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Friday, October 15, 2021

Vaccine passports can be used as a means of encouraging vaccinations, but a U.S. program may face considerable obstacles

The pros and cons of vaccine passports: explained

As of April 5, 2021, more than 18% of the U.S. population is fully immunized against COVID-19. Though many who are eligible and eager to get vaccinated struggle to find an appointment, public health officials are starting to look for ways to incentivize those who are less interested to take the vaccine as more doses become available. 

One such way is through so-called “vaccine passports,” a document issued by public health agencies confirming that an individual has been vaccinated. This document could then be used to gain access to bars, concerts, air travel and other higher-risk activities. The implementation of such programs is similar to how UC Davis students currently access campus facilities through the UC Davis Daily Symptom Survey. The difference being that vaccine passports would verify the person’s vaccination status rather than relying on a recent negative COVID-19 test like the current UC Davis Symptom Survey does. 

Over the last three months, Israel has emerged as a global leader in their COVID-19 vaccination rollout. According to Matan Zamir, the deputy consul general of the Israeli Consulate in San Francisco, over 50% of the total population of Israel has been fully vaccinated. Since children and people recently infected with COVID-19 are currently ineligible for vaccination, fewer than 10% of the eligible Israeli population has yet to receive their vaccination. 

The Magen David Adom, Israel’s national emergency service, began vaccinating the nation’s vulnerable populations in December 2020 before expanding to the general public in early 2021. Zamir credited the quick vaccine rollout to their relatively small population of approximately 9.25 million citizens and their universal healthcare system. Their healthcare system “is very concentrated/centralized and highly digitized,” which allowed their four health maintenance organizations (insurance organizations frequently referred to as HMOs) to easily monitor the vaccine status of all citizens, according to Zamir. Because there are only four different insurance plans with one central health system in the country, keeping track of everybody’s medical records to know who is vaccinated is much easier for the Israeli ministry of health. 

To continue encouraging Israelis to get the COVID-19 vaccine, the Israeli government recently implemented a vaccine passport program called the “green pass.” 

“The green pass is an app which is operated by [Israel’s] ministry of health where you put your ID number, the dates where you got the vaccine doses and the certificate confirming that you vaccinated with either the Pfizer or Moderna COVID-19 vaccines,” Zamir said. “Then the ministry of health confirms this and gives you back an image of green people, who are very happy because they can return back to life. With that, you can go to a restaurant, hotels and cultural performances.”

Israel’s green pass program has been increasing the number of people choosing to get the COVID-19 vaccine, according to Zamir. 

“Luckily, there are very few people in Israel that are 100% opposed to getting the COVID-19 vaccine,” Zamir said. “But there are still many people who are in between [on the decision to get the COVID-19 vaccine] or are looking for motivation to get the vaccine, other than the media campaign. For them, I think, the green pass is also a strong motivator to get the vaccine to see their favorite soccer team or go to a spa.”

While Israel has nearly 90% of their eligible population vaccinated, according to Zamir, the U.S. is closer to 18%, according to NPR. While the U.S. has a much larger population (roughly 332 million to Israel’s 9 million), adding to the complexity of the rollout, the vaccine rollout in the U.S. has largely been criticized for being inequitable. Because of this difference in equity of vaccine delivery in the U.S., Raquel Aldana, a professor at the UC Davis School of Law, believes that implementing a similar vaccine passport program in the U.S. would be “premature.”

“One issue is that the government is responsible for the dysfunction and messiness of creating a system that is inaccessible for people who don’t have access to a computer and the internet,” Aldana said. “There is also a historical reason why people are skeptical. It crosses race. There is a big mistrust of government, particularly among poor people, who feel a sense of abandonment and also a sense of betrayal.”

Aldana believes that the U.S. government needs to find a way to motivate people to be vaccinated against COVID-19. Aldana described how vaccines were historically mandated by the government, and while “that may not be politically feasible today,” Aldana believes there are still efforts that the government should make to encourage trust in the vaccine. 

Meanwhile, other countries such as the U.K. plan to begin testing vaccine passports as early as next week. The U.K. will begin easing COVID-19 restrictions, such as their ban on overnight domestic stays and outdoor patio dining, provided that the customers can prove their vaccination status. Importantly, 50% of adults have received one dose of the COVID-19 vaccine in the U.K. with the government hoping that all British adults would have at least one dose by the beginning of July. It is also important to note that the U.K. has a socialized healthcare system and a population of roughly 68 million people which makes the distribution of the COVID-19 vaccine in the U.K. fundamentally different from that in the U.S..

According to CNN, the Biden administration is currently working to develop standards to prove vaccination in the U.S., implying that there is some discussion about vaccine passports eventually being implemented in the U.S. However, this is much more complicated in the U.S. than in other countries due to the lack of a centralized healthcare system, among other obstacles—one of which is that the COVID-19 vaccines currently available only have an emergency use authorization (EUA) rather than full approval from the Food and Drug Administration (FDA). Though the vaccines have been shown to be safe and effective, the process for getting full approval takes much longer and the government likely cannot mandate any vaccinations prior to full FDA approval. 

As for UC Davis, even with universal vaccine access coming soon in California, it remains unclear if COVID-19 vaccinations will be required for students to return for in-person instruction. For now, UC Davis will continue to rely on the Daily Symptom Survey and frequent testing of students, staff and the community—something the university has worked hard to ensure is universally available and based in equity. 

Written by: Justin Weiner – science@theaggie.org

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