Every day, more and more Canadians are getting vaccinated, and every day, there is more and more hope that normal daily life and activities might resume soon. To enable international travel and accelerate the return of such activities at home, many countries are considering or have implemented “immunity passports” of some kind to people who pose a lower risk of contracting or spreading COVID-19 infection.
In Israel, where more than half of the population is fully vaccinated, “green pass” holders are either fully inoculated or have presumed immunity after recovering from infection. Iceland was the first country in Europe to issue “immunity passports” to those who have recovered from infection or been fully vaccinated to allow people to travel freely within the country and abroad, if recognized by other countries. In the U.K., a digital passport initiative that would show immunity or a recent negative test result is being tested, and the government has announced a review to consider whether such passports could help economic recovery as well as any privacy and ethical issues surrounding their use. The European Commission, meanwhile, will present a proposal this month for creating an EU-wide “digital green pass” to facilitate travel over the peak summer holiday period.
Within Canada, vaccine passports are being considered in Quebec, while federal Health Minister Patty Hajdu has said that Ottawa is “certainly working on the idea” with other G7 countries. But while we cannot fall behind by idling in facilitating international travel for vaccinated Canadians, there are many practical, ethical and bureaucratic challenges to implementing this in Canada. The solution is an international consensus on how such passports should work – but unfortunately, we’re not there yet.
There are lingering questions about what qualifies a person as low-risk of contracting or spreading infection, for the purposes of a green pass. So far, full inoculation appears to be the only point of consensus on who might qualify for such a passport. There is less consensus about whether recent recovery from COVID-19, a recent negative test result or partial inoculation would also be criteria.
The ultimate decision on who would qualify could result in unequal access to digital and health infrastructure, exacerbating existing inequalities. In some countries, ethnic minorities are more vaccine-hesitant, which could lead to their inadvertent exclusion; similarly, some people cannot be vaccinated for medical reasons, including those with allergies or pregnant women. In addition, many Canadians do not yet have access to a vaccine. Will these groups enjoy fewer rights, as a result?
Still, there are significant economic and social benefits to preserving the free movement of people, particularly when they present a low risk of spreading infection. Further, those who are vaccine-hesitant or cannot be vaccinated will be at risk of contracting COVID-19 until sufficient herd immunity is achieved by the majority of the population getting vaccinated.
The emergence and spread of COVID-19 variants further complicate discussions about immunity passports. Evidence is growing that some variants could evade natural and possibly vaccine-induced immune responses, reducing their effectiveness. For example, a recent study shows that the vaccine produced by Novavax is 95.6 per cent effective against the original strain, 86 per cent effective against the UK variant (B.1.1.7) and 60 per cent effective against the South African variant (B.1.351). Reduced effectiveness might not be an immediate problem because vaccines generally elicit a strong immune response, which is likely still sufficient to neutralize infection. It can also be difficult to disentangle whether reinfections are a result of waning immune response or emerging variants.
Given the uncertainty and the lack of a true domestic and international consensus, a good starting point for intergovernmental discussions in Canada would be to align our policy to what countries have agreed on: facilitating the freedom of movement of those who have been fully vaccinated. Recent negative test results should also be considered to enable international travel and possibly reduced public health restrictions domestically, similar to Britain. Including an option for testing as a way to show lower risk of spreading infection is more inclusive for the unvaccinated and is already a requirement for international travellers entering Canada.
Allowing those who pose a lower risk of spreading infection to travel freely has economic and social benefits, and provides an additional incentive to get vaccinated. But leadership and public policy will be required to ensure that efforts to maximize the freedom of movement and civil liberties of the population also result in effective and inclusive policy. The federal government will have to coordinate with provinces and align with the international consensus, for immunity passports to be as effective as possible. With vaccination rates increasing and more and more countries implementing “immunity pass” policies, we must address the tough questions and come to an effective agreement now.
Published in the Globe and Mail
Rosalie Wyonch is a senior policy analyst at the C.D. Howe Institute.