Government must tread carefully in exploring concept of ‘immunity passports’

The notion of an “immunity passport” has been discussed since the earliest stages of the pandemic, but with a Covid vaccine now in sight, there are strong indications that key government and industry figures are genuinely exploring the concept.

Cabinet Office minister Michael Gove tried his best on Tuesday to draw a line under recent speculation – saying people will not be turned away from pubs or entertainment venues if they refuse to be vaccinated – but it seems the wheels have already been set in motion.

Nadhim Zahawi, the new vaccines minister, told the BBC this week that the government is “looking at the technology” for immunity passports, while Baroness Harding, head of NHS Test and Trace, said at an event organised by the Health Service Journal that her staff were researching how to combine test results and vaccine status in the official Covid app.

Her hope, she said, was “in the future to be able to have a single record as a citizen of your test results and whether you’ve been vaccinated”.

Over the weekend, reports also emerged that the Department for Transport is considering plans to stamp the passports of vaccinated tourists, with Robert Courts, the aviation minister, said to be “supportive” of the plan.

Beyond the UK, the Danish Ministry of Health announced last month it is working on official documentation to show whether or not a person has received a Covid jab. The Australian airline Qantas has meanwhile said passengers must be vaccinated against Covid-19 before boarding a flight, once supplies are made available.

Alan Joyce, the airline’s chief executive, said he believed a vaccine would become “a necessity” for international travel.

As dystopian as such proposals may sound, they are nothing new within the world of disease prevention and control. “Evidence of vaccination is already required for certain diseases and situations,” says Dr Alexander Edwards, an associate professor in biomedical technology at the University of Reading.

“Proof of yellow fever vaccination is essential to travel from certain parts of the world where this virus is present, to places without yellow fever. In workplaces where human blood is handled – hospitals, labs – staff usually need proof of hepatitis B vaccination for their own safety.”

But here’s the catch: authorities have a much deeper understanding of these diseases and pathogens compared to Sars-CoV-2, which still remains a mystery in so many ways. Most significantly, it’s unclear how long immunity from vaccination lasts, nor is it known if the new jabs will be able to fully prevent transmission to other people.

Amid these uncertainties, experts have warned it may be too premature to introduce these so-called Covid passports as soon as the vaccines are approved. More time and analysis is ultimately needed to understand how immunity, whether natural-based or artificially induced, lasts against the virus.

Another key difference that sets apart the new proposals is that vaccination could be needed for daily, local activities. Little detail has been provided by the government so far, though Mr Zahawi suggested on Monday that access to restaurants, bars, cinemas and sports venues could be dependent on proof of inoculation – only to be later contradicted by Mr Gove.

Such an approach is by no means simple. Vaccine passes certainly may contribute to the long-term management of the pandemic, helping certain pockets of society to make that slow transition back to normality. Yet “their introduction poses essential questions for the protection of data privacy and human rights,” says Dr Ana Beduschi, the principal investigator of a UK project on digital health passports.

Labelling people on the basis of their Covid immunity could fuel a societal stratification that ends up running along lines of access. “If some people cannot access or afford Covid-19 tests or vaccines, they will not be able to prove their health status, thus having their freedoms de facto restricted," says Dr Beduschi.

“Unless the tests and, once available, vaccines are accessible to all, any large-scale deployment of immunity passports could disproportionately segment the society and potentially breach the rights to equality and non-discrimination.”

And given older age groups are set to be vaccinated first in the UK, what happens to the rest of the population? Will people be excluded from engaging with the ‘Covid-safe’ parts of the economy?

“Many in the community, especially younger people, may not get the opportunity to be vaccinated in the first few months after rollout,” says Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine. “Whether the gains [of immunity passports] will be greater than the problems is unknown.”

In terms of the workplace, there is a risk that social and financial inequities could be amplified under a system that disenfranchises those employees who are not immune, particularly within the gig economy where regulations are not as well-established or strictly observed.

Andy Sumner, a professor in international development at Kings College London, warns of an inadvertent “drift” that could aggravate socio-economic tensions between classes and sections of the labour market. “The poorer you are, the more mobility you need to earn a living,” he tells The Independent, adding that the middle class have the luxury of being able to work from home.

If an immunity passport limits what sort of employment that cleaners, couriers, hospitality workers and others can take on, the outcomes could be devastating for their livelihoods. “In this scenario, there could be polarisation within the poor, where those who are not immune are pushed down and those who are might get pushed up slightly,” Prof Sumner adds.

On the issue of data privacy, Professor Gino Martini, chief scientist at the Royal Pharmaceutical Society, warns that the technology must be secure to ensure “passports can’t be forged if you haven’t had the jab”. Or stolen for that matter. Ideally, Prof Martini adds, people would be able to access it via their phones.

Clearly, there is much to consider – perhaps explaining Mr Gove’s desire to talk down the concept of immunity passports. "Ministers must strike an adequate balance between protecting the rights and freedoms of all individuals and safeguarding public interests while managing the effects of the pandemic,” says Dr Beduschi.

The government should know full well the ethnical, social, economic and political complications that are wrapped up in such a concept. Detangling these various threads of concern will pose quite the challenge. If Downing Street is truly serious about implementing this system, it must tread carefully.