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The promise and perils of vaccine passports

20210130 stp501 captis executive search management consulting leadership board services

THE RACE to vaccinate against covid-19 is on. More than 50 countries have given more than 68m jabs. That is not much of a dent in the global population of more than 7bn, but it is enough to invigorate a debate about whether people who have been vaccinated should be permitted to move around more freely.

To allow this, those who have been vaccinated need to be able to prove it. And thus has begun a discussion about whether certificates of immunity—or vaccination passports—should be introduced. This is not an entirely novel concept. Some tourism-dependent countries, such as the Seychelles, have already opened to people who have been vaccinated, while many more have long made proof of vaccination against other diseases a condition of entry. Opinions differ about how welcome such a thing would be. Some think it is a quick route back to normal life. Others worry that it will be unfair and divisive.

Although to some vaccination passports may seem radical, they are not without precedent. By 1922, many schools in America required that children get smallpox vaccinations as a condition of attendance. And the “yellow card” is an international certificate created almost 100 years ago to record inoculations against cholera, yellow fever, typhus and smallpox. To this day, many countries require a yellow-fever certificate if you want to travel there.

Britain’s health secretary has said he isn’t attracted to the idea, while the prime minister of Greece, Kyriakos Mitsotakis, wants an EU-wide certificate for travel. His interest is likely to have been spurred by his country’s reliance on tourism. Over in America, President Joe Biden has asked for an evaluation of vaccination passports. Around the world a variety of private efforts are under way to create digital versions.

One reason for caution is that it remains unclear how much protection the vaccine offers against transmission. Vaccines will clearly save lives and prevent severe illness, but some of those vaccinated may still be able to catch and transmit the virus. Still, vaccines will probably reduce transmission significantly, and as evidence that it does so emerges, the pressure to allow the vaccinated to resume their normal lives, including travel, will grow.

Even assuming vaccinations help only a bit, some believe vaccine passports are inevitable. Arthur Caplan, a professor of bioethics at NYU’s Grossman School of Medicine in New York, believes they are not only inevitable, but desirable. He notes that health-care workers in nursing homes and hospitals will be required to be vaccinated against covid-19, and to have proof of it. Hospital workers in many places are already required to get flu vaccines, or the hepatitis B jab, in order to protect the vulnerable in hospitals who cannot be vaccinated, such as the immunocompromised, cancer patients and newborns.

Beyond this, some businesses will be completely hamstrung this year, without vaccination passports. These include cruise ships, airlines and restaurants. And many employers are already showing signs of interest in keeping tabs on those among their staff who have been vaccinated. Qantas, an Australian airline, has talked since last year about making it compulsory for passengers to prove they are vaccinated against covid-19 before they board flights.

Governments seem unlikely to refuse entry completely to people without vaccination passports, but they are likely to impose additional conditions, such as a recent negative covid test, and even quarantine in a hotel. Other airlines, such as United, Etihad and Emirates, are all looking at health passports that would record tests or immunisations.

But private companies, like airlines, have a lot more freedom to impose restrictions on customers, or employees, as long as they are not discriminatory. Governments face more challenges. Prioritising who gets the vaccine first, ensuring it reaches everyone reasonably equitably and reassuring the vaccine-sceptical are all politically tricky—particularly if being vaccinated provides benefits, such as freedom of movement or more secure employment, that others do not get. Then there is the question about how to treat people who have natural immunity from an infection with covid-19. The duration of immunity from vaccines and previous infection are unknown, which means that vaccine passports may expire.

Passports are also likely to create a generational divide, as most countries are vaccinating the old first. Many young people have had to restrict their lives a great deal in the past year, largely to protect the older generation. It may seem particularly unfair that old folks are now swanning off to Ibiza this summer, while the young are stuck at home or in quarantine.

Those who cannot be vaccinated for health reasons, such the immunocompromised, may feel aggrieved at their relative confinement. Last, if passports come into wide use, some may feel forced to get a jab, and that their freedom of choice has been compromised.

Even so, in one recent study, more than two-thirds of British people said they would accept them. That is a surprisingly high proportion. People in other countries may well follow suit, whatever their philosophical misgivings. The reason for this might be quite simple. Tight lockdowns are so difficult to tolerate, and so economically costly, that even a slightly cracked door looks like a bright ray of hope.

This is not a CAPTIS article. Originally, it was published here.