Elite Discussion Of Vaccine Passport Challlenges By Those Who Would Mandate Them

Harvard |  As COVID-19 vaccines become more widespread, passports that certify immunization status may facilitate a return to normalcy, write Lawrence O. Gostin, I. Glenn Cohen, and Jana Shaw in a viewpoint published today in JAMA.

But these vaccine passports, or digital health passes, are not without scientific, legal, and ethical challenges.

I asked Gostin, Faculty Director of the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, Cohen, Faculty Director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, and Shaw, a professor of pediatrics at Upstate Medical University, about the key areas of concern and promise for vaccine passports. Our conversation, which has been edited and condensed, follows.

Chloe Reichel: What is a digital health pass?

I. Glenn Cohen: A digital health pass, sometimes referred to as a vaccine passport, is essentially a way of digitally recording that someone has had a vaccination, and then details about the date of vaccination, and potentially the kind of vaccine they were given, to the extent relevant. It might be something created by a governmental authority, or might be something created in the private sector.

CR: How can these digital health passes help us get to a new normal?

Jana Shaw: Vaccine passports, or digital health passes, let others know that you are safe and that you are keeping others safe by getting vaccinated. Places that require digital health passes are making sure everyone there is safe.

Lawrence O. Gostin: Essentially, the goal is to try to return to as normal as possible, as safely as we can, and as soon as we can.

And so the idea of a digital health pass is to make sure that everyone in a given space is protected, and also has a diminished potential for spreading the infection to others.

CR: Can you describe some of the scientific challenges associated with implementing digital health passes?

JS: There are numerous challenges to creating digital health passes.

Length of protection is one of them. However, that can be easily addressed by including the date of vaccination. As we get more information on length of protection from vaccination, vaccine passports can be then used accordingly.

Another limitation is that the efficacy of various COVID-19 vaccines differs. However, we recognize that the efficacy differs against developing symptomatic disease, and all authorized vaccines are very effective against serious illness.

In addition, as we monitor the emergence of variants of concern, there have been reports of decreased vaccine efficacy among certain vaccines. However, that currently is being addressed by vaccine manufacturers. They are developing vaccines that target the emergent variants to ensure that their vaccines will continue to be effective as variants evade vaccine-induced immunity.

We could not really talk about challenges and not talk about access to vaccination. Universal access to vaccines has to be ensured before digital health passes are rolled out, to mitigate the risk of transmission and the risk of creating an equity divide for those who are not vaccinated.