A vaccine passport stands for many as the door to the promised land – as the place where we can gather with families and friends again without restrictions, travel in the world, go to parties and festivals, and take advantage of all the other cultural offerings we have been cut off from and missed for almost a year.
Politicians, trade, and industry associations are also responding positively to the vaccine passport. They see it as an important vehicle to recover from restrictions and lockdowns of the whole community and hence towards achieving a better balance between economic activity and corona fighting.
But on the fly, we may forget that the vaccine passport is not part of the analogue world we long for, rather it comes in a digital version. Most suggestions for a digital passport include a mobile phone app to show if a person has received coronavirus vaccine. Some solutions may contain more information, for instance about COVID-19 antigen testing, test showing antibodies after infection, and/or a person’s history of infection. In this way, the vaccine passport continuously collects health information about the development of infection from the individual, and this information is then shared with actors who have an interest in knowing the person’s health status in relation to corona.
This sounds easy and efficient, and several tech companies are ready with solutions for a vaccine passport. IBM works with a blockchain-based solution where the passport is generated and made available to the user as a QR code.
A vaccine passport therefore already appears to be a real and soon-to-be available solution that can benefit us all, both as citizens, businesses, and society at large.
Uncertain Basis for Decision-Making
So, what is the flip side of it? At the Ada Lovelace Institute in London, a multidisciplinary team of immunologists, epidemiologists, sociologists, lawyers, historians and experts in public health, ethical and technical system design has spent January and February investigating the risks and consequences associated with the spread of a vaccine passport.
Among other things, they point to these three fundamental risk factors:
- A vaccination status today cannot be seen as clear or conclusive evidence that a vaccinated person does not pose a risk of infection to others – we may be able to transmit the infection.
- A vaccine passport will increase freedom for some, but for those without passports, it will prevent them from using their rights and freedoms.
- The creation of a digital infrastructure for the vaccine passport involves a number of risks and problems that have not been identified and addressed.
The expert group also points to the need to define and justify the purpose of the passport, the rationale for providing some of us access to relief from the current restrictions, while others would not be granted this access. Basically, there is a need for legislation in this area that takes into account the purpose of the passport, the intended application, enforcement mechanisms and remedies. Moreover, they point at the need for adaptation to international developments, which should allow the vaccine passport to be used in other countries. In short, the basis for the decision to introduce a vaccine passport is not in place.
Freedom for Some, Discrimination Against Others
When we assess the vaccine passport from a data ethics perspective, it is problematic that it imposes different conditions for citizens in terms of our freedom to moving around, gathering with others, accessing services, and participating in community activities, and cultural and commercial services.
There are potentially many people who will be excluded from getting a vaccine passport: People who, due to illness, cannot tolerate the vaccine, women who are pregnant and breastfeeding, people with other reasonable reasons for rejecting the vaccine, but also those who opt out of the vaccine for personal reasons or children under the age of 16 and probably many more.
In practice, therefore, we have to ask ourselves whether we can accept that the pregnant woman cannot go on a hotel holiday with her family? That the breastfeeding mother cannot take an evening off and go to a festival with her friends? That young teenagers are excluded from sport stadiums and clubs? Or that people with allergies to vaccines do not get access to theatres and museums?
The effect in all cases is discrimination on the grounds of gender, age, or state of health.
For other groups, discrimination may be linked to philosophical or political opinions, social or other factors covered by the EU Charter’s prohibition of discrimination.
Control of Own data and Surveillance Risks
The data ethics principle of individual data control is also in play. There are indications that IBM’s health passport enables the user to decide who should have access to what information in the passport. A Swiss solution only stores the information on the mobile where the app is downloaded and is otherwise developed with data minimizing in the design.
However, in a Danish version, the information will most likely be collected from the Danish Health and Medicines Authority after collection at various locations in the health system and at test centres. And who then has real control over the data in the passport?
We must therefore already now uncover whether the corona passport information and the chosen technology contain a hidden risk of surveillance. In this process we should address questions such as who is looking at the corona profile with the authorities and the supplier? Who decides on granting access to actors with an interest in analysing e.g., completed tests, test sites and frequency, infection history, close contacts and other information that may be contained in the vaccine passport?
Human at the Centre
Another data ethics claim is that our use of data must first and foremost benefit the individual. When we leave large groups of citizens under a restriction line because they cannot obtain a vaccine passport, we are heading down a road where the proportionality between the intervention and the nuisance or discomfort it caused is out of balance.
The goal of fighting corona thus justifies the vaccine pass as the means. On the one hand, this takes us very far from the general principle of proportionality, which governs interferences with our fundamental rights and freedoms. Also, it deviates from the principle that the human being is an end in himself, never a means – a principle that characterizes democratic societies based on equality and justice.
Need for an Overall Assessment
With these possible consequences in mind, an introduction of a vaccine passport calls for a much better enlightenment of policy decisions. It includes better clarity of the epidemiological and virological aspects, and a more thorough socio-legal assessment of the risks and consequences of a vaccine passport for our rights and freedoms, and for our society, both in the short and long term.
In addition, the recommendations of the English Expert Group mentioned above on legal bases, enforcement mechanisms and remedies are important to include.
Combatting the conora virus is both a legitimate and desirable purpose. We all have a profound interest in the state safeguarding public health and the economy. But the way the virus is fought must remain within the framework of democratic principles and be of benefit to the individual.
