Tuesday, April 06, 2021

Vaccine Passports: Where Biosecurity State Aims - Shed - Pandemic Mitigation Pretensions...,

BMJ  |  The critical issue is not the effect that vaccine passports might have on people in general. If one wants to increase take-up, it is the effect on those individuals and communities who harbour doubts about vaccination which matters. 

Based on hard experience, such communities (ethnic minorities in particular) have reason to question whether medical and governmental authorities treat their needs as a priority and this historical distrust provides a framework for interpreting contemporary pandemic policies. [18] Members of these communities are more attuned to the possibility that such policies (including vaccination) are something done to them rather than done for them by authorities who are not of them but against them. Moreover, there are plenty of anti-vaxxers aiming to promote this view by arguing that covid measures are not a matter of public health, but of social control by a hostile elite. [19] The reality, and even the rumour, of vaccine passports for core activities serves to give substance to these fears and to give traction to the anti-vaxxers. Passports can be seen as confirming the perception that vaccination is a measure of compulsion imposed upon the community. And once people begin to regard vaccines as compulsory then the evidence suggests that this produces anger and reduces willingness to get vaccinated. [20]

All in all, there are reasons to conclude that vaccine passports for basic activities may actually undermine vaccine rollout by disincentivising the very populations who most need incentivising. Closer inspection of the Israeli “green pass” scheme serves to reinforce this message. The evidence for passes increasing vaccination uptake is weak, while suspicions of compulsion and reports of people barred from workplaces for not being vaccinated have “resulted in antagonism and increased distrust among individuals who were already concerned about infringement on citizens’ rights”. [21] By contrast, what has proved successful in Israel are basic measures of community engagement: involving trusted community leaders, taking mobile vaccination units into communities, bringing along medical experts who can answer any questions, and providing food and drink to those who attend, has proved successful in Israel. [22]

To conclude: there are many good reasons to reject any passport scheme which makes everyday social participation dependent on vaccination. There are arguments on the grounds of liberties, of equalities, and of practicalities. However, even some of the grounds used to support them (i.e. vaccine take-up) may be another reason to oppose them. At a point in the pandemic where increased engagement is critical, both in order to overcome doubts about vaccination, and to enhance the pandemic response more generally, the mere possibility of vaccine passports threatens to alienate marginalised communities still further. [23,24]

So, let’s stop discussing the use of vaccine passports as a criterion for basic social and economic participation. This is an idea with few redeeming features and even talking about introducing them may be enough to do damage.