William Miller, MD
Updated: Jul 14, 2021
As countries around the world struggle to reopen their economies in the face of this pandemic, proof of vaccination is being looked at as a way of doing that safely. The idea is that once a person is fully vaccinated against COVID, they would be given a certificate, some people are calling it a passport, proving that they have been vaccinated. This could be a paper certificate, but more likely would be a digital one with a scannable code that is downloaded onto your smart phone. For those without a smart phone, a paper print out with the scannable code could be used. This is like how boarding passes at airports and tickets for entertainment events now work; most of us simply present our phone at the entrance for scanning or print out a copy of our ticket with the code.
Businesses could require such proof before allowing a person entry, thereby allowing them to increase their legal capacity if they are only open to vaccinated persons. It might even boost business, at least from those customers who would feel safer to patronize a location where everyone else is also vaccinated. Obviously, the opposite, negative effect would be barring those who have not been vaccinated.
The travel industry is looking at this, in particular airlines and cruise ships, as a means of resuming normal operations. Opening boarders to international travel is another significant benefit. This might help large entertainment venues such as movie theaters and sports events to reopen at larger capacity seating. Universities are considering requiring students to show proof of vaccination before returning to in person learning or living in a dormitory. Employers may also expect it, such as in healthcare settings and restaurants.
The concept of requiring documentation of vaccination is not new. Last year, the University of California system required all students and staff to demonstrate that they had the flu shot. Most states, including California, require hospital workers to show proof of a whole host of vaccinations, including the flu shot.
Several countries are in the process of setting up a COVID vaccine passport system. Israel, which has the highest COVID vaccination rate in the world, started such a passport system in February. The European Union is planning to have one in place by this summer for its 27 member countries. The UK is considering it as well. California recently published new guidelines for some businesses that would allow higher caps on patrons if access is limited to only those who are vaccinated. For example, a theater in an orange-tier county would be capped at 15% indoor capacity, but if the operator of the theater required proof of vaccination or a recent negative COVID test, then the allowed capacity would more than double to 35%. Such considerations could mean the difference between a business being able to generate enough volume to reopen versus staying closed and risking going out of business.
However, there are many challenges to such a passport system. First, it would likely need to be digital so that confirmation of vaccination would come directly from a government health organization and thus avoid the chance of forgeries such as with the current vaccine ID card being issued now. Setting up a digital authentication system that communicates across multiple platforms is challenging. It will also have to protect a person’s privacy. A concern is how requiring vaccination for something like travel could end up discriminating against people who cannot yet get the vaccine or who choose not to. Worries are also raised that this will open a pandoras box where government could extend this to more than just COVID.
In America, where we are fiercely independent, such considerations are already becoming politicized. Texas and Florida, with Republican held state leadership, are taking steps to ban any requirement for proof of vaccination by businesses in their states. Meanwhile, New York and California, with a leadership majority that is Democrat, are heading in the other direction and considering requiring it. Unfortunately, this may become as divisive as mask wearing mandates with the end result being more confusion, frustration and anxiety instead of what is really needed which is a unified approach to this pandemic.
Despite the issues on both sides around requiring proof of vaccination, we should not loose sight of the fact that these vaccines are the most important development in fighting the pandemic in a way that also preserves our economy; something that stay at home lockdowns and restrictions on businesses do not do.
“What a miracle for us to live in a time when we can see a vaccine against an epidemic be developed so quickly and to be so effective,” said Sue Symonds, microbiologist at AHMC. “This is amazing, the vaccine is our real chance of getting ahead of this. Without it, the pandemic would probably kill two or three times more people before it is over.”