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From: Rosalie Wyonch

To: Canadian Vaccination Watchers

Date: March 5, 2021

Re: COVID-19 Vaccine Passports: Green Certificates Around the World

As more and more people are vaccinated, there is hope that more normal daily life and activities might soon resume. There is growing debate about using “immunity passports” to allow those who have been vaccinated or recovered from COVID-19 infection to resume normal life more immediately.

Some countries have implemented such policies, while others have stated that they will not be used for domestic purposes. So, how do immunity passports work? Should they be used in Canada?

Chile was the first country to propose providing “release certificates” to enable people who have recovered to “serve their community” with small likelihood of becoming reinfected or infecting others. The certificates were controversial in May of 2020, and directly counter to WHO advice that there was not sufficient evidence, at the time, that recovery provided protection from reinfection or infecting others. Release certificates were provided but didn’t include privileges related to public health restrictions.

In Israel, where roughly 40 percent of the population has been fully vaccinated, malls and museums are now open to all but only those with a “green pass” have access to gyms, hotels, theatres and concerts. Green pass holders are either fully inoculated or have presumed immunity after recovering from infection.

Iceland was the first European nation 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 UK, testing of a digital passport to show immunity or a recent negative test result is underway and the government has announced a review of whether such passports could help economic recovery along with examining privacy and ethical issues surrounding their use. The European Commission will present a proposal this month for an EU-wide “Digital Green Pass” to facilitate travel over the peak summer holiday period.

There are, however, a number of ethical, legal and logistical challenges to address. Different rates of vaccination coverage and differing access to digital and health infrastructure could exacerbate existing inequalities across regions. 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 – those with allergies or pregnant women, for example. 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.

Providing immunization certificates to allow vaccinated individuals to be less restricted also provides an incentive for people to make the personally and socially beneficial choice to get vaccinated.

The emergence and spread of COVID-19 variants further complicates discussions about immunity passports. Evidence is growing that some variants could evade natural and possibly vaccine-induced immune responses, reducing their effectiveness. For example, one recent study shows that the vaccine produced by Novavax is 95.6 percent effective against the original strain, 86 percent effective against the UK variant (B.1.1.7) and 60 percent effective against the South African variant (B.1.351). Reduced effectiveness might not be an immediate problem because vaccines generally illicit 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.

In Canada, vaccine passports are being considered in Quebec, while the federal government has said it has no plans to implement vaccine passports. The debate balancing the ethics of creating a world of “immunes” and “non-immunes” with unduly restricting the activities of those who pose a lower risk of spreading infection is ongoing. There are many logistical challenges to overcome and remaining uncertainties about COVID-19 variants.

But with many countries moving towards immunity passports of some kind to enable international travel, our governments cannot idle on facilitating vaccinated Canadians to travel internationally. Canadians might lose out on international opportunities during the recovery. Given the complex challenges related to immunity passports, leadership and public policy are required to ensure effective and inclusive policy while also maximizing freedom of movement and civil liberties of the population. Allowing those who pose a lower risk of spreading infection to travel and move about freely has economic and social benefits, and provides an additional incentive to get vaccinated.

Rosalie Wyonch is a Senior Policy Analyst at the C.D. Howe Institute.

To send a comment or leave feedback, email us at blog@cdhowe.org.

The views expressed here are those of the author. The C.D. Howe Institute does not take corporate positions on policy matters.