exp GPS 0307 Caplan on bioethics of Covid-19 vaccine passport_00003610.png
On GPS: Are vaccine passports inevitable?
06:44 - Source: CNN

Editor’s Note: David A. Andelman, a contributor to CNN, twice winner of the Deadline Club Award, and executive director of The Red Lines Project, is the author of “A Red Line in the Sand: Diplomacy, Strategy, and the History of Wars That Might Still Happen” and host of its Evergreen podcast. He formerly was a correspondent for The New York Times and CBS News in Europe and Asia. Follow him on Twitter @DavidAndelman. The views expressed in this commentary belong solely to the author. View more opinion at CNN.

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There was a time when international travelers had to carry a small yellow booklet called an “International Vaccination Certificate.” I still have mine, with stamps inside indicating I’d been vaccinated against typhoid, cholera, yellow fever, smallpox, even bubonic plague. Waves of pandemics involving many of these diseases were the reason for launching this requisite counterpoint to the omnipresent passport. But in 1980 the World Health Assembly declared that the world was free of smallpox and – other than in a few countries still requiring proof of yellow fever immunization – the need for vaccination certificates has largely faded as well.

David Andelman

Now, there’s a big debate erupting, particularly in Europe, about whether to bring them back – this time to identify those who’ve been immunized against Covid-19. Already the European Commission has indicated its support for a Digital Green Pass vaccination certificate, with a single, personal QR code that would be uniform across the continent. Many could be forgiven their skepticism of the commission’s ability to guarantee that system given the rocky and vastly disparate rollout of the vaccination process across its 27 member nations. In France, for instance, by March 3 barely 7% of its population had received even a single dose, compared with 22.5% in Serbia, 19% in Malta and 11% in Denmark.

The other concern is an ethical one: that it could lead to a two-class society, divided between those who have had the Covid vaccine, and those who haven’t or can’t get it.

This, it seems, is largely the position of the World Health Organization. Last April, long before the first Covid vaccine appeared, the WHO was categorically opposed to what it termed an “immunity passport” because there was no evidence that those who’d already had Covid would be protected from another infection. The organization remains opposed, but for more nuanced reasons.

WHO executive director Dr. Michael Ryan said during a Monday Zoom media conference from Geneva that the organization didn’t recommend a certificate of vaccination “because quite simply vaccination is just not available enough around the world and is not available certainly on an equitable basis.” Katherine O’Brien, WHO’s director of the Department of Immunization, Vaccines and Biologicals, said that while WHO is “incredibly supportive of electronic vaccination certificates for a number of reasons” it was important to distinguish between the benefits of individual records and “this distinct issue around using it for the purpose of a requirement on travel.”

With another Covid-dominated summer vacation season approaching, I’d like to see more discussion on the question of who might be able to travel. Would such a document allow me to report from Paris again (assuming Europe would open its frontiers to holders of an American vaccination pass)? Could others around the world also start taking trips again?

Again, the morality of it all is most frequently cited by those opposed to such a certification. “It is an ethically fraught proposal given the deep disparities in which countries have access to Covid vaccines,” Dr. Jennifer Nuzzo, senior scholar at the Johns Hopkins Center for Health Security told me in an e-mail. “Requiring a vaccine passport would be placing a penalty on those countries that have not been able to get vaccines. This penalty will be most felt by low-income countries, as high-income countries are the ones with greatest access to vaccines.”

I understand and accept all these moral arguments. But I’m still in favor of such a card. Okay, I’ll admit I had both shots (Pfizer) more than a month ago. And I’d love to be able to go to shows, ballgames, theaters, opera, museums, even dine out in restaurants. If a little piece of paper, an app or a QR code could get me in, terrific! Though there’s still the inevitable hesitation born from the US Centers for Disease Control’s advice against going full monty in their Monday statement on activities post-vaccine, surely such a system would be helpful in breathing some life back into the Covid-battered economy.

How might such a Covid “passport” work in the US? When my wife and I had our Pfizer shot at Javits Center in New York, we were given a little card with the date of each shot and a stamp. We had ours laminated and carry them with us. But this could easily be institutionalized as a green pass – either as an electronic or paper version, as is offered in Israel. The US already has the “Real ID” driver’s license – which this year will become the only acceptable form of identification for air travel besides a passport. How about a little booth when you leave a vaccination center that would snap your photo, then instantly issue a card with your personal QR code that attests you’ve been “shot”?

The biggest problems internationally, beyond the question of whether it is as yet a good idea, or even legal, to travel, are the possibilities of fraud and the frightening prospect of testimonials to vaccination in a multiplicity of languages. One of Europe’s most efficient vaccine providers, Denmark with a barely 6 million population, has already announced moves toward its own green pass system. In France, there is an app called “TousAntiCovid,” originally designed to designate people who’d been in contact with at-risk individuals but that could also be used to generate a QR code identifying a vaccinated individual. “I protect myself, I protect others,” its website proclaims proudly.

In Israel, more than half of its 9 million people have been inoculated and have been given access to an app that allows exclusive access to a host of venues, including indoor dining. European Commission president Ursula van der Leyen said the EU would propose a unified system for the entire community on March 17 as part of a package of travel measures designed to open the continent and eventually allow travel beyond as well. Travel between the United States and Europe has been largely cut off since last year.

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    So why not a government-run green passport in America? A growing number of states seems to be opening up businesses somewhat indiscriminately while other states are lifting mask mandates – even in states where levels of coronavirus transmission are hardly abating. With CDC director Dr. Rochelle Walensky warning of a fourth wave and the CDC’s Monday statement definitively spelling out the protections of the vaccine, it would seem that it would be helpful to have some uniform method of identifying the vaccinated and allowing various venues to screen for admission.

    A US green pass might also persuade countries still barring American visitors to admit those who’ve been vaccinated. My yellow International Certificate of Vaccination dates back 52 years. Now, I’m hoping that my laminated Covid shot card will let me get back to France. A little dose of certainty wouldn’t hurt.