“Vaccine passports” are coming. Will they guarantee our access to public space, or segregate society?
Like many activists and social change-makers, we are obviously keen to be able to get back out into spaces - interior and exterior - where we can build our connections and community power in the best way, face to face and hand in hand. So we are open-mindedly, but with full caution, interested to hear where there might be some advances.
The march of vaccination rates across European countries has encouraged nations, and the continent, to begin to think of “vaccine passports”. These are digital verifications of people who’ve been double-vaccinated, and thus regarded as both less vulnerable to infection, and less able to transmit it.
There are obvious pressures from various industries - particularly airlines - to make such a passport viable. From Monday 17th of May, your NHS app will allow you to display your double vaccination in a verified way, to passport authorities in other countries (but eventually to venues and establishments). The EU is realising the idea of a “Digital Green Pass” by the end of June.
We’re excerpting from a few viewpoints on this - there are possibilities and anxieties aplenty around the idea of a bio-passport of any kind, and we should be both ambitious and vigilant.
The first piece is from The Conversation UK, written by Barbara Jacquelyn Sahakian and Christelle Langley from Cambridge, and Julian Savulescu from Oxford/Melbourne. It argues generally that a VP is “good for society”:
As more and more people get vaccinated, some governments are relying on “vaccine passports” as a way of reopening society. These passports are essentially certificates that show the holder has been immunised against COVID-19, which restaurants, pubs, bars, sports venues and others can use to grant them entry.
Israel currently operates a “green pass” system, which allows vaccinated people access to theatres, concert halls, indoor restaurants and bars. The UK government, had to roll back plans to trial vaccine passports after some of the venues involved experienced significant backlash against the proposals [but see notes above].
This is perhaps not surprising – vaccine passport schemes are controversial, with some arguing that they will reinforce inequalities. But there is an ethical case for using some form of certification of COVID status, as long as it is designed properly and as long as everyone has access to vaccines.
Let’s look at the ethics of vaccination and certification.
The duty of easy rescue has been used to make the case for public health measures, including the use of health records and the donation of blood. As a society, we have a collective duty of easy rescue.
For example, if each person in the population who was eligible could donate a few millilitres of blood easily (say some vial was created that could be posted to each person), and collectively this would solve the blood supply shortage, then each person ought to donate a few millilitres of blood. Doing so would literally be life-saving, at no cost and minimal discomfort to the donors.
The duty of easy rescue is what is known as a minimal theory of moral obligation. To understand this theory, philosopher Peter Singer famously described the following thought experiment:
If you are walking past a shallow pond and see a child drowning in it, you ought to wade in and pull the child out. This will mean getting your clothes muddy, but this is insignificant, while the death of the child would be a tragedy.
The thought experiment illustrates a situation in which a person can benefit another greatly at minimal cost.
This is currently the case for COVID-19 vaccinations. There is an extremely low risk of serious side effects with the COVID-19 vaccines. So it is not just a safety for oneself and a kindness to others, but a moral obligation to be vaccinated.
Equally, vaccination passports are a minimal cost for returning to normal daily life and for reducing anxiety for those you come into contact with on aeroplanes or in theatres, restaurants or public stadiums. They are a small sacrifice for a greater good.
A duty to ensure health
Governments also have a duty to ensure good public health. For example, in the UK, the US and elsewhere, governments have made smoking illegal in enclosed places because of the risk to public health due to passive smoking.
Studies have shown that smoke-free legislation has been associated with reduced heart attacks related to passive smoking. The danger of being enclosed with individuals with COVID-19 in close environments is similar – in fact, COVID-19 presents a far greater danger to life than passive smoking.
Making room for exceptions
The relatively small group of people who are unable to have vaccinations for health reasons should still be given a form of passport that indicates this is the case, and this should not be the basis for refusing them access to events or venues.
In fact, as with vaccination in general, the existence of these excepted groups makes it even more important that those of us who can get vaccinated do so to protect the whole community.
More than simply helping to reopen the economy, vaccination passports provide a way to allow those who have had to shield during the pandemic, and may have experienced social isolation and loneliness, to have social contact with other members of society without fear. They will also facilitate access to care homes to allow for ease of visitation for families who have been separated for too long.
As members of a society, it is our moral obligation to get vaccinated to protect everyone in our community. Vaccination passports will help with this and also enhance quality of life and wellbeing as we return to normal daily life.
On the other side of the argument, a piece in Open Democracy, which urges caution on the basis of scientific reports, social inclusion
Faulty science behind vaccine passports
The certificate relies on the assumption that those who have been vaccinated no longer carry the virus.
However, current scientific evidence suggests that while the approved COVID-19 vaccines stop disease, they do not entirely stop transmission, as shown by the multiple cases of vaccinated health care workers in Italy (and elsewhere) testing positive for the virus. COVID-19 vaccines – like all vaccines – prevent disease, not infection.
The vaccines approved for use in the EU are effective at preventing disease and thus the symptoms of COVID-19. Reducing the symptoms of the disease reduces the potential rate of transmission by those who have been vaccinated, but that does not make them fully ‘safe’ for non-vaccinated others.
This is why epidemiologists insist that until a large enough percentage of the population is vaccinated, all other containment measures, such as wearing masks and social distancing, must continue to be observed.
Priority categories: who are the frontline workers?
Such differences are multiplied when we examine how different member states select priority groups for vaccination. After the highest-risk categories such as medical personnel and the aged, each state is free to decide subsequent categories. Indeed, the definition of ‘essential’ or ‘frontline’ worker is not the same across the EU.
For example, while Italian and Austrian school teachers and university lecturers are already being called up for vaccination, those in the Netherlands will have to wait for several more months.
The question of vaccine access is even more vexed for those millions within Europe whose formal status does not correspond to their current place of residence. This includes both intra-EU migrant and incompletely documented or partially regular non-EU immigrants. All these individuals are currently excluded from access to vaccination, which will likely drive creation of a vaccine black market.
In the absence of equitable public access, private demand for the vaccine is set to grow. Witness vaccination packages to the UAE and India, while Lufthansa recently announced that it is considering offering ‘vaccine flights’ to Moscow.
Travel sector associations such as IATA are also teaming up with tech giants Microsoft and Oracle to create new digital health passes, as noted by The Economist in its recent report on ‘The Future of Travel’, which predicted that “health information will become as vital to international travel as a passport is today”.
A public or private health good?
The ability to ‘jump the queue’ by paying a large amount of money for a vaccine raises another fundamental legal question: shouldn’t vaccines be considered a public health good, and regulated as such?
Creating a system that incentivises private access (which is what an EU-wide vaccine certificate would do) is highly problematic: both from a legal/ethical point of view, but also from an epidemiological one. As Wolfgang Münchau noted in his piece on ‘vaccine elitism’ (commenting on the unwillingness of some German citizens to have the Oxford/Astra-Zeneca vaccine), vaccines are a textbook public good: “your protection does not arise from receiving a better vaccine than your neighbours. It arises from all your neighbours receiving a vaccine, so that they don’t infect you in the first place.”
There are other legal and regulatory issues. According to preliminary discussions, non- EU travellers vaccinated with Chinese or Russian vaccines, which are not approved by the European Medicines Agency, would not qualify for the Digital Green Pass. This would automatically exclude citizens of Turkey or Serbia where these are the principal vaccines in use, but potentially also people from EU states such as Hungary, which has purchased both the Chinese Sinopharm and Russian Sputnik V vaccines.
A security ‘fetish’
The key question is, what is the rationale behind the Green Pass? If it is to prove the safety of individual travellers, then current scientific evidence urges caution. Or is it an economic rationale that prioritises travel and tourism at the expense of the safety of other Europeans?
It seems more a performance of security than a credible policy option; a fetish that allows EU politicians to offer their citizens a physically tangible illusion of control.
Rather than investing in a fetish, the EU should work even more closely with member states to boost vaccine production capacity and ensure equitable distribution (forbidding national stockpiling and ‘vaccine nationalism’), while also establishing EU-wide categories of priority groups.
The COVID-19 pandemic has had profoundly unequal effects across the European Union. The EU and its member states should focus on addressing these impacts, rather than contributing to creating additional layers of inequality through an exclusionary sorting mechanism, which is what the vaccine certificate would amount to.
The Digital Green Pass might seem like a good solution to governing pandemic risk – but it is based on profiling that has less to do with actual viral risk than simply with unequal access to vaccine-privilege.
Ron Hauge
To complete the picture, have a look at The Ada Lovelace Institute’s series of conditions and checklists before any government (or administrative structure) launches a “Vaccine Passport”:
Checkpoints for vaccine passports: Science and public health
Prior to deploying a vaccine passport system, it is essential to have scientific confidence in its impact on public health
Checkpoints for vaccine passports: Law, rights and ethics
Legal and ethical issues should be weighed in advance of any roll-out of a vaccine passport system, with guidance, oversight and regulation needed.
Checkpoints for vaccine passports: Sociotechnical design and operational infrastructure
Designing a vaccine passport system requires much more than the technical design of an app, and includes consideration of wider societal systems
Checkpoints for vaccine passports: Public legitimacy
Public confidence will be crucial to the success of a COVID vaccine passport system, and will be highly locally contextual
Checkpoints for vaccine passports: Purpose
It is important that governments state the purpose and intended effect of any COVID vaccine passport scheme