COVID Vaccine Passports: How They Could Work, When You Might Need One

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• What will COVID-19 vaccine passports look like?
• Could I need a COVID-19 vaccine passport to travel?
• The ethics and privacy concerns around vaccine passports

As more people receive the COVID-19 vaccine in the United States, excitement is growing for the return to activities such as attending sporting events, watching a movie in a theater, dining in at restaurants and even getting on a plane for that long-delayed trip.

On April 2, the Centers for Disease Control and Prevention (CDC) updated its travel guidelines to allow for fully vaccinated individuals to travel within the U.S. without getting tested for the coronavirus and without needing to quarantine afterward.

Yet there’s still the question of how people can return to all these activities safely and without posing a risk to vulnerable populations. There’s one idea that's gaining traction, especially in the travel industry — vaccine passports.

Essentially, these are official documents that prove a person has been fully vaccinated, and therefore poses less of a risk to others. And vaccine passports are not just being discussed within the travel industry, but also for many types of businesses where people gather. You might have seen them in the news most recently for the fact that Texas Gov. Greg Abbott has issued a ban on vaccine passports in the state, followed by a similar ban from Gov. Ron DeSantis in Florida.

But what is a vaccine passport? What would it look like, and where might you need it? Would you need a vaccine passport to travel? How might vaccine passports interact with privacy considerations, like HIPAA — the federal law that restricts the release of medical information — and what ethical questions could they raise in how they'll potentially affect marginalized communities?

KQED Forum talked with the following experts about the pros and cons of vaccine passports:

• Monica Gandhi, infectious disease expert and professor of medicine at UCSF
• David Studdert, professor of medicine and law, Stanford University
• Catharine Hamm, former travel editor at the Los Angeles Times
• Alexis Hancock, staff technologist, Electronic Frontier Foundation

What Is a Vaccine Passport?

The term “vaccine passports” is currently used very loosely — and it’s unclear what they would actually look like in the U.S., said David Studdert, professor of medicine and law at Stanford University.

“It’s really a form of certification that says the bearer of this thing has completed vaccinations,” Studdert said. He added that passports will likely be in electronic form: “Like a QR code on your phone. But it could be in paper form, too."

“The idea is this would be something that you carry with you, and it would certify your ability to participate in certain kinds of activities. The big question is: which activities? And who is going to be demanding it?" Studdert asked.

A critical element of a vaccine passport is that it would need to be standardized.

“The move towards a passport or some more formal certification would essentially elevate this to the status of a formal document,” Studdert said. “But gathering all that information from all the vaccination sites around the country, from the counties and from the states, and ensuring that the right people are given the right authorization is a gigantic undertaking, and one that I think the government will need to guide very carefully.”

Do Vaccine Passports Exist Already?

Currently, broad vaccine passports don’t exist in the U.S. And with just 17.5% of the U.S. population now fully vaccinated, according to the CDC, this talk around vaccine passports might be premature, said Dr. Monica Gandhi, infectious disease expert and professor of medicine at UCSF.

“There are people desperate to get the vaccine who have not been able to get the vaccine yet, we're sort of in this transition period in terms of availability,” Gandhi said. “Right now, we're already having a kind of two-tiered system where those who are vaccinated feel more safe and those who aren't, don't."

That said, early iterations of a vaccine passport are already being seen around the world. New York just launched the Excelsior Pass, which proves an individual has been vaccinated or recently tested negative for the virus. The pass will initially be accepted at Madison Square Garden and will eventually be used at various venues statewide.

Countries in the European Union are developing a passport that would allow for more travel for its citizens who have been vaccinated or tested negative for the virus. Meanwhile, Israel’s green passports allow holders, who have been vaccinated or recovered from the coronavirus, to participate in entertainment and social gatherings.

The airlines industry is testing a tool called the IATA Travel Pass, which verifies if a traveler meets all COVID regulations during a trip.

The corporate travel management platform TripActions has also built an app where users can upload necessary documentation for domestic and international travel, that can essentially be used a health passport.

Will I Need a Vaccine Passport to Travel?

Travel, schools and health care are among the handful of areas where vaccines have been required, historically.

Vaccine passports are widely being discussed in the context of the travel industry. Studdert said many countries including the U.K., Australia and those in the EU are developing the passport idea around travel.

Catherine Hamm, former travel editor with the Los Angeles Times, said it’s still unclear whether vaccine passports would replace rules and restrictions that are currently in place for travel.

“I would think that if passports become common, and given the number that are under development, that seems likely, I think that those will be in addition to the rules,” said Hamm.

But she said whether not being vaccinated will prevent people from engaging in activities they’re not supposed to remains unclear.

“The only thing apparently in the pandemic that is certain is that there is uncertainty and confusion about what we can and cannot do, particularly as it relates to travel,” Hamm said.

What Activities Could I Need a Vaccine Passport For?

Businesses outside of travel are also considering how useful vaccine passports might be. And Studdert said he suspects that we'll see the vaccine passport technology and protocol coming out of the travel sector subsequently spreading to other areas of life.

Studdert notes, however, that there's a difference between requiring a vaccine passport for essential activities and requiring one for non-essential activities. And he doubts that the United States will see any regulation at the state or federal level around vaccine passports for essential activities, given the "legal questions and ethical questions there."

But when it comes to non-essential activities, like "going to the theater, or to a sporting event or to a restaurant in a bar," Studdert thinks the case for businesses and premises being allowed to require vaccine passports is "a harder case to oppose.” "I think that we allow that kind of thing for lots of activities in our society," Studdert said.

Whatever businesses decide, Studdert said it’s important for the government to regulate the practice and ensure that certain groups are not being discriminated against, by a place using vaccine passports as "a pretext for excluding certain groups."

What Are Other Ethical Issues Around Vaccine Passports?

The pandemic has impacted poor, Black and brown communities disproportionately in every aspect. Not only do these communities have less access to COVID-19 testing, but workers in those communities are usually the ones doing frontline essential work, and are therefore more at-risk.

BIPOC communities also have less access to vaccines. And vaccine passports will further exacerbate those inequities, said Alexis Hancock, staff technologist with Electronic Frontier Foundation.

“We've seen disparity between people who have gotten COVID and died from it, we've seen disparities with people with testing, and now we're seeing disparities with vaccines. They're not widely available yet,” Hancock said.

“Not everyone has a smartphone. And we've already seen people not being able to actually access vaccine appointments, because of technology barriers.”

What About Privacy and Vaccine Passports?

Hancock said vaccine passports also bring up questions around data collection depending on who issues them — whether it’s the government or a third-party company.

“Digital vaccine passports build an infrastructure and culture of mass surveillance," Hancock said.

He notes that while there's absolutely precedent for requiring proof of vaccinations for certain diseases for international travel, or for having your medical information stored by your school or place of work, by contrast we're now seeing a "scope creep" around this data: "beyond international travel, beyond workplaces and schools, and it's going to restaurants, talking about getting services and libraries and access to that.”

What's more, Hancock said it’s important to think about how data will be stored and what happens to that information long-term.

“It could step outside of HIPAA regulations. It won’t necessarily be the medical record that you have to keep confidential between you and your health care provider, and you decide to share the information upon your own volition,” Hancock said.

“We have very variable privacy laws when it comes to our data. Some people out there may be saying, ‘Well, it's just showing that I'm vaccinated. What's the big deal?’ It’s the fact that you're sharing medical data outside the context of the normal protections.”