Vaccine passports during the COVID-19 pandemic

A vaccine passport or proof of vaccination was an immunity passport employed as a credential in countries and jurisdictions as part of efforts to control the COVID-19 pandemic via vaccination. A vaccine passport was typically issued by a government or health authority, and usually consisted of a digital or printed record (such as a vaccine card, QR code, or digital authentication).

The use of vaccine passports was based on the general presumption that a vaccinated individual would be less likely to transmit SARS-CoV-2 to others, and less likely to experience a severe outcome (hospitalization or death) if they were to be infected, thus making it relatively safer for them to congregate. A vaccine passport was typically coordinated with policies enforced by individual businesses, or enforceable public health orders, that required patrons to present proof of vaccination for COVID-19 as a condition of entry or service; in the latter case, these requirements were intended to improve uptake of the vaccines, which in turn would allow for the gradual easing of overall public health restrictions.

Government-mandated use of vaccine passports during the COVID-19 pandemic typically applied to discretionary public spaces and events (such as indoor restaurants, bars, and large-scale in-person events, such as concerts and sports), and not essential businesses, such as retail stores or health care. In France, Italy, Ireland, and Canada, vaccine uptake increased after various levels of governments announced plans to introduce vaccine passports.

Vaccine passports were controversial and raised scientific, ethical and legal concerns. England initially decided against mandating vaccine passports due to worries that discrimination and economic harm would occur, but later joined the other nations of the United Kingdom in mandating vaccine passports due to the threat of the Omicron variant.

The concept proved divisive in the United States; Canada, the UK and much of the European Union citing civil liberties and privacy concerns. The U.S. federal government left the matter to individual states. While some cities and states chose to implement a vaccine passport rule, others explicitly banned them in certain public and private sector contexts, arguing that they discriminate against those who made a personal choice to not receive the vaccine. A federal proof of vaccination requirement for land-based border crossings into Canada by essential workers resulted in the 2022 Canadian trucker protest in Ottawa, backed largely by liberty-oriented groups.

History and background

Many governments, including Finland and Germany, expressed early interest in the concept. Vaccine passports were seen as a potential way to permit a faster economic recovery from large-scale lockdowns that applied to all residents (especially within the travel and tourism industries), improve the confidence of patrons concerned for their health and safety, and incentivize vaccination in order for a population to potentially reach "herd immunity".

In May 2020, Chile started issuing "release certificates" to patients who had recovered from COVID-19, but stated tha the documents did not yet certify immunity. Many governments including Finland, Germany, the United Kingdom, and the United States expressed interest in the concept.

The Royal Society published a report on 19 February 2021, where a lead author of the report, Professor Melinda Mills, Director of the Leverhulme Centre for Demographic Science at the University of Oxford said: “Understanding what a vaccine passport could be used for is a fundamental question – is it literally a passport to allow international travel or could it be used domestically to allow holders greater freedoms? The intended use will have significant implications across a wide range of legal and ethical issues that need to be fully explored and could inadvertently discriminate or exacerbate existing inequalities.” The report listed 12 essential criteria for an international standard.

On 12 March 2021, Ecma International announced its intention to create an international standard which prevented counterfeits and protected private data as much as possible in a "Call for Participation on Vaccine Passports International Standardization" that referenced the earlier report from the UK's Royal Society. In August 2021, Ecma International announced revisions to Ecma-417 (Architectures for distributed real-time access systems) relevant to standards for vaccine passports.

An early advocate of immunity passports during the COVID-19 pandemic was Sam Rainsy, the Cambodian opposition leader. In exile and under confinement in Paris, he proposed immunity passports as a way to help restart the economy in a series of articles which he began in March 2020 and published in The Geopolitics and The Brussels Times. The proposals were also published in French. The idea became increasingly relevant as evidence of lasting acquired immunity became clear. Rainsy and other proponents of the idea, argued that immunity, whether acquired naturally or through vaccination, was a resource which needed to be used to limit the impact of the pandemic on the global economy. Many people in Cambodia depended entirely for their living on a tourism industry which had been wiped out during the pandemic. Poor countries could also benefit from recording immunological status as this would reduce wastage of scarce vaccines. The immunity passport proposed by Rainsy was effectively adopted in the EU under the name of "health pass".

It was initially unclear whether vaccinated people who remained asymptomatic were still contagious and were thus silent spreaders of the virus putting unvaccinated people at risk. "A lot of people are thinking that once they get vaccinated, they’re not going to have to wear masks anymore," said Michal Tal, an immunologist at Stanford University. "It’s really going to be critical for them to know if they have to keep wearing masks, because they could still be contagious."

In January 2021, Israel announced that Israelis who had received their second vaccination and those who had proof of recovery from infection would be eligible for a Green Pass, exempting them from isolation requirements and mandatory COVID-19 tests, including those on arrival from overseas. In February 2021, Israel became one of the first countries to implement a vaccine passport system, dubbed the Green Pass. They were required to access venues such as gyms, hotels, bars, and restaurants. In October 2021, Israel announced an update to its guidelines, requiring the most recent vaccine dose (or proof of recovery) to have been during the past six months. This change made Israel the first country to make a booster shot a requirement for its vaccine passport system.

By region

Africa

Morocco

In August 2021, Morocco established a nightly curfew between 23:00 and 04:30, exempting those fully vaccinated. The curfew was lifted in November 2021.

Asia

Azerbaijan

Beginning on 1 September 2021, Azerbaijan required proof of vaccination for people over 18 to enter virtually all public spaces, and a national mandate of 1 October required vaccination of all state-regulated workers.

China

In February 2020, China started to use digital "health codes", available on a variety of platforms including WeChat and Alipay with scannable QR barcodes displaying a "traffic light" system of colours to enter public transport, shops, restaurants and malls. It was used 40 billion times between February and March.

In March 2021, an "International Travel Health Certificate" was created. In March 2021, the government of China rolled out the world's first COVID-19 vaccine passport system through a partnership with Alipay and WeChat. The system provided a health certificate that included an individual's vaccine status and the results of COVID-19 testing. Initially, the system would only indicate that an individual had been vaccinated if they received a Chinese-made coronavirus vaccine, leading to criticism, though by April 2021 the system began to accept records of receiving the Pfizer-BioNTech, Moderna, and Janssen vaccines. By March 2021, the app was optional and its use was restricted to Chinese citizens. The digital health passport was intended to better facilitate travel. Privacy advocates and Chinese netizens expressed concerns regarding the potential of invasive data collection and the use of data for non-health monitoring purposes.

Iran

The Ministry of Health and Education required a passport number and Iranian national ID card code for issuing vaccine digital foreign travel card.

Israel

Israel was one of the first countries to issue what is known as a Green Pass in February 2021. The pass was discontinued on 1 June 2021, but following a surge of new infections, it was reinstated on 29 July 2021. In October 2021, all existing Green Passes were voided if the most recent shot was administered more than 6 months ago. A new pass would be issued upon proof of a third (booster) dose or a recovery within the past 6 months. A temporary Green Pass could also be obtained with a negative viral test, but would be paid for by the individual unless ineligible for vaccination. Starting 1 March 2022, most COVID-19 regulations were relaxed, and a Green Pass was only required to enter old age homes.

Japan

On 19 July 2021, Japan began accepting applications for its COVID-19 vaccination passport program. When issued, the passports would be in paper form in both Japanese and English, showing the holder's date(s) of inoculation and the vaccine type, and would be available free of charge. By 20 December 2021, entry restrictions were relaxed for Japan vaccine passport holders in 76 countries.

Saudi Arabia

Residents attending restaurants, cafes and public spaces like malls, shopping centres and markets were required to be fully vaccinated. The country used the Tawakkalna app which included information for health appointments, vaccination status and alerted users to COVID-19 exposure for contact tracing purposes.

Singapore

Beginning on 10 August 2021, all residents dining out were required to be fully vaccinated by showing proof of vaccination using the TraceTogether or HealthHub app, or use the TraceTogether token. Proof of vaccination had been progressively implemented in almost all public venues beginning on 13 October 2021, starting with shopping malls, retail shops, entertainment venues except bars, nightclubs and karaoke parlours, attractions, cruises and eateries. It was later expanded to include large events, public libraries, selected events at community buildings and also tertiary institutions, places of lodging, small events and workplaces from January 2022.

South Korea

On 1 November 2021, a vaccine passport system went into effect in South Korea as part of a "living with COVID-19" strategy, requiring vaccination of all residents wishing to access high-risk areas such as bars, restaurants, gyms and saunas.

Taiwan

On 25 October 2021, the Taiwanese government announced that the digital COVID certificate system in the country had been completed. In December 2021, the system was also recognised by the EU as an equivalent of the EU Digital Covid Certificate. On 20 January 2022, Taiwan officially released the certificate and implemented rules that it be required before entering bars or karaoke alike.

Europe

European Union

The European Union offered an EU Digital COVID Certificate (EUDCC), also known as the Green Pass, a digitally-signed proof of vaccination, proof of a recent recovery, or a recent negative test, for use when travelling within the Schengen area with fewer restrictions.

Bulgaria