Among governments and those in the travel industry, a new term has entered the vocabulary: vaccine passport.
One of President Biden’s executive orders aimed at curbing the pandemic asks government agencies to “assess the feasibility” of linking coronavirus vaccine certificates with other vaccination documents, and producing digital versions of them.
Denmark’s government said on Wednesday that in the next three to four months, it will roll out a digital passport that will allow citizens to show they have been vaccinated.
It isn’t just governments that are suggesting vaccine passports. In a few weeks, Etihad Airways and Emirates will start using a digital travel pass, developed by the International Air Transport Association, to help passengers manage their travel plans and provide airlines and governments documentation that they have been vaccinated or tested for Covid-19.
The challenge right now is creating a document or app that is accepted around the world, that protects privacy and is accessible to people regardless of their wealth or access to smartphones.
Here’s what we know about the current status of digital vaccine passports.
A vaccination pass or passport is documentation proving that you have been vaccinated against Covid-19. Some versions will also allow people to show that they have tested negative for the virus, and therefore can more easily travel. The versions being worked on now by airlines, industry groups, nonprofits and technology companies will be something you can pull up on your mobile phone as an app or part of your digital wallet.
“It’s about trying to digitize a process that happens now and make it into something that allows for more harmony and ease, making it easier for people to travel between countries without having to pull out different papers for different countries and different documents at different checkpoints,” said Nick Careen, senior vice president for airport, passenger, cargo and security at I.A.T.A. Mr. Careen has been leading I.A.T.A.’s travel pass initiative.
I.A.T.A. is one of several organizations that have been working on digital solutions to streamline the travel credentialing process for years; during the pandemic, these groups have focused on including vaccination status. The idea is that if you have all the pertinent information on your phone, a significant amount of time will be saved.
In addition to I.A.T.A., IBM has been developing its own Digital Health Pass that would enable individuals to present proof of vaccination or a negative test to gain access to a public location, such as a sports stadium, airplane, university or workplace. The pass, built on IBM’s blockchain technology, can utilize multiple data types, including temperature checks, virus exposure notifications, test results and vaccine status. The World Economic Forum and the Commons Project Foundation, a Swiss nonprofit group, have been testing a digital health passport called CommonPass, which would allow travelers to access testing or vaccination information. The pass would generate a QR code that could be shown to authorities.
As more people are inoculated, there will likely be aspects of public life in which only people who have been vaccinated are allowed to participate. Take the upcoming Super Bowl LV in Tampa, Fla., where a significant portion of attendees will be vaccinated health care workers. (Mr. Careen of I.A.T.A. said that sporting organizations, concert venues and tourism agencies have all reached out for identification tech support).
In order to travel internationally, government and health authorities will need to know if you have been vaccinated or have tested negative for the virus. Many countries are already requiring proof of a negative test for entry. Such passes could be essential to restarting the tourism industry, said Zurab Pololikashvili, secretary general of the United Nations World Tourism Organization.
“One key element vital for the restart of tourism is consistency and harmonization of rules and protocols regarding international travel,” he said in an email. “Evidence of vaccination, for example, through the coordinated introduction of what may be called ‘health passports’ can offer this. They can also eliminate the need for quarantine on arrival, a policy which is also standing in the way of the return of international tourism.”
Dakota Gruener, executive director of ID2020, a global public-private partnership, said that there are three scenarios regarding digital credentialing for the coronavirus response. The first, which is largely off the table, is the creation of immunity certificates. These are documents that would show that people have developed some kind of immunity to the virus. The second scenario is being able to prove you’ve tested negative for the virus; the third is being able to show that you have been vaccinated. The last two scenarios, experts agree, are the most important for getting the travel industry going again.
“We’re seeing a lot of interest from airlines, airline industry groups, customs and border control agencies and travelers, all saying, ‘how do I safely get on a plane or as a condition of entry into a country, get on a train, whatever the case may be, and prove that I have been tested or vaccinated?’” Ms. Gruener said.
Ms. Gruener is one expert in a World Health Organization-sponsored group tasked with establishing global standards for digital vaccination certificates.
Having to prove you’ve been vaccinated in order to participate in activities or enter certain countries is not a new concept. For decades, people traveling to some countries have had to prove that they have been vaccinated against diseases such as yellow fever, rubella and cholera. Often, after being vaccinated, travelers received a signed and stamped “yellow card,” known as an International Certificate of Vaccination or Prophylaxis, which the Centers for Disease Control and Prevention still urge people to take on relevant trips.
“Everybody who has traveled internationally to countries that require vaccination against malaria, diphtheria and other things has had yellow cards,” said Brian Behlendorf, executive director of Linux Foundation Public Health, a technology-focused organization helping public health authorities combat Covid-19 around the world. Its focus is helping projects, communities and companies build open-source technology. “Parents with kids in public school have had to prove their kids have been vaccinated. This is not something new.”
But a major difference between the yellow card of years past and what is being worked on now is the digital component, which comes with new concerns around privacy and accessibility. The Linux Foundation is working in partnership with the Covid-19 Credentials Initiative, a collective of more than 300 people from five continents to help develop universal standards for vaccine credential apps that make them accessible and equitable. The foundation is also working with IBM and CommonPass.
“As these things get rolled out, it’s important for citizens to ask governments and airlines: How do we make this easy so I have one vaccination record to book a flight, hotel and so I can use that to do some other things,” Mr. Behlendorf said. “It should work like email. If it doesn’t, agitate for it.”
Currently more than 150 million people — almost half the population — are eligible to be vaccinated. But each state makes the final decision about who goes first. The nation’s 21 million health care workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. Adults in the general population are at the back of the line. If federal and state health officials can clear up bottlenecks in vaccine distribution, everyone 16 and older will become eligible as early as this spring or early summer. The vaccine hasn’t been approved in children, although studies are underway. It may be months before a vaccine is available for anyone under the age of 16. Go to your state health website for up-to-date information on vaccination policies in your area
You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still be given the vaccine at no charge. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a health department vaccination site or a local pharmacy once the shots become more widely available.
That is to be determined. It’s possible that Covid-19 vaccinations will become an annual event, just like the flu shot. Or it may be that the benefits of the vaccine last longer than a year. We have to wait to see how durable the protection from the vaccines is. To determine this, researchers are going to be tracking vaccinated people to look for “breakthrough cases” — those people who get sick with Covid-19 despite vaccination. That is a sign of weakening protection and will give researchers clues about how long the vaccine lasts. They will also be monitoring levels of antibodies and T cells in the blood of vaccinated people to determine whether and when a booster shot might be needed. It’s conceivable that people may need boosters every few months, once a year or only every few years. It’s just a matter of waiting for the data.
Vaccine passports don’t have to be digital, but they would make the travel process smoother.
“Imagine a future where a plane lands in an airport and a hundred people have a travel pass, 100 have another health wallet, 50 have bits of paper and another 25 have some kind of government document,” said Jamie Smith, senior director of business development at Evernym, a developer that has been working with I.A.T.A. and others on developing a vaccine pass. “What does the airport do? How do they process all those people in a standard, simple way?”
The European Union’s law enforcement agency said this week that sales of fake negative test results are becoming more widespread, another reason the industry is trying to develop digital passes that are secure.
In a world where more than a billion people aren’t able to prove their identity because they lack passports, birth certificates, driver’s licenses or national identification cards, digital documents that show vaccine status may heighten inequality and risk, leaving many people behind. That concern has been at the heart of Ms. Gruener’s work.
“Long predating Covid, we were working on the intersection of digital credentials and immunization,” she said. “It’ll be years before vaccines are universally available on a global level and thus widespread testing is going to continue and must continue alongside vaccination to enable a safe and equitable return to travel and other public activities.”
For those without smartphones, the industry says it will accept paper proof, but even that needs to be standardized.
In addition, there are concerns about privacy and data sharing.
“There are ways this could be done right or done terribly wrong and the wrong ways could lead us to a techno dystopia,” said Jenny Wanger, director of programs at the Linux Foundation, adding that it’s important that the tech-building aspect of these apps be done in the open and doesn’t end up in the control of any one government or company. The technology should be open source and accessible to technologists, no matter who they are or where they are, she and others said.
Technologists and travel industry experts said that although it is possible to rush tech solutions that allow people to have one-use apps, creating long-lasting ethical technology or systems that will not store people’s data, or make it possible to track where they are, takes time.
“The global passport system took 50 years to develop,” said Drummond Reed, chief trust officer for Evernym. “Even when they wanted to add biometrics to that to make it stronger, that took over a decade to agree on just how you’re going to add a fingerprint or a facial biometric to be verified on a passport. Now, in a very short period of time, we need to produce a digital credential that can be as universally recognized as a passport and it needs an even greater level of privacy because it’s going to be digital.”