COVID-19 Health Passes
Practical and ethical issues
DOI:
https://doi.org/10.35305/cf2.vi18.143Keywords:
COVID-19, health passes, health certificates, vaccination, freedomAbstract
Several countries have implemented COVID passports or health certificates to promote a safer return to in-person social activities. These certificates have been proposed as a way for people to prove that they have been vaccinated, that they have recovered from the disease, or that they have negative results on a diagnostic test. However, many people have questioned its ethical justification. This article presents some practical and ethical problems to consider if we want to implement these passports. Among the former, it is discussed how accurate diagnostic tests are to ensure that a person is not contagious; whether vaccination guarantees immunity; what are the levels of immunity after infection, vaccination and protection against variants; the fact that passports can be forged; if they encourage vaccination and the problem that there is no universally recognized passport. Among the ethical issues it is discussed whether passports promote discrimination and inequality, and whether they violate the rights to privacy and freedom. It is concluded that passports have enough ethical justification to be implemented.
References
Referencias
Abu-Raddad, L.J. et al. (2021a). SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy. EClinical Medicine 35, 100861, https://doi.org/10.1016/j.eclinm.2021.100861.
Abu-Raddad, L.J., et al. (2021b). Effectiveness of the BNT162b2 Covid-19 Vaccine against the B.1.1.7 and B.1.351 Variants. N Engl J Med 385(2):187–189.
AFP. (2021). 160,000 protest in France against Covid rules, France 24, 28 de agosto, https://www.france24.com/en/live-news/20210828-160-000-protest-in-france-against-covid-rules.
Amin, K., Cox, C. (2021). Unvaccinated COVID-19 hospitalizations cost billions of dollars. Peterson-KFF Health System Tracker, 14 de septiembre, https://www.healthsystemtracker.org/brief/unvaccinated-covid-patients-cost-the-u-s-health-system-billions-of-dollars/.
AP. (2021). Fake vaccination cards were sold to health care workers on Instagram, National Public Radio, 1 de septiembre, https://www.npr.org/sections/coronavirus-live-updates/2021/09/01/1033337445/fake-vaccination-cards-were-sold-to-health-care-workers-on-instagram.
Bamji, A. (2019). Health Passes, Print and Public Health in Early Modern Europe, Social History of Medicine, 32(3):441–464, https://doi.org/10.1093/shm/hkx104.
CDC. (2021a). COVID-19. Prueba de infección actual. Centers for Disease Control and Prevention, 27 de octubre. https://espanol.cdc.gov/coronavirus/2019-ncov/testing/diagnostic-testing.html.
CDC. (2021b). COVID-19 Vaccine breakthrough case investigation and reporting. Centers for Disease Control and Prevention, 15 de octubre, https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html.
COVID-19 Vaccine Tracker. (2021). 7 Vaccines Approved for Use by WHO. 23 de octubre. https://covid19.trackvaccines.org/agency/who/.
Creedon, K. (2021). Fake COVID-19 vaccine passports being sold online. 9 News, 6 de septiembre, https://www.9news.com.au/national/fake-coronavirus-vaccine-passports-for-sale-online/2d37baad-398f-4971-8d3a-69fefd670552.
Crotty, S. (2021). Hybrid immunity, Science 372(6549): 1392–1393. DOI: 10.1126/science.abj2258.
De Lecuona, I. (2021). Implicaciones bioéticas del uso de datos y apps de salud en la pandemia, en G. Ortiz Millán y M.J. Medina Arellano (coords.), COVID-19 y bioética, México: UNAM, pp. 113–130.
Dinnes, J., et al. (2021). Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection. Cochrane Database of Systematic Reviews 3. Art. No.: CD013705. DOI: 10.1002/14651858.CD013705.pub2.
EC. (2021). EU Digital COVID Certificate, European Commission, https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/safe-covid-19-vaccines-europeans/eu-digital-covid-certificate_en.
Europa Press. (2021). Protestas en Italia por la entrada en vigor del “green pass” obligatorio para trabajadores, Proceso, 15 de octubre, https://www.proceso.com.mx/internacional/2021/10/15/protestas-en-italia-por-la-entrada-en-vigor-del-green-pass-obligatorio-para-trabajadores-273974.html.
Folegatti, P. et al. (2020). Safety and immunogenicity of a candidate Middle East respiratory syndrome coronavirus viral-vectored vaccine: a dose-escalation, open-label, non-randomised, uncontrolled, phase 1 trial. The Lancet Infectious Diseases 20 (7): 816–826.
Gollom, M. (2021). Why vaccine passports may be an important tool in boosting vaccination rates. CBC, 17 de septiembre, https://www.cbc.ca/news/health/vaccine-passports-vaccination-boost-provinces-1.6178203.
Greig, J. (2021). New York State fixes vulnerability in COVID-19 passport app that allowed storage of fake vaccine credentials. ZDNet, 10 de septiembre, https://www.zdnet.com/article/new-york-state-fixes-vulnerability-in-covid-19-passport-app-that-allowed-storage-of-fake-vaccine-credentials/.
Grossenbacher, K. (2021). Addressing workplace discrimination over vaccination status, https://www.seyfarth.com/dir_docs/publications/Law-360-Addressing-Workplace-Discrimination-Over-Vaccination-Status.pdf.
Holder, J. (2021). Tracking coronavirus vaccinations around the world. The New York Times, 29 de octubre, https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html.
Howell, B. (2021). Which countries are using COVID-19 vaccine passports?, MoveHub, 27 de septiembre, https://www.movehub.com/blog/countries-using-covid-passports/.
Ibarrondo, F.J. (2020). Rapid decay of anti–SARS-CoV-2 antibodies in persons with mild Covid-19. N Engl J Med 383:1085-1087. DOI: 10.1056/NEJMc2025179.
IATA. (2021). IATA Travel Pass for Travelers, International Air Transport Association, https://www.iata.org/en/youandiata/travelers/iata-travel-pass-for-travelers/.
Jacobson v. Massachussetts 197 U.S. 11. (1905). Justia. U.S. Supreme Court. https://supreme.justia.com/cases/federal/us/197/11/.
Johns Hopkins. (2021). Coronavirus Resource Center, https://coronavirus.jhu.edu/map.html.
Kofler, N., Baylis, F. (2021). Nope. A Covid-19 travel pass isn’t just like the yellow card. The Hastings Center, 13 de mayo, https://www.thehastingscenter.org/nope-a-covid-19-travel-pass-isnt-just-like-the-yellow-card/.
Kucirka, L.M., et al. (2020). Variation in false-negative rate of reverse transcriptase polymerase chain reaction-based SARS-CoV-2 tests by time since exposure. Ann Intern Med mayo 13. doi: 10.7326/M20-1495.
Laborde, A. (2021). US travel restrictions for international visitors: Which Covid-19 vaccines are accepted? Are there exceptions? El País, 26 de octubre, https://english.elpais.com/usa/2021-10-26/us-travel-restrictions-for-international-visitors-which-covid-19-vaccines-are-accepted-are-there-exceptions.html.
Lee, N.T., Lai, S., Skahill, E. (2021). Vaccine passports underscore the necessity of U.S. privacy legislation. Brookings, 28 de junio, https://www.brookings.edu/blog/techtank/2021/06/28/vaccine-passports-underscore-the-necessity-of-u-s-privacy-legislation/.
Lopez Bernal, J. et al. (2021). Effectiveness of Covid-19 vaccines against the B.1.617.2 (Delta). N Engl J Med 385:585-594. DOI: 10.1056/NEJMoa2108891.
Montaigne, M. (2010). Diario de viaje a Italia. Madrid: Cátedra.
MBMC. (2021). Impact of potential immunization passports on vaccination intentions (international), Montreal Behavioural Medicine Centre, s.f., https://mbmc-cmcm.ca/covid19/research/stats/imm-passports-intl-s9s10/.
NYS. (2021). Excelsior Pass and Excelsior Pass Plus. New York State. https://covid19vaccine.health.ny.gov/excelsior-pass-and-excelsior-pass-plus.
OMS. (2021a). Interim position paper: considerations regarding proof of COVID-19 vaccination for international travellers. Organización Mundial de la Salud, 5 de febrero, https://www.who.int/news-room/articles-detail/interim-position-paper-considerations-regarding-proof-of-covid-19-vaccination-for-international-travellers.
OMS. (2021b). Smart Vaccination Certificate Working Group. Organización Mundial de la Salud, s.f., https://www.who.int/groups/smart-vaccination-certificate-working-group.
Our World in Data. (2021). Share of the population fully vaccinated against COVID-19, 28 de octubre, https://ourworldindata.org/grapher/share-people-fully-vaccinated-covid.
Petitions. (2021). Do not rollout Covid-19 vaccine passports, UK Government and Parliament, 20 de julio, https://petition.parliament.uk/petitions/569957.
Petherick, A. (2020). Developing antibody tests for SARS-CoV-2. The Lancet 395 (10230): 1101–1102. https://doi.org/10.1016/S0140-6736(20)30788-1
Quiggin, J. (2021). Do vaccination passports take away freedoms? It depends on how you frame the question, The Conversation, 1 de septiembre, https://theconversation.com/do-vaccination-passports-take-away-freedoms-it-depends-on-how-you-frame-the-question-166963.
Qureshi, A.I. et al. (2021). Reinfection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in patients undergoing serial laboratory testing, Clinical Infectious Diseases, ciab345, https://doi.org/10.1093/cid/ciab345.
Reuters. (2021). Factbox: Countries making COVID-19 vaccines mandatory. 8 de octubre, https://www.reuters.com/business/healthcare-pharmaceuticals/countries-making-covid-19-vaccines-mandatory-2021-08-16/
Robertson, C., Oliver, W. (2021). Is it a crime to forge a vaccine card? And what’s the penalty for using a fake? The Conversation, 30 de agosto, https://theconversation.com/is-it-a-crime-to-forge-a-vaccine-card-and-whats-the-penalty-for-using-a-fake-166788.
Schmerling, R.H. (2021). Which test is best for COVID-19? Harvard Health Publishing, 5 de enero. https://www.health.harvard.edu/blog/which-test-is-best-for-covid-19-2020081020734.
Tayag, Y. (2021). Stop calling it a ‘pandemic of the unvaccinated’. The Atlantic, 16 de septiembre, https://www.theatlantic.com/ideas/archive/2021/09/persuade-unvaccinated-protect-unvaccinated/620091/.
Thompson, E. (2021). Cybercriminals are offering to sell fake Canadian COVID-19 vaccination certificates online. CBC News, 1 de octubre, https://www.cbc.ca/news/politics/covid-fake-vaccination-certificates-1.6191154.
Turner, J.S., et al. (2021) SARS-CoV-2 mRNA vaccines induce persistent human germinal centre responses. Nature 596, 109–113. https://doi.org/10.1038/s41586-021-03738-2
Wernau, J. (2021). Covid-19 vaccination cards are the only proof of shots, soon an essential. The Wall Street Journal, 30 de marzo, https://www.wsj.com/articles/covid-19-vaccination-cards-are-the-only-proof-of-shots-soon-an-essential-11617105602.
Wilf-Miron, R., Myers, V., Saban, M. (2021). Incentivizing vaccination uptake. The “Green Pass” proposal in Israel. JAMA 325(15): 1503–1504. doi:10.1001/jama.2021.4300.
Yeginsu, C. (2021). What are the roadblocks to a ‘vaccine passport’? The New York Times, 15 de junio, https://www.nytimes.com/article/vaccine-passport.html.
Zimmer, C., Corum, J. y Wee, S.-L. 2021. Coronavirus vaccine tracker, The New York Times, 15 de octubre, https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Gustavo Ortiz Millán

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
CF2 publishes works under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-ND 4.0). This allows commercial or non-commercial distribution, as long as the work is made available in full and without any modifications, and the original author and first publication in the journal are acknowledged.
By simply submitting a piece of work for evaluation and publication, authors transfer the journal the right to first publication under the aforementioned license. Authors can independently and additionally celebrate other contractual arrangements for non-exclusive distribution of the version published in this journal (e.g. to include their work in an institutional repository or publish it in a book) provided that they clearly state their work was first published by CF2.
Text of the license: https://creativecommons.org/licenses/by-nd/4.0/legalcode