The ethics of vaccine passports
Covid-19 ‘vaccine passports’ have been floated by many governments as a way to reopen society and permit individuals’ entry into public spaces without causing another spike of disease. But experts have dismissed the notion on a number of grounds, including discrimination against those who can’t get vaccinated for medical reasons, data protection and human rights laws. Medical Technology writers Chloe Kent and Eloise McLennan argue for and against the proposal.
Vaccine passports for international travel make sense, but a domestic rollout would be unethical
Those who have had both Covid-19 vaccine doses are far less likely to contract or transmit the disease. As such, the US Centers for Disease Control (CDC) have officially ruled that people who are fully vaccinated may once again gather in their homes together without wearing masks. They can also meet up indoors with unvaccinated people from one other household, as long as none of the unvaccinated people are at risk of severe illness should they come into contact with the SARS-CoV-2 virus.
But what of meeting in public venues? Governments worldwide are considering the introduction of so-called ‘vaccine passports’, documentation proving inoculation against Covid-19, to safely reopen society. This could take the form of a physical document, or more likely a QR code stored on a smartphone.
A growing number of countries have already introduced some sort of vaccine passport for international travellers, with EU leaders backing the introduction of a ‘Digital Green Certificate’ to allow those who have been fully vaccinated against Covid-19, recently tested negative or recently recovered from the virus to travel across all 27 member states.
These passports are by and large intended to allow travellers to bypass the otherwise mandatory testing and quarantining currently needed to cross international borders, while these restrictions still exist.
In both the US and the UK, people from some ethnic minority communities are more likely to be vaccine-hesitant.
It’s hard to say how long they may need to continue for and introducing a Covid-19 vaccine passport to allow holidaymakers direct access to the country could go a long way toward stimulating the many economies that rely on tourism to keep afloat.
Requiring – or at least strongly recommending – certain vaccinations before visiting certain countries is something many travellers will already be familiar with. This is particularly true of countries with more limited resources. In cases such as these, a Covid-19 vaccine passport could make a lot of sense.
Even once international travel becomes more feasible, there are nations that are likely to be further behind in their vaccine rollout than others and less able to cope with an unexpected outbreak. Making sure all foreign visitors are inoculated against Covid-19 would help to keep both the country in question and the tourists safe.
But the term ‘vaccine passport’ is a fairly nebulous one that has been applied to more situations than just international travel. The idea of vaccine passports has also been floated as a requirement to attend mass gatherings like concerts, or even for more everyday occurrences like visiting a restaurant or cinema. This is where the ethical issues surrounding the topic get murkier.
A nation that has not offered a vaccination to all of its citizens, but then introduces a vaccine passport for domestic use, would be unfairly discriminating against significant chunks of society.
Given that most nations are rolling out their vaccines based on some sort of priority system, introducing a vaccine passport could leave many people behind until it’s their turn – effectively barring them from public life.
We also know that, in both the US and the UK, people from some ethnic minority communities are more likely to be vaccine-hesitant due to historic mistrust in the medical industry, meaning a vaccine passport could end up inadvertently discriminating against people on the basis of race.
Covid-19 vaccine passports in the case of international travel make a lot of sense under the right circumstances, but domestic use of such a technology could open the door for unacceptable discrimination.
Vaccine passports aren’t ideal, but they may help boost uptake
When the first Covid-19 vaccine candidate was unveiled to the public, one of the key concerns surrounding the jab was adherence.
Vaccine hesitancy has been a growing problem in recent years – thanks in no small part to the surge of misinformation being spread across social media – but for society to progress beyond this pandemic, the majority of patients must be willing to receive a vaccine.
Convincing patients to inject something into their body is not always easy, especially when they are surrounded by confusing and often contradicting information. One way to solve this is to provide an incentive. Vaccine passports, while not ideal, could be a way to incentivise the public to not only accept a vaccine, but to return for their second dose.
This is crucial if we are to come out of lockdown permanently as vaccination significantly cuts the risk of catching and spreading Covid-19.
For society to progress beyond this pandemic, the majority of patients must be willing to receive a vaccine.
Understandably, the use of vaccine passports in social settings is controversial as the distribution of vaccine doses has not extended to every patient, but in specific high-risk situations they could be highly impactful. For example, for those who have waited over a year to visit loved ones in care homes or in hospital.
In fact, a survey by Ipsos MORI of more than 8,300 people aged over 16 in the UK found 78% were in favour of vaccine passports to travel abroad or to visit a relative living in a care home.
Outside of health scenarios, the use of digital vaccine passports becomes more controversial.
People are, quite rightly, debating the privacy and ethical issues of introducing a system that could segregate the population and leave behind those at the bottom of the vaccination list.
These are serious issues, but a digital vaccine passport is not inherently good or bad. It is merely a document that records your vaccination status, something that your health records already show. We have already seen how quickly masks were adopted once they were enforced by private businesses, even with pushback from anti-mask groups.
At the moment, few countries are legally enforcing the use of vaccine passports for domestic purposes. Consequently, it is up to each individual organisation to either demand adherence or ignore their existence, as has been seen with track and trace services. But if having a QR code that can help to protect the public and get us over the hurdle on the way back to some sort of normalcy – isn’t it at least worth trying?