As the West’s first authorized Covid-19 shots were administered in the U.K., an old ethical question in public health is gaining new relevance: Is there a case for issuing proof of immunity to people who have been inoculated?
The idea is that individuals could stop wearing masks and following social-distancing rules if they can prove they have been inoculated and so aren’t a risk to others. Restaurants, theaters and offices could reopen with confidence by admitting those certified as vaccinated, and international travel could resume. As the vaccinated population increases, normal life could gradually resume.
Scientists and public-health experts caution, though, that it is too soon to know whether the vaccines being raced into production will confer true and lasting immunity to infection. Nor is it clear if they will be as effective at preventing transmission as they were at reducing the severity of illness in trials. Such proposals raise ethical and political considerations, too, about whether it is wise or just to divide citizens into new categories based on their vaccination status.
The U.K. became the first Western nation to vaccinate patients against Covid-19. WSJ explains how the country is planning to roll out the BioNTech-Pfizer vaccine at record speed, making it a test case for the rest of the world. Photo: Jacob King/Bloomberg News[object Object]
This debate over the pros and cons of so-called immunity passports as a tool to combat the pandemic has been rekindled by the U.K.’s decision last week, the first by a Western country, to authorize the rollout of a coronavirus vaccine. Elderly citizens and health-care workers started receiving a shot developed by
and Germany’s BioNTech SE on Tuesday.
The Food and Drug Administration and the European Medicines Agency are evaluating the vaccine as well as several others and, if cleared, vaccinations in the U.S. and the European Union could begin late this year or early in 2021, health officials in both jurisdictions say.
Nadhim Zahawi, the British government’s vaccines minister, said two days before the regulator’s authorization of the Pfizer vaccine that bars, restaurants and entertainment venues might eventually start asking customers if they have been vaccinated as a condition of service.
He said the government was looking at possible technological fixes to make it easy for people to declare their vaccination status, perhaps by adding a feature to a coronavirus contact-tracing app that has been downloaded 19 million times.
But he said the U.K. government has no plans to formally issue immunity passports to vaccinated individuals, or to make getting the shot mandatory. His message was reiterated more forcefully by more senior figures in government and Prime Minister
“People have to be allowed to decide for themselves whether they want to be vaccinated or otherwise,” Mr. Zahawi said in a broadcast interview.
The idea of an immunity passport for certain activities isn’t new, especially for international travel. Would-be travelers to more than a dozen countries including Ghana and Nigeria, for example, are required to show proof of vaccination against yellow fever before they are issued a visa. Health-care workers, especially those who handle blood, are in some countries required to be vaccinated against hepatitis B to reduce the risk of infection.
chief executive of Australian airline Qantas Airways Ltd., has said he anticipates his airline will require passengers to show proof of vaccination when making international flights. The Australian government has said it may require visitors and returning travelers to show proof of vaccination as a condition of entry, adding that it expects some other governments could follow suit.
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The prospect that such certification might have wider uses cropped up earlier in the pandemic, when countries including the U.K., Germany and Italy said they were looking at the possibility of testing for antibodies, a sign of past infection, as a way of selecting people who could go back to work. The World Health Organization cautioned against the idea, though, given the uncertainty over the level of immunity that a previous infection would confer, and the practice didn’t catch on.
An essay in the Lancet, a medical journal, in October made the case in favor of immunity passports, suggesting governments consider special wristbands, apps or certificates so individuals can show they have been immunized.
“The only grounds for the use of coercion, of the limitation of people’s freedom by the state, is when they represent a risk of harm to other people,” said Julian Savulescu, director of the University of Oxford’s Uehiro Center for Practical Ethics and one of the essay’s authors. “When somebody is not at risk of harming other people, their freedom shouldn’t be restricted.”
In an essay in The Wall Street Journal on Saturday, former Centers for Disease Control and Prevention director
said he expects immunity passports will come into widespread use despite legal and operational challenges, and that researchers should work fast to figure out unanswered questions about the kind of protection vaccines confer.
Others are more cautious, citing similar objections to those raised by the WHO earlier in the pandemic. Some scientists say we don’t yet know enough about how effective the vaccines will be at reducing transmission or how long the immunity they confer lasts to allow public-health measures to be dropped. Information about potential side effects is so far based solely on clinical trials, not widespread deployment.
Some legal experts see pitfalls in creating a distinction between vaccinated and non-vaccinated individuals, as well as issues around data protection, privacy rights and forgery. And some groups who might make use of greater freedoms the most, such as young people, aren’t scheduled to be vaccinated for months.
“There’s not enough evidence to suggest that immunity passports are a good idea,” said Nicole Hassoun, professor of philosophy at Binghamton University in New York state.
More on Vaccines
- U.K. Begins Rollout of Pfizer’s Covid-19 Vaccine in a First for the West
- Pfizer, BioNTech’s Covid-19 Vaccine in the U.K.: What You Need to Know
- Covid-19 Vaccines: What’s Coming and When?
- Covid-19 Vaccine Rollout Faces Public Concerns Over Safety (Dec. 7)
- How the U.K. Beat the U.S. and Europe to a Covid-19 Vaccine (Dec. 2)
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