Vaccine Passports: What Are They, and Who Might Need One?

With vaccinations against Covid-19 on the rise, attention is turning to tools that can help people prove they have been vaccinated and potentially bypass the stifling restrictions put in place to fight the pandemic.

Although the idea has met with opposition over privacy and equity concerns, there are already several types of coronavirus vaccination records, sometimes referred to as “vaccination records,” in paper and digital form. Hundreds of airlines, governments, and other organizations are experimenting with new electronic versions, and the number is growing every day, even though their use has been very limited.

Portable vaccine records are an old idea: travelers to many parts of the world, children enrolling in school, and some health care workers have long had to show them as evidence that they were vaccinated against diseases.

However, vaccination records use digital tools that take the concept to a new level, and experts predict that electronic verification will soon become part of everyday life, especially for international air travel, but also for access to crowded spaces like theaters.

Here are some of the most important questions to be asked.

In general, the term is understood to mean an electronic vaccination record, possibly in the form of a QR code, which is easily accessible via a smartphone or possibly stored on the device, but can also be printed out.

At its simplest, the documentation is a physical card created by the Centers for Disease Control and Prevention and usually given to people who receive their first Covid-19 shot in the US, or the ” yellow card “of the World Health Organization for decades by travelers vaccinated against diseases such as yellow fever. But these are on paper, filled in by hand, and are quite prone to forgeries.

The tool may need to take into account several variables: it is unclear how long it will take to vaccinate, poor batches can occur, and the emergence of new variants of the virus will likely require new vaccines. In the long run, an electronic record may need to indicate which specific vaccine a person received from which batch and when.

More than a dozen competing versions are already being developed and promoted.

In the short term, the clearest application may be in international travel, and the reason is obvious at every major airport: the number of passengers is a fraction of the prepandemic, but there are enormous lines at airline counters and passport control.

Many countries already require proof of a recent negative coronavirus test for entry. So far, this documentation has existed almost exclusively on paper or on the passenger’s phone and has to be confirmed by human eyes at the airport. Therefore, it is not possible to check in for a flight online or even at an electronic kiosk in the terminal.

As travel restrictions wear off, the volume will increase and many nations are expected to start demanding proof of vaccination (or previous coronavirus infection) to enter, or simply skip the quarantine requirement. More passengers and more documentation requirements make processing even more unwieldy.

“We need to automate this,” said Nick Careen, senior vice president of the International Air Transport Association, an airline industry trading group. “Even if compulsory vaccination has never been approved, there will still be a test requirement and we cannot do it manually.”

(Even with an electronic system, officials say there will be some people who will have to use paper health documents because they don’t have access to digital tools.)

No major country has publicly released vaccine reviews for domestic travel. However, some governments and companies are already requiring proof of a negative coronavirus test for access to certain crowded places, and some are now requiring proof of vaccination, increasing the desire for an electronic alternative.

Updated

April 10, 2021, 6:01 p.m. ET

To be most useful, a digital record would need to be widespread – from governments controlling travelers, airlines and shipping lines screening passengers, corporations restricting admission, and the conglomeration of healthcare providers, government agencies and pharmacies that give the shots.

This in turn means that it has to be easy to use and relatively inexpensive. It would be an obstacle if companies had to spend a lot of money or introduce new software.

In February, the Israeli government began issuing their digital Green Pass or physical certificate to vaccinated people. She has to enter places like hotels and theaters.

In the past month, hundreds more companies around the world – airlines, governments, drugstore chains, and others – began using privately controlled digital systems to review health records. Most use the systems – including one called CommonPass and the International Air Transport Association’s own system, Travel Pass – on a trial basis to check for negative coronavirus tests.

The systems are designed to also provide evidence of vaccination if required.

In March, Aruba and JetBlue allowed US passengers to show CommonPass, a negative test developed by the Commons Project, a Switzerland-based nonprofit organization, with support from the World Economic Forum. Lufthansa passengers flying to the USA can also use it.

In the same month, Singapore Airlines became the first airline to use the Travel Pass only to a limited extent for passengers between Singapore and London and will use it on a large scale in May.

Also in March, New York State became the first US government to introduce a system developed with IBM, the Excelsior Pass, which some venues could use to prove vaccination. Florida and Texas governors have vowed to block such a system in their states, calling it a violation of government and privacy invasion.

Iceland this month eased entry restrictions for people who have been vaccinated, and the UK is about to experiment with a vaccine review requirement to attend sporting events. So far, however, neither country has implemented a digital system.

The Biden government admits that private entities will use such systems, but says the federal government will not be involved in creating such a system. “There won’t be a federal vaccination database or federal mandate that requires everyone to receive a single vaccination record,” White House press secretary Jen Psaki said this week.

However, this does not preclude a federal agency from using a privately developed electronic health record to screen international travelers.

Many of the concerns raised are about privacy, but the people who develop the systems say they can be addressed.

For example, CommonPass and its app do not contain any health information about the user, said Paul Meyer, executive director of the Commons Project Foundation. If a participating airline needs to know if a passenger had a negative test or vaccination and a participating pharmacy has the information, CommonPass can communicate with both and return a simple yes or no answer without providing any specific data.

“You shouldn’t have to give your health record to Yankee Stadium or an airline,” Meyer said.

Many technology and health institutions have come together as the Vaccine Credential Initiative to develop a commonly agreed set of open standards. This means that the software underlying a verification system is transparent and can be easily adapted to other systems, while at the same time protecting privacy. The WHO has a similar initiative, the Smart Vaccination Certificate.

However, some companies create closed, proprietary systems that they want to sell to customers, and some appear to have access to user information.

One concern is that a variety of systems may not be compatible, defeating the purpose of making it easier to verify a person’s status.

Another objection is that any requirement to prove vaccination status would discriminate against those who can’t get the shot or refuse the shot, and there is still uncertainty about how well vaccination prevents virus transmission.

For these reasons, the WHO said this week that it does not support asking for proof of vaccination for travel – for now.

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