Ask the Pharmacist: COVID vaccine passport – a good idea?

Q) I have heard a lot of talk about vaccine passports recently. Just what are they and are they a good idea?

A) Vaccine passports are yet another new term that have been added to our vocabulary along with other recent additions such as social distancing and contact tracing. With vaccines arriving on our shores at unprecedented rates and provinces starting to ramp up mass vaccination administration for their populations, Canada along with the rest of the world are starting to look at what a post pandemic world should look like.

So, let’s start with the basics (and to be frank, the easy part of this whole discussion) and discuss just what a vaccine passport is. A vaccination passport or pass is simply some form of documentation that proves you have been vaccinated against the COVID-19 virus. Some versions may also be able to show as to whether you recently tested negative for COVID or have previously been infected with it. They may come in the form of a paper but most agencies and businesses that are involved with this process (think airlines for one) are pushing for a version that is internationally standardized and digitized.

The rational for this is obvious. Think of how long it already is to get through customs at your local airport and then add another layer of complexity as people search their purses or briefcases for wrinkled papers in assorted languages and formats as the people behind them in line age rapidly by the minute.

Canada, and Quebec in particular, are currently debating just how a pass should work but make no mistake, they are likely to become a reality in some form in the very near future. In fact, versions of these have been used for decades by some countries who will only allow you to travel there if you have proof of having been previously immunized against such diseases as yellow fever, cholera and rubella.

For industries and countries that rely on tourism, these passports could well be the key to reopening them and bringing in much needed jobs and money. Just about every country is looking into these and some countries have already gone ahead with the idea. Israel, which is way further ahead of us in vaccinating their population (46% of it as of mid March), launched its Green Pass way back in February for those of its citizens who have already received two doses of one of the COVID vaccines. This pass allows Israeli citizens to have exclusive access to gyms, hotels, theatres and concerts with some limitations.

The case in favour of a vaccine passport is a strong one. As mentioned earlier, they could be the key to restarting the travel industry which is a vital part of most country’s economies both in terms of bringing foreign dollars into the local economy and in re-employing tens of thousands of laid off workers in the airline, hotel and assorted hospitality industries. They should also eliminate the need for the two week quarantine upon arriving and returning from a destination which would be a vacation killer for those of us with the standard two to three weeks of vacation time a year.

There is also a strong case for these vaccine passports to be made mandatory in order to be employed in certain careers such as education, long-term care and health care.

It appears that a slight majority of Canadians are in favour of this idea in some form or another. A recent online poll found that 55% of respondents felt that vaccination should be a requirement in order to be able to attend a public school or university in person. These passes might also entice many otherwise vaccine ambivalent citizens to get their “shots” in order to reap the benefits these passes might offer. This would be a very good thing as there will be those among us who cannot be vaccinated or will not respond to it and are therefore dependent on the rest of us keeping well in order to protect them (this is the concept of herd immunity which has been discussed in earlier columns).

But the tricky question is how far to extend the benefits such a pass might offer to its recipients, especially on the domestic front. In the U.K., several companies are purportedly considering policies that will require their employees to provide proof of vaccination in order to remain employed.

There is a real ethical debate here on many different levels. If, in the next few months, a pass is required to dine inside a restaurant or attend a concert/ sporting event in person, is this fair to those who have not been given the opportunity to be vaccinated yet (especially when there isn’t even a vaccine approved yet for those under the age of 18)? How about for those admittedly few people who cannot be vaccinated due to medical conditions they are afflicted with or because they have a increased chance of having a life-threatening type of allergic reaction to the vaccine? Then, there are what will likely be the millions of Canadians who make a conscious decision not to receive the vaccine.

For some, it may be due to religious reasons, others due to information they may have read that has caused them to fear the vaccine. Many will not have sympathy for this latter group, perhaps thinking that their refusal puts others in harm’s way. And yet, it will be extremely hard to create a pass that differentiates among those who have not been vaccinated and it may not even be legal as there are laws that prevent discrimination (such as those based on religious beliefs).

Lastly, think of the people who may be required to enforce these restrictions. Is it right of us to ask a teenager who is employed at an establishment to tell an adult that they are not allowed in this bar/ restaurant/ gym? It’s not a good visual for those of us who recall the stories from last spring about adults demonstrating their anger about being asked to simply wear masks while shopping.

In a perfect world, as more and more of their fellow citizens get vaccinated and display no ill effects and the literature continues to demonstrate their very favourable risk to benefit ratio, the sceptical individuals will eventually come on board. However, that perfect world does not exist and therefore, in the meantime, our governments will be forced to make some hard decisions. For more information about this or any other health related questions, contact your pharmacist.