By: Kelsey Cloud
As the percentage of fully vaccinated individuals continues to increase globally, countries have begun to consider whether or not to require vaccine passports—digital passes confirming that the owner has been fully vaccinated against COVID-19—in order to attend sporting events, concerts, and other pre-pandemic activities. A simple scan of a QR code on a smartphone or printed paper would allow the flow of international travel to resume, as well as allow consumers access to certain businesses, events, or locations within their home countries. China, New Zealand, Israel, and the United Kingdom have already launched various versions of vaccine passports, with widely varying policies and methods of implementation. For example, the European Union’s Digital Green Certificate collects an individual’s name, birthdate, date of issuance, and vaccine information. Moreover, a multitude of international organizations, including the World Health Organization and International Air Travel Association, have begun launching efforts to coordinate vaccine passport implementation as well.
In the United States, President Biden issued an Executive Order instructing the State Department to collaborate with global health organizations to establish international travel guidelines. However, the administration explicitly stated that the federal government will not issue vaccine passports, nor collect or store personal vaccine data. As such, without a federal mandate, vaccine passport initiatives in the U.S. remain in the private sector, driven by companies such as Microsoft, Salesforce, IBM, and MasterCard. All applications are still in the development stage, and several governors have already issued executive orders banning the use of vaccine passports in their states. The absence of a federally issued vaccine passport, coupled with the lack of uniform digital standards at an international level, create significant implementation issues that stir complicated political and ethical debates surrounding privacy, inequality, discrimination, and fraud.
Private Sector Digital Vaccine Passports Full of Privacy Concerns
The lack of a federal privacy law regulating the collection and use of personal information fosters concern surrounding oversight and control of that information. While companies developing passport applications seek to preserve as much individual privacy as possible, a federal application would likely need to include enough personal and medical information to confirm that someone has been vaccinated, such as name, contact information, and medical records from health care providers. The protections of the Health Insurance Portability and Accountability Act (HIPAA) would not be implicated in most situations, since passport applications could be developed without transmitting information to HIPAA-covered entities such as hospitals.
While some companies claim that their applications have robust privacy protections by encrypting confidential user data, the lack of legal remedies for privacy violations still leaves digital vaccine passports ripe for abuse and vulnerable to privacy breaches. Allowing private companies direct access to medical records raises questions concerning if and how third-party companies will store and use that data. Without oversight from the federal government, those private companies could capture personal health information in ways that create a significant target for hackers.
Current Vaccine Distribution Policies Reinforce Systems of Inequality
Additionally, restrictive vaccine distribution policies favor high- income countries and worsen inequalities domestically and internationally. Globally, most low and middle-income countries still lack access to COVID-19 vaccines, and within high income countries, African Americans and Hispanic individuals continue to be vaccinated at lower rates than White individuals. As of April 15th, only 0.1% of the 841 million administered vaccine doses went to individuals in low-income countries. Joia Mukherjee, Chief Medical Officer of Partners in Health, warns that the world is “creating another superstructure or colonial hierarchy of people from wealthier countries having access and poorer countries not having access.” In the U.S., high poverty and uninsured populations, as well as non-citizen immigrants, share a direct correlation with lower vaccination rates. Moreover, vaccine passports have the potential to discriminate against those who cannot receive vaccinations due to medical or religious reasons. While many vaccine passports, such as the State of New York’s Excelsior Pass, allow for the use of a negative COVID-19 test in place of proof of vaccination, other countries like China exclusively admit vaccinated individuals, increasing the possibility for discrimination.
In addition, those without smartphones, mobile devices, or a reliable mobile data plan would suffer technological discrimination. Vaccine passport applications would disregard those in marginalized communities, such as formerly incarcerated people or undocumented people, who typically hold higher fears of government surveillance of their private health information. Requiring digital passports for travel, both domestically and internationally, could only exacerbate these inequalities.
Towards a Unified Global Approach Vaccine certifications for international travel are not new—many countries currently require proof of yellow fever vaccinations, for example. Mass vaccination initiatives have sprouted throughout history, both in the U.S. and around the world. Prior vaccine initiatives in place before COVID-19 already carry vaccination requirements for attending work, educational institutions, and traveling internationally, which the vast majority of the world complies with. In order to ensure the effectiveness and reliability of COVID-19 vaccination passports, private companies, international organizations, and other entities developing vaccine passports must safeguard the privacy of medical information, prevent fraudulent vaccination data, and implement anti-discriminatory policies that lessen global inequalities.