cannot be vaccinated.

It is also the belief that these privacy concerns are not insoluble, through modern day technological advancement. 

Challenges relating to the implementation of Vaccine Passports ought to be met with targeted solutions to maximise their overall benefit as their forced introduction would exacerbate existing inequalities with marginalised groups subject to more scrutiny and perhaps, racism. 

Next logical step, among the options available? 

Of course, many feel that Vaccination Passports is seen as the next logical step after negative COVID-19 tests, to get the travel sector up and running. 

Some others maintain Vaccination Passports will be inevitable and/or even mandatory. 

One idea in UK Government is to adopt the NHS App to hold proof of “Vaccine Status” and test results, with encryption to keep data secure and facial recognition to stop it be borrowed.

There are many benefits for Vaccine Passports but at the same time there are also challenges. The pandemic has provided many ways of new thinking. Everything today is a measure of proven efficacy rather than only a passport to freedom.