Health

Unequal vaccination raises questions on vaccine passports

Sidra Javed

The stark difference between the pace of vaccination in developed and developing nations and the lack of universal recognition to all vaccines in use will prove discriminatory if and when vaccine passports are recognised globally, writes SIDRA JAVED

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A Covid vaccine passport is a digital or paper document that certifies its holder is completely vaccinated against the virus and allows access to physical spaces and travel since it is considered 'safe.'

The idea is based on the proof of vaccination that several countries required even before the pandemic. US- and India-bound travellers from several African countries are obligated to produce proof that they have been vaccinated against certain diseases such as yellow fever.

Vaccine passports have led to the inevitable debate of their validity in an unequally vaccinated world. Where developed nations, like the US and the UK, are way ahead in terms of the percentage of the population vaccinated, fewer than 1% of people in low-income countries have been partially vaccinated.

What is a vaccine passport?

As mentioned above, a vaccine passport is a document that ensures hassle-free travel. While some countries have started accepting proof or certificates of vaccination to avoid quarantine, a standard and universal version of a vaccine passport are yet to emerge.

These passports allow individuals to travel more freely within their own countries, socialise within their communities, travel to other countries or engage in activities barred during the pandemic.

Various associations, non-profits and a few countries like Israel have issued their vaccine passports. The International Air Transport Association is developing an app called Travel Pass, which will enable airlines to check for vaccination proof and its availability through a common platform. CommonPass is an app being developed by the non-profit Commons Project and contains a passenger's vaccination record.

Israel's Green Pass, which only applies within the country's territories, allows access to services and places that must comply with the document's restrictions.

Also read: Israel's Discriminatory Vaccine Push Underscores Need for Action

Is vaccine passport discriminatory? 

An average citizen of a developed country is more likely to get vaccinated than a high-risk citizen—for example, a healthcare worker—in a low-income country since rich nations had already ordered a massive stock of vaccines.

India had opposed vaccine passports in June with then-Union health minister Harsh Vardhan telling a G7 meeting of health ministers that any such move would be highly discriminatory against developing nations since they had only vaccinated a far smaller percentage of their population compared to developed countries.

In July, external affairs minister S. Jaishankar said that testing passengers before and after an international trip should be good enough proof for travel. 

Vaccine passports have several advantages too. They will provide much-needed relief to the devastated tourism industry, allow activities that were normal before the pandemic and encourage vaccination. However, such passports could prove to be disadvantageous to others due to the inequality in global vaccine distribution.

Also read: Explained: Pros and cons of vaccine passports in COVID times

Legality of the document

It is important to differentiate between a vaccine passport and a digital health certificate. While a digital health certificate certifies that a person is vaccinated, a vaccine passport can be termed as an extension of it, allowing an individual to avail certain benefits.

The legality of a vaccine passport depends mainly on state regulations. American states like Florida and Texas have banned businesses from demanding vaccination certificates stating that it will reduce personal freedom and invade privacy.

While several companies are already offering 'vaccine incentives', some have mandated Covid vaccines. It is, however, preferable to do so in the presence of reasonable scientific and ethical grounds. It is significant to carefully implement mandatory vaccination or a 'pass', such as in Israel since it can restrict freedom.

Also read: Are Covid-19 Vaccine Passports Legal?

The fundamental ethical challenge that companies, organisations, institutions, states and countries shall face while executing mandatory vaccination or a vaccine passport is the inequity of distribution of vaccines both domestically and globally.

Unequal vaccination rate and recognition

More than 4.46 billion vaccine doses were administered worldwide, equal to 58 doses for every 100 people, till August 9, according to The New York Times (NYT) Covid World Vaccination Tracker.

The tracker reveals a massive difference between vaccination drives of different countries with 83% of shots having been administered in high- and upper-middle-income countries and only 0.3% in low-income countries.

The vaccination rate, calculated by the number of doses administered per 100 people, is 90% in Europe and 86% in North America as against only 5.5% in Africa, where some nations haven't even started inoculation drives.

NYT's latest Coronavirus Vaccine Tracker shows that 99 vaccines are under clinical trial on humans and more than 75 are being tested on animals. However, the World Health Organization (WHO) has approved only Moderna's mRNA-1273, Pfizer/BioNTech's BNT162b2, J&J's Ad26.COV2.S, Oxford/AstraZeneca's AZD1222, SII's Covishield, Sinopharm's BBIBP-CorV and Sinovac's CoronaVac.

Another major drawback of such passports is that not all countries have recognised and granted permission to every vaccine candidate in use. India's first indigenous vaccine Covaxin, developed by Bharat Biotech, is still awaiting WHO approval

Similarly, Covishield—the made-in-India version of the Oxford/AstraZeneca vaccine being widely in poor countries under the Covax programme—is not recognised by the European Medicines Agency. These facts pose real ethical concerns when it comes to the implementation of vaccine passports.

Also read: Here's just how unequal the global coronavirus vaccine rollout has been

Though data on the access of minorities and the underprivileged in India to vaccines is missing, it has been revealed that more men than women have got vaccinated. It indicates that it is less likely that the benefits of vaccination will be distributed equally.

Considering the imbalance of vaccine availability globally, people from high-income countries are likely to travel to places where the local population is still in some form of lockdown. As a result, vaccine passports could perpetuate inequality and disparity that already exist in these countries.

(Sidra Javed is a law graduate and writes about contemporary socio-legal issues. The views expressed are personal.)