Saturday, May 01, 2021

The PROs and CONs of vaccine passports

There was a fascinating exhange about vaccine passports on CBC today (the audio is here, skip to minute 32:50 for the relevant section). I knew that the issue was controversial, but this debate, between a Dalhousie University philosophy prof and bioethicist (who warns against vaccination passports) and an infectious diseases specialist at the University of Toronto (who is for them), brings home just how messy the whole issue really is.

The starting point here is that the EU, which is already establishing a Digital Green Certificate system for travel within the bloc, has just announced that Americans who have been fully vaccinated will soon be able to travel to Europe with a comparable vaccine passport for a vaccine that is recognized in the EU (sorry, China, Russia), and Canada may be able to join that exclusive club later.

CON: Because some people have been vaccinated and some not (mainly poorer people in more marginalized areas), the very idea of vaccine passports automatically introduces systemic discrimination, depending on people's access to vaccinations.

PRO: Digital vaccination passports are coming, and indeed are already here in some places, so we have little choice but to get on board. As of now, the passport system only accomodates the global North (EU and North America), but the situation is constantly changing and updating.

CON: There is still much uncertainty about the extent to which vaccines will stop transmission of the virus, how long the vaccines will be effective, the effectiveness of different vaccines (should there be different classes of passport/certificate?), how effective different vaccines are against different variants (e.g. it is thought that AstraZeneva may be quite ineffective against the South African variant), etc.

PRO: If we want to open up international travel, it is still safer to have a system of certification than not. Also, people from India, for example, who are currently completely blocked from travelling to many countries, would at least be allowed to travel insofar as they are completely vaccinated.

CON: It is unfair to only allow certification for those vaccines that the EU happens to have approved (Pfizer/BioNTech, Moderna, AstraZeneca, Janssen/Johnson & Johnson). It builds up barriers based on science, but also based on politics.

PRO: This is nothing new: we already have a system for requiring yellow fever vaccinations, for example, for countries where that disease is a problem.

CON: Yellow fever is very different from COVID in many ways: yellow fever certification is issued and managed by WHO (which has not, so far, approved COVID vaccine certificates); the yellow fever vaccine has been around since 1938, is single dose, life-long, and nearly 100% effective; there is just a single type of yellow fever vaccine, as opposed to the many different COVID-19  vaccines; the yellow fever vaccine is about protecting the traveller, not the country being travelled to.

PRO: Vaccine passports act as an incentive for people who might otherwise be hesitant to receive it, getting us closer to herd immunity.

CON: On the contrary, it is actually a kind of subtle coersion that might make vaccine-hesitant people and anti-vaxxers resentful and suspicious, and possibly even less likely to be vaccinated. And most poor, marginalized and racialized people, who are more likely to be vaccine hesitant, are not in a position to travel abroad anyway, and so will not be inventivized.

On balance, the PRO arguments here may be vaguer and more defensive, so the CON arguments may have won this particular exchange. But, speaking as someone who wants to get back to travelling, rational arguments are not the only things at play here. Tricky stuff!

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