The Vaccine Passport - news and views

This story hit the news in the UK yesterday. Up until this point the UK government had been firmly against introducing a “vaccine passport” - here envisaged as a proof of vaccination, necessary to allow you to use a restaurant, bar, theatre, etc:

So now the idea is, lets say, gaining ground. I would suggest that, in some form, it’s going to be inevitable - but I concede there are issues.

“Vaccination assport” can also have a second meaning:

Last month, Ursula von der Leyen, president of the European Union Commission, said that she supports creating a common EU-established vaccination certificate that can be issued by member states to their citizens. Von der Leyen even suggested that such a certificate should be a “medical requirement.”

She was responding to a letter from Greek Prime Minister Kyriakos Mitsotakis, in which he called upon the European Commission to introduce a standardized coronavirus vaccination certificate to facilitate travel within the European Union bloc.

From where I sit, it almost doesn’t matter what Boris Johnson and his government thinks - there’s no swimming against the tide on this one.

So, this thread is for updates on vaccine passport news, issues and opinions around the world. What’s the situation where you are? What do we all think?

j

I hope that by the time these various countries get their act together, COVID-19 will be fading away. At the current rate of vaccination, there (hopefully) won’t be any need for this in 6 months, and I cannot imagine the EU coming to agreement and rolling out a secure system in less than 6 months.

While I think this sounds like a pretty good idea, I also think that it will fail. I could easily fake the vaccine card I received and I’m not an expert by any means.

I honestly doubt that any online process will be secure.

Vaccine passports will be the next “service” animal because entitled people are entitled.

This thread is kind of an offshoot of a debate that started in the Vaccine Refuser Data Thread - in part, the issue that the passport is intended to address is refusal. As I said in the other thread, regarding vaccine passports:

The issue ties into this [Vaccine Refuser] thread because vaccine passports are an obvious way to persuade people to vaccinate - if you are not willing to contribute to a return to normal life, why should you be allowed to partake in that return to normal life, and by doing so increase risk of harm for others?

Some EU countries have alarming levels of refusal (I’ll try to dig out some stats to support that statement). In six-or-twelve months time there may still be a problematic number of people who need to be encouraged (or coerced) to vaccinate. I’d love to think that in 6 months time the issue will have gone away as a consequence of vaccination. But I have my doubts.

j

Then make extremely stiff penalties for forging one.

Maybe you get caught, maybe you don’t. But is it worth 10 years in jail to go see that new flick at the theater?

Some number of those refuseniks will get vaccinated when they see everyone doing it and surviving. At least one or two people I know are taking a wait-and-see approach.

Others will get it and die or be naturally immune. Either way, unless refusers are a really significant portion by June, I think this be much less of an issue by the end of summer.

Back to your OP, I’m OK with a vaccine passport. There will likely be some people faking them, but most people aren’t that tech savvy or that motivated to fake it, so it will still do some good. The vast majority of people with pets don’t fake a service animal certificate either.

That’s a typo to die for. If a passing Mod sees this, could you be so kind as to ease my embarrassment?

Thanks in advance,

j

I agree that it will largely go away by the time a system is implemented - if there are no refusers. They constitute an additional well of potential infectors beyond those where the immunity doesn’t take or are actually unable to get vaccinated. If 20% of people refuse, that’s still enough to keep the infection going with a virus with an R0 of 8.

I’m on the fence of whether to give special privileges to those who have managed to get the vaccine over those who are willing yet unable. You need to get the economy back going again and it would provide an incentive to get the shot, but it would also provide an incentive to pull strings to skip the line.

Dies vaccine passport equal pharmacovigilance surveillance strategies? What say you?

COVID-19 Vaccine Safety Surveillance | FDA
“While development and manufacturing proceed, the HHS–DOD partnership is laying the groundwork for vaccine distribution, subpopulation prioritization, financing, and logistic support. We are working with bioethicists and experts from the NIH, the CDC, BARDA, and the Centers for Medicare and Medicaid Services to address these critical issues. We will receive recommendations from the CDC Advisory Committee on Immunization Practices, and we are working to ensure that the most vulnerable and at-risk persons will receive vaccine doses once they are ready. Prioritization will also depend on the relative performance of each vaccine and its suitability for particular populations. Because some technologies have limited previous data on safety in humans, the long-term safety of these vaccines will be carefully assessed using pharmacovigilance surveillance strategies.”

February 9, 2021

The Center for Biologics Evaluation and Research (CBER) at the FDA is monitoring the safety of authorized COVID-19 vaccines through both passive and active safety surveillance systems. CBER is doing so in collaboration with the Centers for Disease Control and Prevention (CDC), the Center for Medicare and Medicaid Services (CMS), the Department of Veterans Affairs (VA), and other academic and large non-government healthcare data systems. In addition, CBER participates actively in ongoing international pharmacovigilance efforts, including those organized by the International Coalition of Medicines Regulatory Authorities (ICMRA) and the World Health Organization (WHO). These efforts are in addition to the pharmacovigilance efforts being undertaken by the individual manufacturers for authorized vaccines. A coordinated and overlapping approach using state-of the art technologies has been implemented."
" BEST

To elaborate further, the BEST system, which is part of the Sentinel initiative, comprises large-scale claims data, electronic health records (EHR), and linked claims-EHR databases with a data lag of approximately three months. The system makes use of multiple data sources and enables rapid queries to detect or evaluate adverse events as well as studies to answer specific safety questions for vaccines. The linked claims-EHR database makes it possible to study the safety of vaccines in sub-populations with pre-existing conditions or in pregnant women. The major partners for BEST currently are Acumen, IBM Federal HealthCare, IQVIA, and Columbia University and many affiliated partners such as MedStar Health, BlueCross BlueShield of America, the Observational Health Data Sciences and Informatics (OHDSI), OneFlorida, University of California and several others. (1)

Using BEST, CBER plans to monitor about 15 adverse events External Link Disclaimerthat have been seen with the deployment of previous vaccines but have yet to be associated with a safety concern for an authorized COVID-19 vaccine at this time. CBER further plans to use the BEST system to conduct more in-depth analyses should a safety concern be identified from sources such as VAERS.

CMS

CBER has worked over the past several years with CMS to develop capabilities for routine and time-sensitive assessments of the safety of vaccines for people 65 years of age and older using the Medicare Claims database. Because it was already in place, this system was immediately put into use for COVID-19 vaccine surveillance to monitor for adverse events."

"Because some technologies have limited previous data on safety in humans, the long-term safety of these vaccines will be carefully assessed using pharmacovigilance surveillance strategies.”

So is the FDA stating the above quote? If not who issued this statement? The vaccine manufacturer? Why not quote them?

It would not be hard to make a difficult to fake one if anyone cared to do so. Make a free app that hooks up to a government database, put a QR code on the vaccine card that links to the database, and when you try to go in, your card gets scanned and the app pops up a photo of the person the card is valid for, or a notice that says “invalid”

It’s still possible to fake that, but it’s not easy.

I’m in favor of something like this being an option. If you run a shop and want to limit it to vaccinated people and advertise that fact, then you can verify it. If you don’t care and the general levels of disease are low enough that shops can open, then whatever.

From what I am reading, there won’t be a paper vaccine passport because the current generation of cards can be forged. And whatever the cyberspace credential may be, you’ll be able to get it with a current vaccine (current, if this drags on and annual boosters are needed) or recent negative test.

This seems reasonable to me.

Half of northern Europe heads south to the sunshine states around the Mediterranean for their summer holidays. Spain, Portugal, Italy, Greece, Croatia, etc all have economies where tourism is a very important. At the moment they are locked down and there are travel restrictions in place.

However, there are vaccination programs in operation in many countries, which, it is hoped, will lead to the re-opening of the tourism and travel business in the summer. But there are risks. Covid-19 spread very rapidly last year in the UK. The vector was from tourists returning from winter holidays in Italy. This could happen again if vaccination proves to be ineffective against a new variant of Covid-19. But then there are hopes to develop new, efficient procedures where new vaccines can be found quickly…But we are not there yet.

Any vaccine passport is going to have to be thorough if it is to be used as the basis on which someone can board their holiday flight. There is also the question of testing. Someone can be vaccinated but can also be infectious.

If someone from the UK wants to go for two weeks holiday in Greece, what would they need? Proof of a vaccine shot and booster? Lateral flow test or swab test? Do they get tested again when they come back? What if they are positive for some variant?

The vaccination rollouts in many EU countries are quite glacial at the moment and the politicians are under a lot of pressure. Many are making very contrasting interpretations of the vaccine trial data regarding who does and does not get a vaccinated with which vaccine. The French have decided that the Oxford vaccine is not effective for the over 65s, so they will have to wait for supplies of an alternative to become available. In the UK the authorities have come to exactly the opposite conclusion looking at the same data. The decision on the efficacy of a vaccine is clearly a political issue, depending on what exactly the government has on the vaccine shelf at that moment to offer its population.

So if someone over 65s from the UK wants a holiday in France, what is the status of their vaccine passport if it says Oxford vaccine? There will be many such inconsistencies that need to be resolved.

This will get very confused and messy, very quickly trying to find common ground amongst many national governments. The EU is not good at quick solutions to short term problems. It takes too long to reach a consensus. This is becoming very painfully obvious with its vaccine procurement process, which has been widely criticized for its slowness and poor leadership.

I expect the UK may come to some bi-lateral deals with Greece and Spain, where there is a mutual interest in getting the travel and tourism markets opened up. I am sure if it includes help with their vaccine roll-outs, that would certainly oil the wheels of commerce.

As we go from vaccine nationalism to vaccine diplomacy, it is clear that the Russia and China are already there in the world outside the western bubble.

All the talk of science and technology is just a fig leaf used by governments to excuse the decisions they have already made on the basis of their political relationships and resources at hand.

So it will be, with talk of vaccine passports. Who gets to travel where and when is a political matter, it does not depend on what technology is used. Regular passports are already a huge mix of technical standards that are by no means universally implemented to the same standard. It is unlikely that vaccine passports will be any different.

I would not be surprised if Boris Johnson does a deal with Greece for holidays in the sun for Brits trying to shake off the Covid winter blues. Some mutually recognised passport stamp? He knows the vaccine program is going well, way ahead of the EU states. If you are coming from a country with an effective vaccine rollout and has lockdown policies to mitigate infection, that is far safer bet that one that is clearly in the doldrums.

However, it is a game of two halves. What about those returning from a couple of weeks holiday? That would need testing at the airports and that could involve huge numbers of people. At the moment travel is very locked down and 10days in government nominated quarantine hotel at your own expense is not practical. So if that were to be relaxed, what do you do with those that test positive? You can’t exactly send them back if they are your own tourists. So send them home to self isolate?

The complications seem endless!

If you’re going to test everyone there is zero point to having a vaccine passport as far as international travel goes.

There was a twitter poll on (UK TV program) The Last Leg last night. I think the question asked was something like “Are you OK with Vaccine Passports being introduced?”. Result: 68% in favour. I suspect the demographic of the show leans toward young and liberal.

I tried googling to get the exact question asked, and failed - but I found two interesting pieces in the Guardian.

First, a discussion of ethical issues:

And second, on similar ground, a more practically minded story from a couple of days ago, addressing the issue of how you would go about designing a passport system:

The issues are urgent and some countries are already introducing passports, say the scientists in a report. Estonia has joined with the World Health Organization and others to test a vaccination certificate on its borders, while Israel is developing a green passport and a purple badge, visible on a smartphone and linked to ID, allowing people access to gyms, places of worships, hotels and cultural events.

The Royal Society’s report highlights 12 criteria that need to be considered, from certifying immunity, to data protection and ensuring people did not lose their jobs because of a health reason or personal belief that prevented them being vaccinated.

We’re not advocating for or against, but we’re saying this is coming. Countries have already introduced it, companies are already saying they’re going to put it into their contracts. We have to openly break this open and discuss it,” said Prof Melinda Mills, the director of the Leverhulme Centre for Demographic Science at the University of Oxford and a lead author of the report.

My bold.

Here’s a link to the page on the Royal Society website where the report is summarised and the 12 criteria are listed. There is also a link there to the report itself (20 pages, haven’t got round to looking through it yet).

j

The problems with vaccine passports are many. Which vaccine? How many injections done? What evidence of protection provided by the vaccine from an extending list of variants of Covid-19. Which national health authorities assess the vaccine treatment as effective for controlling infection?

Most of the stats seem to be about the protection the vaccine provides for the individual vaccinated: whether they are likely to suffer serious illness or death. The evidence of how effective they are at controlling the spread of infection is not there.

Testing is also problematic, they cannot detect when someone is at an early stage of infection. So quarantine is used to be sure. But even that does not catch all cases, as has been seen in New Zealand, where cases do get through the strict quarantine and testing regime they have put in place and they are forced into impose localised lockdowns to stop the spread.

Imposing controls at the border by requiring some kind of vaccine passport seems to offer very little guarantee that the holder is not infectious. Vaccines are the wrong tool for this.

Using them internally is maybe a better approach as long as it keeps the consent of the public. Vaccination as a requirement for a job dealing with the elderly and medically vulnerable seems reasonable. As requirement to get into a bar or attend a festival or cultural event? Less so!

I missed this article from four days ago:

A petition urging the government not to introduce vaccine passports could be debated by MPs after it gained more than 200,000 signatures.

The online petition says the passports could be “used to restrict the rights of people who have refused a Covid-19 vaccine”…

…Any parliamentary petition signed by over 100,000 people must be considered for a debate in Westminster Hall, the Commons’ second chamber.

So the government will have to consider whether they want to consider the thing that Boris Johnson* is already committed to consider. A (smallish) show of force, I guess. And utterly irrelevant in the context of travelling to another country; which will decide on necessary documentation for admission as they see fit.

j

(*) - see OP

Y’know sometimes you see a headline and then read the story - and the story turns out to be not at all what you were expecting?

Having seen a few earlier stories about Brown, I assumed that he had been forced out of the festival line-up because of his vocal opposition to vaccination. Imagine my surprise…

Singer Ian Brown has pulled out of headlining a festival over his refusal to play events that “accept vaccination proof as condition of entry”.

Festival organisers said they would “comply with conditions” set out by the government through the local authority…

…The organisers of the Warrington festival, who have replaced Brown on the bill with fellow indie icons James, added: "No decisions will be taken by government until 21 June at the earliest.

So, the way I read it, if the festival goes ahead the government may require proof of vaccination (or proof of a negative test, it says elsewhere) as a condition of admission - something which the organisers would comply with, of course. And that was enough to set Brown off.

Looks like he might not be working the circuit too much in the foreseeable future.

j

Building up to a vaccine travel passport:

…once travel is allowed again, the success of the UK’s vaccination programme makes Britons especially attractive to countries wanting to attract holidaymakers, especially those European countries which are traditionally popular with British tourists…

…Rita Marques, Portugal’s secretary of state for tourism, told the BBC: “I do believe that Portugal will soon allow restriction-free travel, not only for vaccinated people, but those who are immune or who test negative. We hope to welcome British tourists from 17 May.” [Note: In the UK it is currently illegal to holiday abroad; it is anticipated that restriction will be lifted on 17 May]…

…Cyprus’s deputy tourism minister, Savvas Perdios, said the country would allow Britons who had been given vaccines approved by the European Medicines Agency (EMA) to enter without the need for a negative test or to quarantine.

I think there’s a whiff of inevitability about this now, albeit that it’s going to get very complicated.

j

This is a strange article - half health politics, half holiday suggestions and destinations.

But it does give a sense of inevitability of the passport for international travel; an idea of how far it has progressed; the scale of coverage; and how the system is going to operate.

As the European Commission prepares to present a project to issue a digital vaccination passport, some European Union member countries are ready to recognize the document and are implementing lighter conditions for vaccinated travelers in an effort to rescue summer tourism.

With a tourism industry that provides 27 million jobs throughout Europe and generates around 10% of the E.U.'s GDP, countries across the continent are desperate to encourage the return of summer tourists with the “digital green pass” or vaccination passport appearing as the best scheme to facilitate travel to the E.U…

…Whether in digital or paper form, the vaccine passport or proof of vaccination will be issued by the country of origin and will allow travelers to move around Europe and to come to Europe from abroad, without having to do additional Covid-19 tests or enter quarantine.

One of the links is to this site:

Whether in digital or paper form, this vaccine passport or proof of vaccination will be issued to you by your country of origin once your vaccine has been made. Its advantage? Allow you to travel without having to do additional Covid-19 tests and without risking being in quarantine.

The Vaccine Passport or vaccination certificate must be validated by the respective country of origin and state the name, date of birth, health number, type and date of the test and vaccines (date of the two doses taken) and respect for the immunization period according to the instructions for each vaccine.

You do not need to be European to travel to Europe thanks to your vaccine passport since many European countries are already committed to recognizing passports issued by other countries at international level.

(Incidentally, a big chunk of text of these two links - the holiday location promotions - appears to be identical. Hmm)

j