Immunity Passport – Great Idea or Hard Pass?

Amid the terrible surge in COVID-19 cases around the world, there has been encouraging news about the potential vaccines that may be available in the next few months. Moderna, Pfizer and AstraZeneca are working hard to ship their vaccine before the end of the year. These vaccines will be key in the battle against the virus.

However, now that we are on the cusp of having these vaccines available, the idea of immunity passports (or proof of vaccination) have once again surfaced. Early in the pandemic, several scholars put forward the idea of having passports for those that were proven to be immune to COVID-19. In an interview with BBC, Husayn Kassai, CEO of Onfido described the passport as follows:

“An immunity passport is a presentable proof of immunity to Covid-19. It is designed to help an individual prove that they have been tested and that their test result belongs to them, but without having to share any personal information.”

Many pushed back on the idea for two main reasons:

  1. It would create a societal gap
  2. It required reliable, widespread testing for COVID-19 – something which we still do not have

The idea never took off, mostly because of reason #2.

However, now that vaccines are here, immunity passports are suddenly practical. It is much easier to track the administration of vaccine rather than test for the presence of COVID-19 antibodies. But are these passports a good idea?

The CBC published a column that warned against their use. The authors made multiple cogent arguments:

  • Immunity passports would create a novel kind of biological divide between the haves and have-notes
  • Those with passports would have access to options and opportunities, including the ability to return to work, that would not be available to those without confirmed immunity
  • This disparity would lead to efforts to falsify documentation
  • If immunity/vaccination information were held centrally, then it would be vulnerable to breach or abuse

Ethicists Natalie Kofler and Françoise Baylis have written that immunity passports are “the height of folly” and pointed to the historic example of New Orleans during the height of yellow fever where presumed immunity to yellow fever was “weaponised to justify white supremacy”.

A more modern precedent is the immunization required for children to attend school. Many districts do not allow students to be in class who have not been vaccinated against chicken pox, measles and other diseases. In recent years, that practice has come under scrutiny because in some cultures and religions, vaccination is not accepted.

But whether you believe in vaccines or not, isn’t the central issue. The issue I would like to discuss with the HCLDR community is whether immunization information should be used by private companies like airlines, workplaces or amusement parks to deny entry. On one hand, it could be argued that they are just trying to keep people safe and limit the spread of this deadly virus. On the other, it is a form of elitism that could create a new societal gap.

On Tuesday December 1st at 8:30pm ET (for your local time click here), please join me as we discuss the topic of immunity passports:

  • T1 Do you believe that private companies (airlines, workplaces, amusement parks, etc) should have the ability to see a person’s immunization info and use it to deny entry or service?
  • T2 Would an immunity passport widen the healthcare gap? Does your opinion depend on whether the vaccine is free?
  • T3 Who would you want to have as the central holder of immunization information? Payers? Providers? Government? Yourself?
  • T4 What would be an alternative to the immunity passport? Just continue to wear masks and stay physically distant?

Resources

Krause, Philip R et al. “Maintaining confidentiality of emerging results in COVID-19 vaccine trials is essential”, The Lancet, 27 October 2020, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32259-5/fulltext, accessed 29 November 2020

Ross, Casey. “After 9/11, we gave up privacy for security. Will we make the same trade-off after Covid-19?”, Stat, 8 April 2020, https://www.statnews.com/2020/04/08/coronavirus-will-we-give-up-privacy-for-security/, accessed 29 November 2020

“Immunity Passports in the context of COVID-19”, World Health Organization, 24 April 2020, https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19, accessed 29 November 2020

Greely, Henry T. “Covid-19 ‘immunity certificates’: practical and ethical conundrums”, Stat, 10 April 2020, https://www.statnews.com/2020/04/10/immunity-certificates-covid-19-practical-ethical-conundrums/, accessed 29 November 2020

Meneguzzi, Justin. “Will you need an immunity passport to fly?”, BBC, 31 August 2020, http://www.bbc.com/travel/story/20200831-coronavirus-will-you-need-an-immunity-passport-to-travel, accessed 29 November 2020

Baylis, Francoise and Kofler, Natatlie. “Why Canadians should fight tooth and nail against proof-of-immunity cards”, CBC, 7 May 2020, https://www.cbc.ca/news/opinion/opinion-pandemic-coronavirus-immunity-passport-1.5551528, accessed 29 November 2020

Brown, Rebecca CH et al. “The scientific and ethical feasibility of immunity passports”, The Lancet, 16 October 2020, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30766-0/fulltext, accessed 29 November 2020

Webb, Andrew. “Coronavirus: How ‘immunity passports’ could create an antibody elite”, BBC, 2 July 2020, https://www.bbc.com/news/business-53082917, accessed 29 November 2020

Brown RCH, Savulescu J, Williams B, et al. “Passport to freedom? Immunity passports for COVID-19”, Journal of Medical Ethics, 15 August 2020, https://jme.bmj.com/content/46/10/652, accessed 29 November 2020

Lovelace Jr, Berkeley. “WHO doesn’t recommend coronavirus passports, because immunity remains questionable”, CNBC, 16 September 2020, https://www.cnbc.com/2020/09/16/who-doesnt-recommend-coronavirus-passports-because-immunity-remains-questionable.html, accessed 29 November 2020

Image Credit

Photo by Annika Gordon on Unsplash

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