Vaccine Passports: Frequently Asked Questions - Canadian Civil ...
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Vaccine Passports:
Frequently Asked Questions
The lines are being drawn
between those who support
and oppose some version of a
vaccine passport. At the
Canadian Civil Liberties
Association, we have flashed
red and yellow lights at any
effort by a Canadian
government to mandate
public disclosure of private
health care information. But
that does not mean that we
simply oppose the measure
without debate. Instead, we
have a job to educate the
public about their rights and
freedoms, in addition to
advocating against
unconstitutional laws. When
reasonable people can
reasonably disagree about the clear “public good” at
hand, heated debate is inevitable. When it takes place after a year of sacrifice, isolation,
economic distress for some, and relative privilege for others, it’s got the potential to get ugly.
But any good debate requires a factual underpinning, so in that spirit, CCLA offers the following
Vaccine passport FAQ.
Those who favour mandatory vaccine passports say that everything
that can be done to potentially reduce COVID19 infection, should be
Bring on the done. If we wear masks to keep others safe, why wouldn’t we
vaccine passport, similarly be willing to demonstrate our vaccination status? It’s been a
year of extraordinary legal orders to control and monitor human,
says one camp ranging from contact tracing apps, heat-mapping gathering spots,
snitch lines for “covidiot” reporting and a wide range of
1recommendations and legal restrictions on activities. Some of these have arguably been
necessary and proportionate, others not so much, and disagreement remains as to which is
which.
Vaccine passports
do more harm
than good, says
another
Those against vaccine passports point out that proof of vaccination does not equal immunity,
and they warn of discrimination and privacy invasion. The proposed passports have an explicit
goal of making private decisions about our health coercively public. Just as some communities
and groups of people—Black, Indigenous, newcomers, poor, elderly—have been
disproportionately impacted by the virus, so may they be particularly impacted by this very
public and dispersed version of surveillance as systemic racism may influence choices of service
providers and others about who to demand “proof” from, and who to deny access, particularly
in the absence of a strict legal regime governing their use. For those with medical or religious
grounds for being unable to get vaccinated, risks of discrimination based on who or what they
are raise obvious and significant rights concerns. For those on the "no” side of the debate,
vaccine passports are in fact a prescription for public harm.
What is a vaccine passport?
Theoretically (because this is a new idea), a vaccine passport provides proof that you’ve been
immunized against a contagious infection. It’s something you carry, in either paper or digital
form, and that you may be required to show to authorized parties on request in order to access
a service or enter a venue.
Although the terms are sometimes used interchangeably, a vaccine passport is similar but
slightly different than an “immunity passport” which would include information about past
COVID-19 infections, on the theory that those who were infected and have recovered have
some immunity from re-infection.
2What is the science behind the idea?
The idea of a passport is premised in part on theory that those who are immunized or who have
had and recovered from the virus are less likely to get COVID-19 again, and less likely to infect
others. The science to support these suppositions remains unsettled, however.
Individuals who have recovered from COVID-19: Studies suggest that most people who recover
have some protection themselves against the virus; one peer-reviewed study found evidence of
protection up to 8 months post-infection. Another study with more than 20,000 health care
workers in the United Kingdom found that 6600 had had a previous infection, and only 44
contracted it again. A similar study in the US with 3000 Marine recruits found that of the 190
participants who had contracted and recovered from the virus, 19 were re-infected (important
note: these latter two studies have not yet been peer reviewed). It does seem as though there
is some immunity for some period of time after having COVID-19, but it is not clear how long
that immunity lasts, or, since reinfection is possible, whether it is reasonable to assume
someone who has had the virus will not pass it to others in future. This suggests that evidence
for efficacy of an immunity passport that treats individuals who have had COVID as safe is
lacking.
Individuals who have been vaccinated: Clinical trials that led to approval of the vaccines were
designed to determine if they effectively prevented serious disease or death, not transmission.
To be clear, evidence shows they are very effective at preventing serious disease or death.
However, the World Health Organization (WHO) has advised, as recently as February 2021,
against using a vaccination passport for international travel, for now, because:
• It’s unknown how long immunity lasts from any of the current COVID-19 vaccines
for any of the currently known COVID variants;
• The necessity and/or timing for booster doses is unknown;
• It’s unknown whether vaccination offers protection against asymptomatic
infection.
The WHO’s concerns are instructive, as it’s often assumed that international travel is the most
uncontroversial use case for a vaccination passport. WHO will update their guidance in 3
months.
3What is the precedent?
There are a few “almost similar” precedents that apply in particular contexts. The most
commonly cited is the yellow paper card created by the World Health Organization that
travelers must carry and show when entering some countries to demonstrate they have been
vaccinated against yellow fever. Currently yellow fever is the only disease mentioned in the
International Health Regulations (to which Canada is a signatory) for which countries can
require proof of vaccination for international travelers.
There are some Canadian provinces (Ontario, New Brunswick and BC) in which schools require
proof of vaccination for children for contagious or dangerous diseases including measles,
mumps, rubella (the MMR vaccine) and diphtheria, tetanus, and whooping cough (the DTaP
vaccine). In all cases, there are options for parents to opt out of providing such proof based on
religious grounds or conscientious objections.
Neither of these is quite the same as a vaccination passport as currently proposed, to the
extent that such a passport would ostensibly be required across a wide range of contexts,
where risks and benefits varied, and subject to interpretation not by regulated institutional
actors (a border agency, a school board) but by a wide range of private and public sector actors
(everyone from a shopkeeper to a concert ticket-taker to a cab driver or transit operator,
potentially). In other words, the intervention would not be targeted, specific, and auditable, but
pervasive, variable, and diffuse.
Why require a vaccine passport?
The argument for such a document is that it will facilitate a faster, safer return to a pre-Covid
lifestyle by providing a means to identify people as “safe” to participate in public life by virtue
of either a past infection or vaccination that has given them antibodies against COVID-19.
Suggested uses range from resuming international travel without requiring quarantines or
testing regimes pre/post arrival, to re-opening large-scale gatherings like sporting events or
concerts, to participation in everyday life, including visiting a restaurant, movie theatre, gym, or
store. The implicit presumption is that people will be hesitant to fully resume a pre-pandemic
level of activity without some reassurance of safety, and such hesitancy will hamper economic
recovery unless there is a tool to mitigate the perceived risk. The corresponding assumption is
that knowing others around us have been vaccinated will contribute meaningfully to our own
feelings of safety.
4There are a variety of reasons why the concept of a vaccination passport is a troubling one.
First, the science doesn’t support their utility. But beyond that, even if they were perfectly
effective, they raise significant risks to rights and freedoms including:
Privacy: allowing private entities to collect and use personal health information about
us is invasive. Tying the ability to participate in public life with a ubiquitous or persistent form
of surveillance (“show us proof you have made a socially acceptable choice about your health”)
is a diminishment of the level of freedom we expect in a democracy, particularly when weighed
against the questionable efficacy of the passport to reliably indicate an inability to transmit the
virus.
If the passport is digital or has a digital version, additional issues of technical privacy,
security, and access arise.
Mobility: Canadians have experienced unprecedented restrictions on moving around
within Canada, from province to province, during the pandemic. A provincial/territorial
patchwork of vaccination proof tokens or apps would make the problem worse.
Equality: the choice to be vaccinated is not open to all. There are some people with pre-
existing medical conditions or disabilities where vaccination would be counter-indicated, and it
is unclear how many people that affects because the vaccines were generally (or primarily) only
tested for emergency authorization on healthy adults. People who live with persistent illness or
disability are among those who most need human rights protections to
ensure equal treatment. Even if the passport simply indicates “medically
Why not? exempt”, that categorization may affect how individuals are treated (even if
such differential treatment is technically prohibited).
Not all members of our society are at equal risk or have equal means to navigate the
pandemic while maintaining their health, safety, and income. Front line workers in service and
retail are often women, newcomers, racialized, and/or financially insecure, and a vaccination
passport regime that predicates participation in the workplace or other activities on proof of
vaccination will disproportionately impact those individuals who have little social or political
power to resist.
Socially sorting people based on personal decisions about their health, which they are
legally and ethically entitled to make, runs the risk of creating different levels of freedom for
different “categories” of people, a risk that is likely to intersect with other systemic inequalities
and affect some groups more than others. Accommodations for
5Liberty: policies that facilitate vaccination status as a precondition to full participation in
public life run the risk of rendering a voluntary vaccination regime de facto mandatory, via
diffuse coercive impacts.
What are some current initiatives for a digital version of a
vaccination passport, and what would be the benefits and risks
of making the passport digital?
There are already a number of initiatives underway to create some version of a vaccination
passport, either building on existing tools or starting from scratch. Locally, the Ontario
government is working on one. Canada’s Health Minister, Patty Hajdu, met with the health
ministers of other G7 countries on March 31, 2021 to discuss the possibility of a coordinated
approach to vaccine passports, while stressing that Canada would only consider using such a
tool if it is based on “reliable scientific evidence” and noting that the decision to issue such a
passport would be led by provinces and territories.
Internationally, the WHO is working on a Smart Vaccination Certificate, pulling together a
consortium of experts to focus on software-neutral specifications, standards, and a trust
framework. Rather than create an app, they will be vetting apps created by others and creating
a list of those that adhere to their standards for security, authentication, privacy and data
exchange.
IATA (The International Air Traffic Association) is working on a Travel Pass Initiative, a digital
platform they pitch as “a global and standardized solution to validate and authenticate all
country regulations regarding COVID-19 passenger requirements.”
The European Union has proposed a “Digital Green Certificate” for use within Europe. Israel
also has a “Green Pass” that can be used to access gyms, hotels, and travel to limited locations.
The risks of making a vaccination passport digital are similar to those of any digital tool that
collects and shares sensitive personal information with potentially consequential impacts on
people. All the privacy and other rights-based concerns identified above continue to apply
regardless of whether the passport is paper, plastic or digital, but going digital adds complexity
to the concerns due to the potential for data collection, combination, and breach.
Concerns range from ensuring the right technical privacy protections. Questions are multiple:
what data is collected and used? Where does it come from? Where does the data live--your
device or a central server? How is it transferred to a requestor? Authenticated? Updated?
Secured? Is it used to simply display a credential (much like flashing a paper certificate or ID
6card) or scanned and recorded, and does the scan connect to a personal identifier accessible to
the requestor? The right data governance framework will also impact the way the tool works in
the world: is the credential tied to a central digital identifier? Is that identifier--such as a health
card number--shared or kept private after it’s used to authenticate the user and vaccination
status? How is that authenticated? Who certifies the authentication for external requestors?
What kinds of data linkages are created and what linkages are made possible that may be
undesirable? Will there be risk scores/AI-driven analysis as part of a system? There are more,
but that’s enough to make the point. Is it governments, a private sector vendor, or a
collaboration that creates the tool, and which of those stakeholders has access to data
collected on the app? At the same time, while going digital ups the ante in terms of
complication, it may still be desirable for some users because of convenience and flexibility. For
example, it would likely have the capacity to be updated quickly and relatively easily, or serve
other public health goals, such as reminding people when they’re due for a booster.
What would be the legal basis for requiring
the use of a vaccine passport?
There isn’t one yet, and there would need to be. A mandate for requiring an individual to
display a vaccine passport could be created in a similar way to the masking requirements many
provinces or territories have enacted. In Ontario, for example, we have a regulation (546/20)
under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020 that mandates masks
indoors. Any legislation would of course have to be constitutional, which is an appropriately
high and fundamental bar.
At an international level, for international travel, the Review Committee on the Functioning of
the International Health Regulations (2005) During the COVID-19 Response might make
recommendations on how to document safe traveler status, which possibly could result in the
amendment of the IHR which eventually, if passed, would affect the 196 countries signatory to
it.
It is also possible, although undesirable, that non-regulated uses of vaccination passport tools
would arise in sites such as workplaces, concert venues, sporting arenas, or other settings
where there is private incentive to either verify safety or at least, be seen to be trying to do so.
In such cases, the legality would require close examination within specific jurisdictions and with
attention to a range of relevant statues, including but not limited to privacy laws, health and
safety laws, labour laws, and human rights legislation.
7Governments around the world are considering
What’s next? using vaccination passports, but the science
supporting their use (or not) is not yet there. The
idea that Canada might require proof of health
status to access public or private services
domestically is actually a radical one. Radical doesn’t mean bad, or good, but it does mean that
serious consideration on ethical, moral, social, health, and legal grounds needs to be given
before moving forward. We shouldn’t be having an “of course” moment about this kind of
intervention. And it’s easy to miss that fact, because we’ve been dealing with so many
restrictions, in a time of so much fear and uncertainty, that we’ve been slowly acculturating to
the idea that the end justifies the means when it comes to the pandemic. Sometimes it does.
Sometimes it doesn’t. We need to step outside of our own fear, and demand government
leaders step outside of theirs, and subject every intervention, vaccine passports included, to a
rigorous analysis grounded in science, in necessity, and in proportionality. With this, as with
every policy decision and technical intervention we make to facilitate public safety during this
pandemic, we still need to think, up front, about what we want our country to look like now,
and in the future.
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