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"COVID passports" are already starting to roll out in some parts of the world. Here's what you need to know about how they could work as more people get vaccinated.

By Korin Miller
April 06, 2021
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As of this second, about 18 percent of the U.S. population is fully vaccinated against COVID-19, and plenty more are on their way to getting their shots. That's raised some big questions about how fully vaccinated people can safely travel and re-enter public spaces — from theaters and stadiums to festivals and hotels — as they begin to reopen. One possible solution that keeps coming up? COVID vaccine passports.

State officials in New York, for example, have launched a digital passport called Excelsior Pass that residents can voluntarily download for free to show proof of COVID vaccination (or a recently-taken negative COVID-19 test). The pass, which resembles a mobile airline boarding ticket, is meant to be used at "major entertainment venues like Madison Square Garden" as these spaces begin to reopen, according to the Associated Press. Meanwhile, in Israel, residents can obtain what's known as a "Green Pass," or a certificate of COVID-19 immunity that's issued by the country's Ministry of Health via an app. The pass allows those who've been fully vaccinated, as well as those who've recently recovered from COVID-19, to access restaurants, gyms, hotels, theaters, and other public entertainment venues.

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The U.S. government is reportedly considering something similar, although nothing is concrete at this point. "Our role is to help ensure that any solutions in this area should be simple, free, open source, accessible to people both digitally and on paper, and designed from the start to protect people's privacy," Jeff Zients, a White House coronavirus response coordinator, said at a briefing on March 12.

But not everyone is in favor of the idea. Florida governor Ron DeSantis recently issued an executive order banning businesses from requiring customers to show proof that they've been vaccinated against COVID-19. The order also forbids any government agency in the state from issuing documentation for the purpose of providing proof of vaccination, noting that, "vaccination passports reduce individual freedom and will harm patient privacy."

This all raises a lot of questions about vaccine passports and their potential for the future. Here's what you need to know.

COVID vaccine passport
Credit: Getty Images

What is a vaccine passport?

A vaccine passport is a print or digital record of a person's health data, specifically their vaccination history or immunity to a certain illness, explains Stanley H. Weiss, M.D., professor at the Rutgers New Jersey Medical School and the Department of Biostatistics & Epidemiology at the Rutgers School of Public Health. In the case of COVID-19, that can include information about whether someone has been vaccinated against the virus or recently tested negative for COVID.

Once someone is granted the passport, the idea is that they can then travel to certain locations and, theoretically, be granted access to certain businesses, events, or areas, explains Dr. Weiss.

The general goal of a vaccine passport is to limit and contain the spread of a disease, says Dr. Weiss. "If you're worried about spreading a particular illness, having to document that you've been vaccinated to reduce the risk of spread makes sense," he explains. (Related: Everything You Need to Know About COVID-19 Vaccine Side Effects)

A vaccine passport is also important for international travel because "the world is on different timelines for vaccination," notes infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. "Knowing someone is vaccinated may facilitate easier international travel because that person may not need to quarantine or be tested," he explains.

Do vaccine passports already exist for other illnesses?

Yup. "Some countries require yellow fever proof of vaccination," Dr. Adalja points out.

Yellow fever, ICYDK, is found in tropical and subtropical areas of South America and Africa and spreads through mosquito bites, according to the Centers for Disease Control and Prevention (CDC). The illness "can result in outbreaks," leaving people with fever, chills, headache, and muscle aches at best and, at worst, organ failure or death, says Shital Patel, M.D., assistant professor of medicine in infectious diseases at Baylor College of Medicine. "After getting vaccinated for yellow fever, you receive a signed and stamped 'yellow card,' known as an International Certificate of Vaccination or Prophylaxis (or ICVP), which you take on your trip" if you're traveling somewhere that requires proof of yellow fever vaccination, she explains. (The World Health Organization has a detailed list of countries and areas that require a yellow fever vaccine card.)

Even if you've never traveled anywhere that required proof of yellow fever vaccination, you may have still participated in a vaccine passport of sorts without realizing it, adds Dr. Patel: Most schools require childhood vaccines and documentation for illnesses like measles, polio, and hepatitis B before kids can enroll.

How would a COVID-19 vaccine passport be used?

Theoretically, a COVID vaccine passport would allow people to return to "normal" life — and, in particular, to loosen COVID-19 protocols in crowds.

"Private businesses are already thinking about using proof of vaccination as a way to modify operations when they're dealing with the vaccinated," explains Dr. Adalja. "We're already seeing this at sporting events." The NBA's Miami Heat, for example, recently opened vaccinated-only sections for fans at home games (despite Governor DeSantis' executive order banning businesses from requiring customers' proof of COVID vaccination). Fans who've gotten the COVID vaccine "will be admitted through a separate gate and required to show their Centers for Disease Control vaccination card," with dated documentation on the card proving they've been fully vaccinated (meaning they've received both doses of the Pfizer or Moderna vaccine, or one dose of the Johnson & Johnson vaccine) for at least 14 days, according to the NBA.

Some countries may also begin requiring proof of COVID vaccination for international visitors (many countries, including the U.S., already mandate a negative COVID test result upon arrival), notes Dr. Adalja.

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Still, that doesn't necessarily mean the U.S. federal government is going to issue or require formal COVID vaccine passports anytime soon, Anthony Fauci, M.D., director of the U.S. National Institute of Allergy and Infectious Diseases, said on the Politico Dispatch podcast. "They may be involved in making sure things are done fairly and equitably, but I doubt the federal government is going to be the leading element of [COVID vaccine passports]," he explained. However, Dr. Fauci said that some businesses and schools may require proof of vaccination to enter buildings. "I'm not saying that they should or that they would, but I'm saying you could foresee how an independent entity might say, 'Well, we can't be dealing with you unless we know you're vaccinated,' but it's not going to be mandated from the federal government," he said.

How effective could COVID vaccine passports be at limiting the spread of the virus?

A lot of this is speculation at this point, but Dr. Patel says that COVID-19 vaccine passports "can be effective in preventing spread," especially among people who aren't vaccinated in areas with low vaccination rates. To be clear, though, the CDC says that fully vaccinated people "could potentially still get COVID-19 and spread it to others," meaning proof of vaccination doesn't necessarily guarantee the prevention of COVID transmission.

What's more, Dr. Weiss says it's difficult to prove through research how effective these vaccine passport policies can be. However, he adds, "It's clear that you only get infected by an infectious agent if you're exposed to it and the person is susceptible."

That said, COVID-19 vaccine passports come with the potential of singling out or discriminating against people who don't have the opportunity to get vaccinated. For instance, some communities lack the services needed to access the vaccine, and some people may not want to get vaccinated because of a certain health condition, like a severe allergy to one of the vaccine ingredients. (Related: I Got the COVID-19 Vaccine at 7 Months Pregnant — Here's What I Want You to Know)

"This is a challenge," admits Dr. Patel. "We should make sure that everyone who wants to get vaccinated has access to the vaccine and can get vaccinated. We definitely need to put in policies and procedures in place to prevent discrimination and also protect the public to curtail the pandemic."

Overall, are COVID vaccine passports a good or bad idea?

Experts seem to think that some requirement to show proof of COVID vaccination will be helpful. "There are advantages to a form of documentation for vaccines being incorporated in certain situations to help reduce and stop the spread of COVID-19," explains Dr. Patel. "How to navigate this will be complex. It needs to be transparent, thoughtful, and flexible, especially as access to vaccines increases."

Dr. Weiss agrees. While he notes concerns about people abusing the system (read: coming up with fake passports), he says that, ultimately, "the idea of restricting certain activities at this juncture in time to those who have documentation of vaccines is a good idea."

The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it's possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.

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