Enforcing a vaccination requirement

This started as a hijack of the Breakthrough thread. Assuming that there is an effective and reasonably priced vaccine by spring, countries, states, companies, restaurants, etc. will start requiring proof of vaccination for their patrons. How will this be handled? This thread is for discussing that question.

I am old enough to recall having to show proof of a smallpox vaccination within, I believe, five years. That was coming from Europe to the US. From other areas, there were additional requirements.

When I landed at JFK in 1964, you went through three separate inspections: immigration, customs, and health. For the last, you had a yellow card that showed all vaccinations. I believe they were signed by the doctor who vaccinated you. It would not have been hard to get one of the cards and get a fake signature. Somehow it never occurred to me to do that.

A system of that sort could be instituted here, but I bet every anti-vaxxer would immediately get a fake card. Is there any way of controlling that? I can’t think of any.

In 1964 there weren’t enough people dumb enough to avoid the Small Pox vaccination to worry about. Additionally, there was that distinct scar on your arm in the US at least.

I can’t see restaurants trying to enforce a vaccination requirement. I suspect it won’t be required of them.

In principle at least I don’t see a problem.

Firstly, a card or certificate is designed with a few basic security features such that it’s not the kind of thing that can be trivially photocopied or printed. Then you include some kind of scannable code, that when decrypted, references a hospital and patient ID that could be externally electronically verified.
Finally you have sufficient penalties for using fraudulent documents to deter all but a tiny minority from ever trying (no, I’m not saying it has to be Draconian; a relatively short custodial sentence will make the risk / reward equation unpalatable for almost everyone. Yes a select few will still try, but that’s always the case for everything).

I know that to some people this might sound pie-in-the-sky, but let me make this wager: some countries will implement all of the above. The question is, how piecemeal is this going to be, or will we get some degree of international cooperation?

And which country is going to be the biggest embarrassment (in terms of wasting money on a system that doesn’t work) this time – the US, or my native UK?

I expect that most anti-vaxxers wouldn’t actually get a fake card, or that the quality of fake cards they could get would be pretty poor and could be fairly trivially invalidated if we cared to do so.

Normal vaccination records require the vaccinating authority to indicate when the vaccine was given, and have contact info on them. If you think that someone’s record is fake, you check that the doctor is a real doctor, then call them up and say “please verify that you gave patient X a covid vaccination on date Y”. There are certainly ways to get around this kind of thing, but creating a paper trail that survives even mild scrutiny is a lot harder than most people think.

If anyone is doing this en masse, then as soon as one person gets caught with a fake and the details of the fake are publicized, all the other fakes become worth a lot less, so the effective way to accomplish this sort of fraud is going to be bespoke, rather than wholesale. That again cuts down on how much of an issue it will be.

The issue is more one of political will. Many places are currently not willing to enforce a mandate to wear masks in public places, which is trivially verifiable and effectively impossible to fake. I expect that vaccine requirements will really only be effective in places where the population largely already wants to get vaccinated, just like mask mandates are mostly effective in places where most people are already wearing masks because it’s the right thing to do.

Missed edit window.
Although I talk about cards and certificates here, a phone app would probably be sufficient, not dissimilar to the tracing apps in use in many countries.

Countries: Show a document signed by a doctor at the border. Said document should include contact info for the doctor.
States: The US states are not going to require proof of vaccination to move among them. At most they will say “you need to be vaccinated, or quarantine yourself”. I don’t expect active enforcement. or even anyone asking which you do.
Companies: Your employer can ask for a note from the doctor. Or trust you.
Restaurants: Not a chance they will be asking for proof of vaccination. I doubt they will even request vaccination.

Something like that is my thinking as well. As other’s point out, cards can be forged, but if you make the penalties stiff enough and the vaccine accessible enough, most people would rather just go to Walgreens and get the shot.
Another incentive to get people vaccinated would be to exempt them (fully or partially) from covid restrictions. As an example (and it’s just an example, nothing more), if you have a bar with a capacity of 100 people, but covid restrictions have changed that to 25, you could allow 25 vaccinated people and 75 (or some percentage of that) of vaccinated people in.
Similarly, people with the card won’t need to wear a mask indoors. Instead of yelling at the cashier, show them your card and go about your business. Again, just an example, I know there’s flaws.

The big downside I see to that is that if restricting people based on this very limited medical history becomes easy (and allowable for private businesses). They’re going to push it further. While I’m all for everyone getting vaccinated, I’m not sure I’m all for, say, Walmart being able to demand proof of those vaccinations. I’m not totally sure how that could be bad, but it seems like it could be bad.

These elaborate scanners-Who is going to pay to install them in all the restaurants and stores, and who is going to pay for the training?

But if proof of vaccination could be no more difficult than showing some type of standard card (similar to an ID), I don’t think it would be that difficult.
I don’t see police (at the state level) going after individuals, but if hotels required proof of vaccination before checking in, that would slow down a lot of travel.
Same with restaurants. Make it easy for them to check, and let the health department or police enforce it.

That wasn’t part of my hypothetical, but if we had ‘elaborate scanners’ (why are they elaborate?), I don’t think you’d need them in private businesses. ISTM, if there’s a question about the validity of a card, you can call the people with the scanner (police? health dept?) or a centralized number that can run a quick check for businesses. But unless there’s a question, I’d hope they could be trusted as much as you can trust an ID belongs to the person presenting it to you.

Personally, I think most people are going to be willing to get the vaccine, even if they choose to let some amount of time pass in case there’s a problem that didn’t get picked up during the trials. Having some type of system like this would hopefully be more of an incentive for people on the fence. Once enough people have had the vaccine, it’ll much more similar, I think, to the flu, where not getting the shot is mostly your problem and not everyone else’s. The trick is to get to that level as quickly as possible.

Another thing about forgeries. The sheer amount of people that walk into my store without a mask and upon being asked to put one on will throw a temper tantrum, swear at the employee and/or yell about how it’s all BS before getting in their car and leaving instead of just saying ‘uh, I have medical problem’ and that being the end of it, suggests to me that they’re not going to look for illegal ways to subvert the system. It’s been 8 months and they still think yelling at people will work, that’s not likely to change.
I’d also be surprised if a significant percentage of those people would even know how to go about getting a fake card.

In my case I wasn’t thinking of restaurants and stores, more like airports, hospitals and other places where verification of vaccination status is critical.

But anyway, it doesn’t have to be expensive. If we go the phone app route then it’s one app for personal verification and one scanning app. i.e. free.
As I say this is already the case in many countries in terms of tracing / status apps.

Finally, even if the cost were, say, $1000 per venue, how much has covid cost us already, and how much is it worth to get back to something like normal?

When it come to government funding, what is paid for and what is worth paying for is oft times linked by greed/self-interest. I agree that it would totally be worth it…but I don’t have any say in how our government distributes the cash.

I don’t see restaurants wanting to do that. And there will be people who can’t get the vaccine. Do they have to have a separate “medical exemption” card? Who is standardizing this? Unless it’s a state program, like a driver’s license, I just can’t see it working. And I don’t expect any of the states to do that. Certainly not all of the states.

Restaurants also don’t want to operate at 25% capacity or be entirely shut down either. I’d think they’d be game if this system meant they could allow more patrons in at the same time.

No idea. Maybe they’d be able to get a card just like everyone else has. If they can’t be vaccinated but it’s decided that they’re exempt, no one needs to know they’re not vaccinated, just that they have the card. Or maybe, at least in the beginning, if they’re not vaccinated, regardless of the reasoning, they don’t get a card.
Along those same lines, some people are exempt from wearing masks. Personally, I think that, even if you’re exempt from wearing a mask, if you’re coughing (for any reason at all) or otherwise showing symptoms, you shouldn’t be allowed in a business. Exempt from wearing a mask doesn’t make you exempt from catching and spreading it. Same with someone that can’t get a vaccine. It doesn’t matter why you can’t (or don’t) get it, if you aren’t vaccinated you’re at a much higher risk to spread it.

I don’t know. It’s just something I made up because it seemed like a good idea. Those details aren’t something I gave any thought to at all.

For the US at least, I don’t see any reason to worry about people getting fake cards - I doubt there will be any reason to. Restaurants and stores won’t be interested in checking vaccination status unless they are mandated to - and it will be very difficult in the US to mandate that a private business turn away unvaccinated customers. Someone correct me if I’m wrong, but I don’t think there has ever been a vaccine mandate that applied to everyone in the US - they’ve applied to people seeking a visa or permanent residency, they sometimes apply to people in certain jobs (mandated by the employer) , and they apply to people attending public or private schools and possibly colleges. There are medical and sometimes religious/philosophical exemptions to some of these requirements , but there’s always a way out. Even if the only way out is by homeschooling my children, that’s still a way out. I just don’t see US governments being able to mandate a vaccine to begin with. From what I’ve read, vaccination requirements in Canada are currently pretty similar to those in the US, so I’m not sure if it realistically could be made mandatory for everyone there either.

“Come enjoy dinner tonight; all food cooked and served by our fully vaccinated staff.”

As to scanners. …

In many states bars are required to have driver’s license scanners. If you seem to be of tender age they’ll scan the nationally standardized 3D barcode on the back and the relevant DMV will report the true age and whether the barcode is valid.

Certainly that system could be piggy-backed on if DMVs were given the vaccination status of people by the administering medical facility, not by the patient.

The largest objection, besides the whole civil liberties discussion, is that this need for vaccination proof ought to be temporary.

If we do the collective vaccination thing well enough, the transitional period where some have been and some have not will be brief, as in a few months, not a few yeas. I certainly understand the “carrot & stick” value of giving the populace some tangible immediate benefit from having been vaccinated.

But ISTM at least for the rational ones (a high hurdle I recognize), the intrinsic motivation of being immune to a serious disease ought to dwarf any possible extrinsic motivation of some tangible reward like access to a restaurant.

I know schools in our area are already requiring vaccination records before they allow kids to be enrolled in public or private schools, and schools need to do that to stay accredited. And those requirements were set before the beginning of the 2019-2020 school year as my state (Washington) no longer allowed families to opt out for religious purposes. So that was prior to Covid-19 being discovered.

There is precedence in the US, while government doesn’t force people to be vaccinated (such as the military rounding people up and vaccinating them like paranoid anti-vaxxers fantasize about) it can make life very inconvenient if you don’t. Which I think is the right way to do it. Don’t force people, but really, kind of force people.

I just read today that only 58% of Americans want to be vaccinated. So low has trust in science sunk.

That is really depressing and incomprehensible to me.

I work in the healthcare field and plan to get vaccinated but I am absolutely not okay with people being required to vaccinate. Barring the mentally incompetent, no one should be forced to put anything in their body without their consent.

I would be okay with limiting travel, etc without proof of vaccination.