Vaccine Passports are a Dumb and Dangerous Idea

Although the idea of vaccine passports have been floated about for at least half a year, the concept has really begun to pick up steam over the last month. Public health advocates have been pushing for their adoption as a means for 'returning to normal' for Americans. Also, the concept is starting to gain some popularity not only in people who will develop the app (and make money with its adoption) but also in certain large spectator venues like sports arenas and concerts as a way to get quick state approval to reopen to near capacity.

What is a Vaccine Passport?

Vaccine passports, at least how they are being described, are NOT just a traditional passport that you need for international travel. This would be some sort of electronic app that would store your immunity (either through natural infection and maybe antibodies or vaccination to SARS-CoV-2). In theory, you could present this to certain private venues where the public gathers to allow you access to a safe. It would be an electronic app that you could put on your smart phone to allow for easy access into all sorts of private and (probably) public facilities. One could imagine more than large scale public venues requiring a passport to keep their patrons safe.

Essentially, the passport would be used in a domestic manner for commercial access to events, dining, shopping, traveling, etc. Although one could imagine it also required by some countries for international travel, it is likely that they would continue accepting proof of vaccination to travel as they do now for other infectious diseases. This electronic vaccine passport would almost certainly just be required for moving domestically. Moving on any sort of plane, train, or bus would probably require this passport after a time.

What are the Practical Limitations to the Passport?

Let's begin with the practical limitations to a vaccine passport. First, would be how you define someone as immune to SARS-CoV-2. Would it be vaccination? How recently? Would you require antibody proof? How about if someone had a native infection with the coronavirus? Would you require antibody verification or would a positive PCR test suffice? If so, how recently for the test? One could imagine you could devise an algorithm to answer those questions but it would not be based on any sort of science which will be unknown for years.

Second, how would people prove their immunity if they don't have a smart phone or don't have the app? There are millions of Americans who don't have smart phones, would you deny them entry into domestic travel or businesses? What if you forget your phone? Or it loses its charge? Or you lose cell service for not paying a bill? Will you be able to go purchase groceries at the store or enter the restaurant or ride a bus?

Finally, how would information be corrected and altered if it is entered incorrectly or changes? This is a non-trivial question if you have ever encountered an electronic medical record and looked to make a correction. It is a clunky and not so simple process. If you want an accurate system how do you verify the data is from a trusted source?

In the US, by the Time We Develop Vaccine Passports they Will Be Useless.

The strongest argument against the creation of a vaccine passport is that they will be obsolete before they are really ever implemented. Ostensibly, the reason for the passports is to ensure people who are entering that airplane, venue or business that they will be amongst others who cannot transmit SARS-CoV-2 to them. But we have a highly effective vaccine with 95% efficacy in preventing severe disease in those at highest risk - an amazing accomplishment. Also, within about 2 months we will have well over 75% of the country either vaccinated or immune from natural infections putting us near or at herd protection from large exponential outbreaks. The chance of a significant wave of serious infections will be incredibly small except in children who are the least likely to end up in the hospital anyway.

If the whole point of the the passports is to signal that people who are vaccinated or had natural infections that it is safe to move around and gather in large groups of people - that will already be the case. There will always be infections and reinfections of SARS-CoV-2 because it will become endemic in mankind but our immune response will almost certainly become more and more benign as we encounter it again and again in our lives. We've discussed this on the show before here, here, and here. This pandemic, although tragic, will come to an end soon in the US and much later in the rest of the world. However, the stress that it puts on our health care system will wane significantly this year and be, at worst, a nuisance in 2022.

What Civil Liberty Concerns are there for a Vaccine Passport?

Outside of the practical problems of the passport and the fact that it will be useless for controlling or 'keeping people safe' are the very serious civil liberty concerns that a passport like this will present to Americans. Never before have we had to 'show our papers' to move about in our normal activities in the country. A government regulated private app would make it 'official' and one could imagine large heavily regulated industries demanding that people present their proof of vaccination to use their services. It would begin with large scale travel in planes, cruise ships, trains, and concerts and sports gatherings. But this requirement would soon be insisted upon by other businesses as they are concerned with liability and seek a passport requirement as a way to prevent getting sued by people who contract SARS-CoV-2 and are harmed. You can easily see this happen with large chains like Costco or Walmart and soon move to smaller yet large grocery stores or restaurants.

The restrictions on domestic movement would be real. It is also unlikely that the passport would just be used for SARS-CoV-2. Soon after it would be convenient to add your other vaccinations (which would also be required to use businesses). Not long after, one enterprising legislator would suggest that we store other health information on this passport like allergies or emergency medical conditions in case you are in an accident. Maybe mental illness could be added allowing for easier background checks for the purchase of firearms or alcohol or other drugs. On top of all this, all your private health information would be held by a private company who could have the data hacked or sell it to third party vendors using HIPPA measures which allows for the quick and easy movement of health records.