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The UK government is reluctant to mandate vaccine passports as part of the route-map out of lockdown. There are concerns about ethics, discrimination, rights and privacy which the Prime Minister sees as potential reputational damage. Nevertheless other countries are pushing ahead and Israel has already launched a vaccine passport with other countries now examining the feasibility. Irrespective of the domestic market, where restaurants and theatres might require health certification for entry, it is international travel where uptake of vaccine passports will be dictated.

Yellow fever certificates offer a precedent for international health passports. Although the disease is prevalent in 43 countries in Africa and Latin America, proof of vaccination is required for entry to only 20 of these. The purpose of the certificate is to demonstrate that the traveller has taken a precautionary vaccine, not only to protect him/herself from the risk of yellow fever, but also to protect the country’s health infrastructure should he/she add a burden to it, either directly through falling ill, or indirectly through spreading the disease among an un-vaccinated population.

The health passport is designed to show that you are not a risk. In the case of yellow fever it indicates that you cannot catch it and therefore cannot transmit it. The big question that still remains is: can this same assurance be offered by a Covid 19 vaccine certificate? Proof of recent vaccination demonstrates that you have some personal protection from the strain for which the vaccine was originally intended. The jury is still out on its effectiveness on emerging strains. Assorted public health systems around the world may not be prepared to take this risk of this unknown.

Airlines and the travel industry will push hard for vaccine passports to kick start international travel and prevent the collapse of businesses which depend on foreign customers. Individual governments will be lobbied both by their health officials and business interests, but must ultimately agree a universal standard. They achieved this with the PCR Covid test that quickly became the gold standard for identifying infection. A vaccine passport will need to reassure border control officials and much will depend on their local remit. A passport is designed to enable transit across a border, and permission lies with customs officials on the border with power to deny entry.

A passport that fails to achieve transit is just a piece of paper, so any vaccine passport must provide evidence that the individual presents no risk to the country: risk to public health and ultimately risk to the economy. Efficacy and duration are key determinants, not only must the effectiveness of protection be evident, but the duration of it be acceptable. Unlike national passports which have a 10 year life, vaccination passports will most likely have a six month one. The administrative cost will not make them any more appealing to governments reluctant to introduce them in the first place.

The UK government is also well aware of public resistance to extra state bureaucracy. A lot of energy went into developing ID cards before the proposal was finally scrapped. On balance the advantages were outweighed by the disadvantages and the lessons are still raw. Any vaccine passport that is put forward by the UK government will be presented as something very different to avoid being seen as another form of state control. Nevertheless the rest of the world may want vaccine passports so we may have to introduce something to get through borders and enjoy foreign travel once again.