Why We’re Seeing Déjà Vu with Vaccination Passports

Designed by Cameron Linhares-Huang

Whether or not they may be the right move forward, vaccine passports are here to stay — especially as new variants cause fresh outbreaks and the questions about how to resume global travel and trade still loom. Yet the waves of opposition in different countries have hindered the implementation of these passports across the globe.

‘Le pass ç’est la division (‘The pass is dividing us’) read a sign amid a crowd of protestors waving the French tricolor as they marched down a street on 22 August 2021—beginning the sixth week of protests in the country. Twitter filled with images and live feeds of citizens as they began striking against the COVID-19 Health Pass approved by its government.

Meanwhile, in its former colony, Morocco, the local government banned residents without a vaccine passport from visiting the tourist hotspots of Casablanca, Marrakech, and Agadir.  In the North African country with only 35% of its population vaccinated, vaccine passports were introduced nationwide in June 2021 in the form of physical certificates and digital QR Codes. 1

France and Morocco are just two of many around the world considering vaccine passports as the next step in their reopening process. Whether or not they may be the right move forward, vaccine passports are here to stay — especially as new variants cause fresh outbreaks and the questions about how to resume global travel and trade still loom. Yet the waves of opposition in different countries have hindered the implementation of these passports. In France, protests were triggered due to the perceived unfairness in imposing greater restrictions on unvaccinated persons. Similarly, protestors in Canada and Australia found the pass relegated the unvaccinated into a separate underclass and effectively forced them to take the vaccine to access greater liberties. 2 3

Governments have tied vaccine passports with existing physical IDs and passports, to use as identification for individuals to travel or enter events and establishments. In particular, some countries have used vaccination passports alongside electronic identification, with mobile applications or QR codes to ease usage of the pass.

Interestingly, passports, physical ID, and electronic identification prompted similar concerns during their introduction. Yet, countries have been able to implement some of these tools successfully regardless. Perhaps we can find the key to implementing vaccination passports from the experience gained by administrations in crafting previous forms of identification. Specifically, clarifying data protection regulations, ensuring accessibility to all communities, and provisions for vulnerable populations should form some of the pillars of implementation strategies. However, vaccination passports will have to surmount similar challenges of their predecessors, such as ethical issues and the question of global standardization. 

While the vaccination passport is a novel policy tool due to the pandemic, it is part of a larger trend of digitizing forms of identification. Since the advent of electronic payment and digital signatures, the use of electronic identification has grown exponentially. First developed in the form of a card with an RFID microchip in 1999, electronic ID was introduced by banks and governments used to access social services and for authentication in Finland. 4 Before the pandemic, the development of NFC (Near-Field Communication), allowed some states to transfer electronic identities to mobile applications. Countries such as Germany, Guatemala, and Kazakhstan already had in place electronic identity cards and affiliated systems before the pandemic. Some countries such as Singapore and Turkey had developed Singpass and e-Government Gateway, respectively, as one-stop platforms for citizens to access public services.

With such digital infrastructure in place, many governments saw that transferring the vaccination passports to the aforementioned platforms could ease the usage of the pass in everyday activities. Be it entering a restaurant or clearing an immigration checkpoint, adding a vaccine certification to existing digital systems could expedite the process of verification, as compared to producing a physical card or certificate.

In China, the government introduced International Travel Health Certificates through mobile apps, AliPay and WeChat. Singapore allowed its citizens to access vaccination records through its contact-tracing app, TraceTogether, itself linked to the national identity system, Singpass. In the UK, individuals could access their vaccination passports using the NHS App, which is also used to book appointments at healthcare institutions. 

These are a few of the several digital forms that vaccination passports have taken. With such platforms, states can also move a step further to digitize other social services. A digital identity would ease citizens in obtaining other government services, including paying for taxes and healthcare bills.

Yet, they would have to first overcome the hurdle of implementing vaccination passports. One of the many concerns with the tool is that of violation of privacy. While implementation of vaccine passports may vary from state to state, the fundamental basis of the pass is the storage of personal healthcare information. How this information is stored and who has access to it largely depends on the authority collecting such information. Without proper regulation or privacy laws in place, individuals are skeptical if such information is handed over to corporate entities or leaked out.

For instance, according to a Harris Poll, 80% of American respondents were worried that their personal information was being endangered by the use of a vaccination pass. With such fears, the buy-in for vaccination passes piloted in states has been significantly low. A 16% sign-up rate for New York’s Excelsior Pass and a 7.5% rate in California as of July 2021 is a testament to the lukewarm response to vaccination passports. 5 This is especially pertinent in countries where vaccination centers are run by and information is held by private healthcare providers or pharmacies. In the US, with Walgreens and CVS collating data on its customers who have walked in to receive vaccination, what regulations are there to govern its use? 6 7

To assuage these fears, governments need to dictate how data is managed and who has access to data. While many states try to etch out what data protections look like, the EU has a potential example with its General Data Protection Regulation Law (GDPR), first written in 2016. The law, which governs the use of data regarding any individual in the EEA, stipulates the rights of the data subject, the role of data controllers and processors, as well as associated penalties. 8 Preceding this, the EU had implemented eiDAS (electronic IDentification, Authentication and trust Services), a regulation that stipulates how electronic identification can be used within EU states. This regulatory framework facilitated the development of digital identification for citizens of the EU countries to perform transactions and access public services. As a precursor to GDPR, it also enshrined privacy and user consent as key principles in the management of handling digital personal information.

When implementing the EU Digital COVID-Certificate, the EU cross-applied the same laws governing the use of personal information. Since June 2021, citizens of EU Countries have been using Digital Certificates to travel smoothly between countries. 9 As other countries begin using digital passports, they should consider setting up data protection regulations first or streamlining it in the case of countries with varying laws across different territories. 

For vaccination passports to be successful, it also requires significant buy-in from all residents, especially underprivileged communities. The case of photo ID in the US highlights the issue of accessible identification. 10 Because photo ID is not mandatory, the federal and state governments directed existing agencies to produce photo IDs upon request for civilians. Government offices are disproportionately more accessible to wealthier communities, thus making it far more difficult for low-income residents to obtain an ID. Without this ID, marginalized residents may find it difficult to buy a gun, access healthcare, or in some states, vote. 

The difficulties of getting a vaccination passport are irrelevant, however, if an individual does not get a vaccine in the first place. In June, MPs from the Public Administration and Constitutional Affairs Committee in the UK found vaccination passports “would likely disproportionately discriminate against people on the basis of race, religion and socioeconomic background”. 11 The fear that minority communities, where vaccine hesitancy is higher, may not have access to vaccination passports and the greater freedoms that come with it is very real.  In March this year, the Office for National Statistics announced findings showing that vaccination rates among elderly Black African, Black Caribbean, and Pakistani and Bangladeshi groups were 58.8%, 68.7%, and 75% respectively, markedly lower than the national average of 90%. 12

To ensure that vaccination passports do not become another source of inequality along wealth and racial lines, it is important to ensure that all citizens are given the opportunity to get vaccinated and the accommodations necessary to do so. If there is hesitancy amongst groups, it is all the more important to conduct educational campaigns so that no community is left behind. A successful case of this was observed in France, where making centers more accessible in poorer neighborhoods has increased vaccination rates. For instance, the region of Seine-Saint-Denis saw the vaccination rate exceeding that of the national average shortly after pop-up immunization centers with translators were set up. 13 

Some individuals, however, cannot get vaccinated because they are immunocompromised or are medically unable to take the vaccine. Vaccine passports would isolate them further from the rest of society. As such, while it is important to prevent unvaccinated individuals from being exposed to more dangerous variants, governments should do their best to ensure that differentiated regulations do not affect daily livelihoods in preventing people from working or going to school. 14 In doing so, vaccination passports can become less of a divisive tool, and account for the vulnerable.

On the other hand, there is a group of individuals who may not take the vaccine due to personal choice or religious obligation. With these individuals, there is the question of the ethical basis of differentiated restrictions. At the current moment, the U.S. federal government has introduced a partial mandate that compels employees of most large corporations to be vaccinated or face weekly testing.

Such restrictions may prompt accusations of implicitly forcing individuals to get vaccinated. Such a dilemma is not exclusive to vaccination passports — it also preceded the introduction of the much older travel passports. In the aftermath of World War I, countries met in 1920 to set out ways for the world to return to its pre-war state. High on its agenda was the abolition of passports to ensure freedom of movement. 15 Proponents of this principle claimed that passports would unfairly limit the right to movement of individuals who chose not to get a passport. However, the countries finally agreed to an International standardized passport to be used, recognizing the security risks that were eminent at that time. 

Today, governments have to choose whether the risk of infections is a more significant issue than protecting the freedoms of unvaccinated individuals. Even if governments would like to implement differentiated restrictions to increase uptake of the vaccine, it may not be successful. Inspection of the Green Pass in Israel found that tiered restrictions according to vaccination status “resulted in antagonism and increased distrust among individuals who were already concerned about infringement on citizens’ rights”. 16

Amongst the various models that countries are piloting, the use of ‘Vaccination or Regular Testing’ adopted by Singapore in particular sectors may provide a middle ground. As per its namesake, employees who are not vaccinated are required to take a Polymerase Chain Reaction (PCR) or Antigen Rapid Test (ART) twice a week. While testing may be inconvenient, it would still allow for unvaccinated individuals to work in person, while protecting the rest of the employees. 17

Perhaps the most significant challenge that lies ahead for vaccination passports is that of standardization across different countries. While the development of an international standardized accreditation is still premature, it would be essential in the future to facilitate global travel and trade.  As different governments have adopted varying levels of restrictions, different models of vaccination passports—digital or physical—as well as different approvals by health authorities may also hinder travel and authentication of immunization status.

Conventional passports follow standards from the International Civil Aviation Organization, making it easier for immigration authorities to process travelers from other countries. The International Air Transport Association has announced it is trialing a Travel Pass that mimics a conventional passport, a digital pass that contains testing and vaccination records. While 43 airlines have adopted its trials, it has not been adopted by most governments. As of April this year, the WHO still had not supported the use of vaccination passports, as they were not confident that vaccination prevented transmission and associated ethical issues. 

Ultimately, the vaccination passport will have to face many hurdles before it becomes a key to more relaxed domestic restrictions and smoother global travel. The opposition toward the pass is bound to continue as states further embrace digital identity. Yet, we opt into identity cards, social security numbers, or biometric passports, because they give us the ability to access social services and other goods. While we are accustomed to such forms of identification, they faced similar concerns, of exclusion, privacy, and accessibility when they were introduced. Perhaps what we need then, is time — to fine-tune the passport to accommodate as many of us, to communicate the safeguards that come with it, and to be accustomed to it being a new global norm.

Rewired is a digital magazine where technology and society meet. We’re committed to curating stories that amplify diverse perspectives and bridge disciplines.
Sign up to receive updates about upcoming issues and submission openings via email.