Vaccine Passports during the COVID-19 Pandemic
A vaccine passport or proof of
vaccination are immunity passports which have been employed as a credential in
a number of countries and jurisdictions as part of efforts to control the
COVID-19 pandemic via vaccination. They are typically issued by a government or
health authority, and have consisted of a scannable barcode, QR code or are
accessible in paper form or as part of a mobile app. They may or may not use a
COVID-19 vaccine card as a basis of authentication. As of 5 October 2021, more
than 46 percent of the world population has been vaccinated with a COVID-19
vaccine.
The use of vaccine passports is
based on the general presumption that a vaccinated individual would be less
likely to transmit SARS-CoV-2 to others, and less likely to experience a severe
outcome (hospitalization or death) if they were to be infected, thus making it
relatively safer for them to congregate. They are typically used in tandem with
policies enforced by individual businesses, or enforceable public health
orders, that require patrons to present proof of vaccination for COVID-19 as a
condition of entry or service. There may be exceptions to such mandates if a
person is incapable of being vaccinated for valid, however extremely rare medical
reasons, while some countries may also allow them to be issued to individuals
deemed to have developed immunity to SARS-CoV-2 by means of a past infection.
Government-mandated use of vaccine passports typically apply to discretionary
public spaces and events (such as indoor restaurants, bars, or large-scale
in-person events such as concerts and sports), and not essential businesses
such as retail stores or health care (although they may very by region).
In jurisdictions like France,
Italy, Ireland, and Canada, vaccine uptake increased after various levels of
governments announced plans to introduce vaccine passports. Despite the
benefits of vaccination in improving economic and social problems caused by the
pandemic, vaccine passports are controversial and have raised scientific,
ethical and legal concerns. Critics also argue that vaccine passports violate
civil liberties. In the United States, there is no vaccine passport at a
federal level, and some US states have preemptively banned vaccine passports in
certain public and/or private sector contexts. England canceled a planned
vaccine passport program in September 2021.
Many governments including
Finland, and Germany, expressed early interest in the concept. Vaccine
passports were seen as a potential way to permit a faster economic recovery
from large-scale lockdowns that apply to all residents (especially within the
travel and tourism industries), improve the confidence of patrons concerned for
their health and safety, and to incentivize vaccination in order for a
population to potentially reach "herd immunity". In May 2020, Chile
started issuing "release certificates" to patients who had recovered
from COVID-19, but "the documents will not yet certify immunity".
Many governments including Finland, Germany, the United Kingdom, and the United
States expressed interest in the concept.
By Region
Azerbaijan Azerbaijan
requires proof of vaccination for people over 18 to enter virtually all public
spaces. This policy began 1 September 2021. A federal mandate has also required
all state regulated workers to be vaccinated as of 1 October 2021. Despite this effort, a report suggested there
was evidence of fraudulent vaccine passports created by bribing healthcare
workers.
Brazil In December 2020,
the Brazilian Senate approved a document giving digital proof of all
vaccinations - not just those in respect of COVID-19. However, the urgency for
creating such a digital proof of vaccination came from the COVID-19 pandemic.
Canada
Vaccine passport status in
Canada:
Grey = No plans for a vaccine
passport
Yellow = Partial vaccine passport
Blue = Vaccine passport or plans
for a vaccine passport
On a nationwide level, Canada
will implement vaccine mandates for people 12 and older on all federally
regulated travel including airplanes, trains and cruise ships. Anyone using
these methods of travel must be fully vaccinated by 30 October 2021, or show
proof of a negative test. After 30 November 2021, the testing accommodation
will no longer be an option. All 10 provinces in Canada, and two of the three
territories, have currently implemented or announced plans to implement a
provincially-regulated COVID-19 vaccine passport. Each province has a different
system in place with their own rules and regulations.
Alberta In Alberta, the
Restrictions Exemption Program was introduced in September 2021 due to rising
cases in the province. It applies to eligible venues and events, and is
described by the government as an opt-in system allowing them to operate with
fewer restrictions they mandate vaccination of patrons. If a facility does not participate,
they are required to comply with all public health orders, which as of
September 2021 restricts maximum capacity to one-third, and prohibits the
operation of dine-in restaurants. Later that month, the city of Calgary
passed a municipal bylaw requiring all eligible industries to participate in
Restrictions Exemption Program.
Manitoba was the first
province to introduce a passport system in Canada on 17 July 2021. The passport
requirement was removed for movie theatres, museums and galleries on 7 August
2021, only to be reinstated on 3 September 2021, upon Manitoba expanding its
passport system. The province utilized physical Immunization Cards which faced
supply shortages in production.
Quebec was the second province
to implement a vaccine passport system on 1 September 2021, using QR codes.
Northwest Territories will
implement an opt-in vaccine passport system on 22 October 2021 using original
vaccination receipts.
British Columbia has
created a Proof of vaccination system which utilises a QR code. The system
initially relied on paper receipts of the BC vaccine receipt and gradually
migrated to a digital system. The QR code can also be physically printed out.
New Brunswick requires a
Proof of Vaccination system using original immunisation records.
Newfoundland and Labrador
has plans to release a QR code based system for their vaccine passport.
Nova Scotia has a Proof of
Full Vaccination Policy using original government issued proof of vaccination.
Ontario introduced a
passport system on 22 September 2021. The system relies on original vaccine
receipts and on 22 October 2021, will migrate to verifiable QR codes.
Prince Edward Island uses
the PEI Vax Pass Program using original government issued vaccination
information.
Saskatchewan has a Proof
of vaccination mandate effective October 2021, using either the
government-issued vaccination receipts, or a digital or printed health record
with QR code.
Yukon territory will
implement a passport system beginning November 30, 2021 to access non-essential
indoor facilities.
China In February 2020,
China started to use digital "health codes", available on a variety
of platforms including WeChat and Alipay with scannable QR barcodes displaying
a "traffic light" system of colours to enter public transport, shops,
restaurants and malls. It was used 40 billion times between February and March.
In March 2021, an "International Travel Health Certificate" was
created. In March 2021, the government of China rolled out the world's first COVID-19
vaccine passport system through a partnership with Alipay and WeChat. The system provides a
health certificate that includes an individual's vaccine status and the results
of COVID-19 testing. Initially, the system would only indicate that an
individual had been vaccinated if they received a Chinese-made coronavirus
vaccine, leading to criticism, though by April 2021 the system began to accept
records of receiving the Pfizer-BioNTech, Moderna, and Janssen vaccines. As of
March 2021, the app was optional and its use was restricted to Chinese
citizens. The digital health passport is intended to better facilitate travel.
Privacy advocates and Chinese netizens have expressed concerns regarding the
potential invasive data collection and the use of data for non-health
monitoring purposes.
Denmark Denmark introduced
a Coronapas on 21 April 2021. Those unvaccinated with a recently negative test
of 72 hours or previous infection of COVID-19 of up to 12 weeks prior were
included in the pass system. Due to high uptake of vaccines, Denmark retired
their system on 10 September 2021.
European Union
The European Union offers a EU
Digital COVID Certificate (EUDCC), a digitally-signed proof of vaccination,
proof of a recent recovery, or a recent negative test, for use when travelling
within the Schengen area with fewer restrictions. It launched in July 2021, and
is applicable for citizens of the EU, and also for travelers from outside of
the region. In October 2021, Johannes Bahrke, the European Commission's digital
spokesman, said the EUDCC "set a global standard by being the only system
currently in operation internationally". Since the July 2021 launch more
than 591 million certificates had been issued, 438 million of them on the basis
of vaccination. Some EU countries, such as Hungary, started to recognize
digital vaccine passports from outside of the EU, including from Kazakhstan.
However, those certificates are not applicable in the Schengen area.
France France issued a
Health Pass (or Pass Sanitaire in French) on 9 August 2021, for use in
non-essential settings for those 18 and older. To obtain the pass people must
be fully vaccinated or undertake a test within 72 hours of attending a
non-essential space or have recovered recently from an infection of the virus. The
initial announcement of the pass system is believed to have encouraged an
additional one million people to sign up for vaccination the day following the
announcement,and is credited to encouraging a further 3.7 million people to
sign up for vaccination in the following week. Following 1 October 2021 the
pass requires anyone 12 and older to be vaccinated to attend certain
non-essential venues
Ireland In July 2021,
Ireland introduced a vaccine certificate program (EU Digital COVID Certificate)
which allowed vaccinated individuals to attend cafes, bars and restaurants. Due
to one of the highest uptakes of COVID-19 vaccines in the world, the Republic
of Ireland (but not Northern Ireland) has plans to retire their vaccine
passport program on 22 October 2021.
Israel Israel was one of
the first countries to issue what is known as a Green Pass in February 2021.
The pass was discontinued on 1 June 2021, but following a surge of new
infections, it was reinstated on 29 July 2021. In October 2021, all existing
Green Passes were voided if the most recent shot was administered more than 6
months ago. To obtain a new valid pass and to be considered "fully
vaccinated" in Israel, the holder would need to show proof of a third (or
booster) dose of a vaccine or show proof of a recovery within the past 6
months. This change affected more than a million residents who had previously
been regarded as "fully vaccinated". A temporary Green Pass can be obtained with a
negative viral test, but must be paid for by the individual unless they are not
eligible for vaccination.
Italy
In August 2021 the Italian
government extended the requirement of the EU Digital COVID Certificate, also
known as "Green Pass", to the participation in sports events and
music festivals, but also to the access to indoor places like bars, restaurants
and gyms, as well as to long-distance public transportation. On 15 October,
Italy became the first country in the world to establish a mandatory COVID-19
vaccination certificate for the entire work force, public and private.
Japan On 19 July 2021,
Japan began accepting applications for its COVID-19 vaccination passport
program. When issued, the passports will be in paper form in both Japanese and
English, showing the holder's date(s) of inoculation and the vaccine type, and
are available free of charge. As of 22 July 2021, Japan vaccine passport
holders are exempt from entry restrictions in Austria, Bulgaria, Italy, Poland,
and Turkey. South Korea will also exempt those travelling for specific
business, academic, or humanitarian reasons. Entry is also facilitated by
Germany; Honduras; Hong Kong; Lithuania; St. Kitts and Nevis; St. Vincent and
the Grenadines; and Thailand's islands of Phuket, Samui, Ko Pha-Ngan, and Ko
Tao. Japan is in negotiation with other countries (including China and the
United States) to accept the passport.
Morocco currently has a
nightly curfew between 23:00 and 04:30 pm, people who are fully vaccinated are
exempt from curfew.
North Macedonia Residents
wishing to attend events, bars, restaurants, and other dining establishments
must present proof of vaccination.
Saudi Arabia Residents
attending restaurants, cafes and public spaces like malls, shopping centres and
markets must be fully vaccinated. The country uses the Tawakkalna app which
includes information for health appointments, vaccination status and alerts
users to COVID-19 exposure for contact tracing purposes.
Ukraine In Ukraine,
citizens with at least one dose of a vaccine are allowed to attend certain
high-risk indoor settings which would normally be closed or heavily restricted
in hot spots.
United Kingdom In early
September 2021, the NHS proposed the Covid Pass vaccine passport in England, Scotland,
and Wales. It was proposed for those who had received either two doses of the
Pfizer, Moderna, or AstraZeneca vaccines; one dose of the Janssen vaccine; or
"proof of natural immunity shown by a positive PCR test result for
COVID-19, lasting for 180 days after the date of the positive test and following
completion of the self-isolation period" England cancelled the
Covid Pass program on 12 September 2021 following pushback from Conservative
members of parliament and business leaders over potential discrimination and
economic harm, while Scotland and Wales have retained the program. Northern
Irish citizens who have been fully vaccinated for COVID-19 in Northern Ireland
can apply for a certification that they are vaccinated through an automated
method administered by the Department of Health.
United States
(A map showing which US states
have proposed or implemented (green), banned (red), or partially banned
(yellow) COVID-19 vaccine passports. Gray indicates that the state has neither
implemented or banned COVID-19 vaccine passports. Also included is states that
have significant localities with COVID-19 vaccine passports (Aqua). Green
includes states which have created a vaccine passport mobile application, but
the application is not mandated to be used in the public or private sector. As
of October 2021, no US states had mandated use of vaccine passports.)
Although the country does offer a
paper "Vaccination Record Card", issued by the Centers for Disease
Control and Prevention (CDC) to provide a log of the patient's doses and when
they are received, the United States does not have, and will not implement, a
federal framework for a digital vaccine passport. Federal officials cited
privacy and human rights concerns in its decision, thus leaving their
implementations up to individual states. Prior to the issue becoming
politicized, public views on vaccine passports were evenly split and the divide
crossed, rather than followed, political and ideological lines. Since then,
criticism and conspiracy theories surrounding the vaccines in general, and in
turn vaccine mandates, have largely come from the political right; for example,
U.S. representative for Georgia's 14th congressional district Marjorie Taylor
Greene, a Republican, asserted that requesting the disclosure of one's vaccine
status was a violation of data privacy rules for the health care industry, even
though said rules only apply to entities such as health insurers.
The state governments of California,
Hawaii, Louisiana, New York, North Carolina, and Virginia have each rolled
out mechanisms where residents can choose to receive proof of COVID-19
vaccination in the form of a scannable QR code by linking to records within
each state's immunization registry. Illinois has a Vax Verify website,
where residents can download proof of COVID-19 vaccination for businesses that
require it. In New Jersey,
residents can obtain a digital COVID-19 vaccination record through its mobile
app Docket; Governor Phil Murphy has specifically avoided using the term
"vaccine passport" to describe the service. Each state credential has
varying degrees of interoperability with other state and foreign governments;
some states have closed systems, with QR codes that are only usable within the
issuing state, and others have broad interoperability, with New York offering
both types of credentials for its residents. Arizona, Maryland, Mississippi,
North Dakota, Washington, West Virginia, Puerto Rico, and the District of
Columbia have contracted with an organization that interfaces with
governmental vaccination records to produce a PDF proof of vaccination, but has
also moved toward scannable QR codes. Health departments in Indiana, Colorado,
and Georgia can provide proof of vaccination in PDF form but not via a QR
code. On the other hand, a number of states have prohibited state agencies from
issuing vaccine passports. Twenty US states including Florida and Texas
have preemptively banned vaccine passports in the public and/or private
sectors, citing discrimination and privacy concerns.
Los Angeles County Los
Angeles County began a proof of vaccination system for indoor bars,
restaurants, venues and nightclubs on 7 October 2021.
New York City New York
City began its Excelsior Pass or Key to NYC vaccine passport system for dining,
fitness, events and indoor entertainment on 13 September 2021.
New Orleans New Orleans
began to require proof of vaccination or a negative test to enter indoor bars,
restaurants, events, fitness, and sporting events on 16 August 2021.
Arguments and Controversy In
April 2021, the World Health Organization (WHO) advised against the use of
mandatory COVID-19 vaccine passports for travel, citing ethics and efficacy
concerns. In February 2021, the position of World Health Organization (WHO) on
requiring proofs of COVID-19 vaccination for international travel purposes
remains against on using this as a condition for departure or entry.
Effect on vaccine uptake In
some jurisdictions vaccine uptake increased after various levels of governments
announced plans to mandate their use.
Ethical and social issues The
ethical issues that arise in the acceptability of vaccine passports revolve
around the policy objectives and the intended use. The public health restriction on implementing
vaccine passports limits the freedom of an individual to perform social
activities. People who are privileged to receive the vaccination will
have gained access to going back to normal life while low-income populations
will remain disproportionately low on vaccinations which hinders their ability
to participate in non-essential activities. Religious people and people who
refuse to get vaccinated have also restricted their own liberties.
Due to the imbalance in the
distribution of vaccines in the developing world, there are concerns about the
inequity of vaccine passports for travellers. In an 15 April 2021 meeting
published 4 days later, the World Health Organization's emergency committee
opposed vaccination passports, saying "States Parties are strongly
encouraged to acknowledge the potential for requirements of proof of
vaccination to deepen inequities and promote differential freedom of
movement". However, many countries may increasingly consider the
vaccination status of travellers when deciding to allow them entry or whether
to require them to quarantine. “Some sort of vaccine certificate will be important”
to reboot travel and tourism, according to Dr. David Nabarro, special envoy on
COVID-19 for the World Health Organization (WHO), in February 2021. Countries
experimenting with or seriously considering COVID-19 vaccination passports
include Aruba, Britain, Israel and Canada. In March 2021, Bernardo
Mariano, the WHO's Director of Digital Health and Innovation, said that
"We don't approve the fact that a vaccination passport should be a
condition for travel." Lawmakers in several US states are also considering
legislation to prohibit COVID-19 vaccination passports. Ethical concerns about
vaccine passports have been raised by Human Rights Watch (HRW). According to
HRW, requiring vaccine passports for work or travel could force people into
taking tests or risk losing their jobs, create a perverse incentive for people
to intentionally infect themselves to acquire immunity certificates, and risk
creating a black market of forged or otherwise falsified immunity certificates.
By restricting social, civic, and economic activities, vaccine passports
may "compound existing gender, race, ethnicity, and nationality
inequities." Immunity certificates also face privacy and human rights
concerns.
Natural immunity People
may acquire a degree of natural immunity from SARS-CoV-2 when they are exposed
to the live virus, and develop a primary immune response which produces
antibodies that can recognize specific variants. As of May 2021, the World Health Organization
(WHO) reported that more than 90% of individuals established recognizable
antibodies in a within four weeks after an infection. For most people, these
detectable antibodies roughly stay for at least 6-8 months. However, antibodies
may not guarantee immunity from novel variants and mutations of SARS-CoV-2. The
uncertainty of the science behind immunity to SARS-CoV-2 has raised issues over
their applicability within passport frameworks. It has been argued that
the primary difference is that vaccination certificates such as the Carte Jaune
incentivize individuals to obtain vaccination against a disease, while immunity
passports incentivize individuals to get infected with and recover from a
disease.
https://en.wikipedia.org/wiki/Vaccine_passports_during_the_COVID-19_pandemic
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