Now that a COVID-19 vaccine looks set to start rolling out across the US within weeks, discussion has turned to whether some type of vaccination or immunity "passport" might be required.
The idea is that once the vaccine is widely available, the passport would be issued to people who have been vaccinated to let them move more freely, both locally and globally, by allowing access to indoor restaurants, movie theaters, and international travel.
At this stage, it's all still speculation. However, the International Air Transport Association (IATA), an airline trade association that represents 290 airlines worldwide, said on November 23 that it was in the final stages of developing a digital vaccine passport for travelers. The IATA Travel Pass will let travelers share their vaccination status and COVID-19 test results with airlines and border authorities, via a contactless passport app.
In Australia, Qantas chief executive Alan Joyce told Network Nine television last month, "We are looking at changing our terms and conditions to say for international travelers, that we will ask people to have the vaccination before they get on the aircraft."
South Korea's largest airline, Korean Air, might do the same. Spokesperson Jill Chung said governments are likely to require vaccinations as a condition for lifting quarantine requirements for new arrivals, ABC News reported. However, Chung added that this wasn't a matter for airlines to "independently decide," and that it was up to governments to determine when and how to reopen borders safely.
A vaccine passport is nothing new
Some countries already require immunization certificates for diseases like polio and yellow fever to prevent global spread. And decades ago, international travelers carried "International Certificates of Vaccination" approved by the World Health Organization and sponsored by the US Department of Health, Education and Welfare Public Health Services.
"It worked well—travelers carried the record with them and used it to enter countries that required proof of immunizations," former hospital CEO, health care advisor, and biomedical ethicist Michael Hunn tells Health.
Immunization passport benefits are pretty clear
Basically, a vaccine or immunization passport is the quickest and easiest way to prove you've been vaccinated. "It will make it easier to understand who is vaccinated and who is not," infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security in Maryland, tells Health. "Those who are not vaccinated may have to undergo testing or a quarantine when they travel internationally, while those who were vaccinated may have a simpler entry mechanism."
Hunn agrees. "As states, countries, and governments come to grips with new and evolving viruses and diseases, having a safe, secure, accessible, and coordinated record of immunizations appears to make sense," he says. "The advantages are absolutely clear, for the ongoing health and safety of individuals and countries, the verification of immunizations against diseases (including COVID-19) is critical."
What about COVID-19 vaccine passport apps?
There's a lot of talk about these apps, which would contain information relating to your COVID status—including test results and details of your vaccine if you've had one. It's not clear exactly how they'd work, but the idea seems to be that they'd act as kind of a health pass you could present at an airport or public place to gain access.
Several are in development. CommonPass, which "lets individuals demonstrate their COVID status," will be rolled out this month for passengers on flights from New York, Boston, London, and Hong Kong; JetBlue, Lufthansa, Swiss International Airlines, United Airlines, and Virgin Atlantic are among the airlines taking part. In October, the app was successfully trialed on Cathay Pacific Airways and United Airlines flights between Hong Kong, Singapore, London, and New York.
The Commons Project Foundation said in a press release. The International Chamber of Commerce is developing AOKpass, which the ICC describes as "a scalable solution that enables governments and border authorities to reopen cross border travel safely and efficiently."
But more data is needed
For many people, it's simply too early to be talking about a vaccine passport or app—we don't even know yet if immunization stops someone from being contagious. So far, the vaccine trials show that the shots are very effective at preventing illness, but more research is needed to establish whether they also prevent someone from spreading the virus.
"It's unclear if the first generation vaccines provide sterilizing immunity," Dr. Adalja says. "What is clear is that they prevent symptomatic disease. There are plans to conduct studies to determine whether these vaccines prevent asymptomatic infection and contagiousness, but the results will likely not be known for sometime." He points out that the data from the Oxford-AstraZeneca vaccine trials suggest that it can prevent asymptomatic infection and therefore contagiousness in some recipients. (This is one of several other vaccines seeking approval by regulatory authorities around the world.)
Passport or not, immunization records are crucial
A record of immunization has other benefits besides foreign travel. "It will help to ensure accuracy of dates for any future booster vaccinations or the ability to notify vaccine recipients of any discovered negative effects over decades," Hunn says.
The federal government has said it will issue a vaccine card for this purpose. "We've set up everything [in] a draconian process, where when we sent out the ancillary kits which have needles and syringes, we've included paper cards to be filled out and… given to the individuals, reminding them of their next vaccine due date," Army Gen. Gustave Perna, Warp Speed's chief operating officer, said at a briefing on December 2, as reported by NPR.
And in the UK, where the vaccine rollout has already started, the National Health Service (NHS) will provide a COVID-19 ID card to every UK resident who has the vaccine. The information on the card will include the type of vaccine, batch number, date it was administered, and a message to remind the patient of the date of their crucial follow-up dose. This information will be registered on an NHS database.
However, these paper documents aren't the same as a "passport" to be used for international travel, or to gain entry to bars and restaurants. This conversation is likely to continue over the next few months, with every country making its own recommendations and plans.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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