The Futility of Vaccine Passports

Domestic vaccine passports are fine on the surface, but they don’t provide help to the people who need it most.

A passport emblazoned with a golden syringe
The Atlantic

While much of the world remains in the throes of the pandemic, Ayelet Baram-Tsabari’s life has mostly returned to normal. In the weeks since Israel implemented its “green pass” system, reopening much of the country’s economy to its vaccinated population, she has returned to work, been to the movies, and even planned a staycation with her family.

“It’s wonderful,” she told me from her home in Tel Aviv. “It’s like you can breathe again.”

Only a year ago, Israel was entering the first of what would be three national lockdowns. Since mid-December, it has rolled out a mass-vaccination campaign that has made it the envy of the world. And for more than a month, many Israelis have been able to flock to restaurants, gyms, hotels, and other public places simply by showing their green pass, which has a QR code proving that they have been fully inoculated or have recovered from a confirmed COVID-19 infection. Though the system is not without its hiccups (concerns have been raised over counterfeit passes and the potential lack of enforcement), many countries nonetheless view it as a fast track back to normal.

But this shortcut comes at significant cost. It splits society into the jabbed and the jabless, creating the perception that the vaccine is de facto compulsory and that those who refuse one will face social exclusion. That division, public-health experts warn, could entrench inequalities and dissuade vaccine-hesitant populations precisely when governments need to shore up their confidence. Perhaps most concerning, the proposal undermines the narrative that we are all in this together by creating a system that benefits those who are open to vaccination at the expense of those who have concerns.

Of all the countries considering a domestic vaccine-passport system, Britain appears to be the most commonsense contender. Like Israel, it has administered vaccines at an incredible clip; nearly half its population has already received at least one dose. The country’s hospitalization and death rates have steadily fallen. And while much of Europe is going back into lockdown, Britain is gradually lifting its coronavirus restrictions, with indoor dining slated to reopen as early as next month.

Prime Minister Boris Johnson confirmed in a national address on Monday that his government is exploring the feasibility of “COVID-status certificates,” which would be acquired through vaccination, a recent negative COVID-19 test, or proof of natural immunity (such as a positive COVID-19 test from the past six months). Though these certificates would be required to access mass events and venues, including festivals, stadiums, and nightclubs, Johnson said they would not apply to essential public services, such as supermarkets and public transport.

The appeal of this kind of system is understandable. For countries that have already vaccinated much of their population, domestic passports offer the quickest and safest way to reopen their economy and get society going again. Proof of a jab seems like a small price to pay for freedom. Many countries already require proof of vaccination against specific diseases as a condition for entry. Plus, who wouldn’t feel a bit more comfortable venturing into the world knowing that everyone around them isn’t a vector of disease?

There’s also the added hope that tying access to places such as pubs and restaurants could persuade those who are hesitant about vaccines to get a shot. In Israel, lacking a green pass doesn’t completely exclude you from public life—you can still dine at a restaurant, for example, so long as you sit outdoors. “It’s just less comfortable,” Baram-Tsabari said. “It’s creating a situation in which the right choice is also the easy choice.”

Though Israel’s green-pass system has been credited with motivating people to get a jab, that isn’t its primary goal. “The reason these rules have been put in place is not to encourage vaccine-hesitant people to get vaccinated,” Ran Balicer, the chairman of Israel’s national coronavirus task force and the chief innovation officer of Clalit, the country’s largest health-care provider, told me. “It’s simply done to make sure that vaccinated people can go and safely eat and enjoy cultural activities and not be exposed to undue risk during this process.”

The problem, however, is that intention and perception don’t always align. The pandemic has already inordinately affected people on the basis of race, gender, and socioeconomic status, and vaccine appointments are disproportionately being taken up by white Britons and those from more affluent areas. By making a return to normal social activity contingent on vaccination, natural immunity, or a negative COVID-19 test, those inequalities could be ingrained further. Though London has promoted testing as an equalizer that will prevent nonvaccinated people from being excluded, it isn’t widely accessible in Britain. Until it is, “the same people who are most at risk are going to be the same people who are least able to get a test,” Clare Wenham, an assistant professor of global-health policy at the London School of Economics, told me, noting the challenges facing those who cannot currently access testing due to cost, inability to get time off work, and transport issues.

Recent polls have shown that a majority of British people support vaccine passports. But this enthusiasm isn’t shared among young people, ethnic minorities, and those in poor areas—the same groups that have exhibited some of the lowest levels of vaccine confidence in the country. Though the British government has taken proactive steps to address people’s concerns about the vaccines, including targeted messaging campaigns and pop-up vaccination clinics, those efforts could mean little if the same communities that are looking for assurances from the government are simultaneously being told that their ability to reenter public life is conditioned on their willingness to get a shot. Such an approach not only risks amplifying distrust, but could also provide fodder for anti-vaxxers wishing to cast doubt on the vaccines and the public-health institutions promoting them.

“If you have vaccine inequalities by ethnicity, by race, and also by social deprivation, and you add vaccine passports for basic social activities onto that, you begin to get vaccine apartheid,” Stephen Reicher, a member of a group of behavioral scientists that advises the British government’s pandemic-response committee, told me. “If you want to get people to do things like get vaccinated, community engagement is what is central. And precisely at a time when you want community engagement, the worst thing you could do is [impose] a measure that could alienate those communities and could lead them to be less likely to take the vaccine.”

With or without vaccine passports, Britain is already well on its way to normal. Come next week, people will be allowed to return to gyms, nonessential shops, and pub gardens. If transmission remains low and the vaccine rollout progresses as planned, the lifting of further restrictions won’t be far behind.

Vaccine passports may accelerate the path to normalcy, but they would also almost certainly risk leaving parts of the country behind. Until everyone can be offered a vaccine and until the concerns of hesitant communities are addressed, the only assured destination that vaccine passports can offer is further inequality and division.

The Atlantic’s Covid-19 coverage is supported by a grant from the Chan Zuckerberg Initiative.