Blake Murdoch is a senior research associate with the Health Law Institute and the privacy officer of immunization software company CANImmunize.
In the wake of federal announcements about proof of vaccination requirements for travel, and news of provincial vaccine passports that could be used to grant access to certain venues and nonessential services, commentators have expressed concerns about the equity and privacy issues these immunization records could create. While vaccine passports do involve the sharing of health information, the severity of the negative impacts has been overstated and used to construct arguments that, intentionally or unintentionally, misrepresent the situation.
It’s important to understand what’s at stake. The decision to receive a vaccine is a personal choice, but its impacts are societal. Individuals who get vaccinated are fulfilling the social contract and contributing to the effort to establish herd immunity. But not enough people are getting vaccinated to reach herd immunity, especially with the Delta variant being far more transmissible than other versions. This will almost certainly lead to continual vaccine-preventable outbreaks. A very high percentage of the population will need to be fully vaccinated in order to reach herd immunity, and an even more transmissible variant could develop.
One issue raised by critical commentators is that vaccine passports would be unfair to individuals who cannot get vaccinated for medical reasons. In reality, the vast majority of eligible but unvaccinated individuals do not have a medical reason. They are vaccine hesitant, opposed to vaccination or simply complacent. Small groups of people may have medical reasons for remaining unvaccinated. But because the mRNA vaccines, in particular, are so incredibly safe, this population is not large. These individuals can easily be accommodated with exemptions or, if necessary, rapid testing.
A second concern is the idea that vaccine passports will create divisions in society and unequal access. Ontario Premier Doug Ford, for example, has said he doesn’t want to have a “split society.” This is just taking issue with the basic premise of the passport: to exclude people who are unvaccinated without reason from certain places or require them to take measures such as wearing a mask for the purpose of public safety. In other words, this is a feature, not a bug. The idea that personal decisions about things such as vaccination should be made in a vacuum, with no impact on how an individual gets to interact with society, has always been false. It ignores the harms a decision can inflict on others in the absence of policy. Case in point: We make people stop at stop signs so other drivers don’t get T-boned and die.
The job of public health is to ensure public safety in a manner that is proportional to the need, with minimal infringement on freedoms. Of course, passports can help prevent further closures and could actually be a net contributor to the retention of freedoms. Another likely benefit is an increase in vaccination rates among the hesitant and the complacent, who will become highly motivated to get their shots.
A third issue is the potential for surveillance, because vaccine passports will be scanned often. The thing is, the potential for surveillance is already almost absolute in a world where most people carry cellphones with GPS, cameras, microphones and other sensors. But will our governments choose to engage in this surveillance (see CSIS and Five Eyes)? And what legal protections do we have against it? These questions always deserve attention. But surveillance is not an issue unique to the use of vaccine passports. This risk can be mitigated through technical measures and is not a strong argument against the implementation of passports, especially since they directly mitigate one of the gravest global health crises of the past hundred years.
A hard truth is that the majority of Canadians have already given up much of their privacy, mostly unintentionally, to fill the coffers of corporations that package our data and sell it as a product. My first recommendation for people worried about privacy issues surrounding vaccine passports is to delete every social media account they have ever created. A simple yes/no vaccination status is far less personalized and delicate than some other personal and health information that is already online – and would be used for a far more pressing purpose than advertising profits.
Personal health information is protected by law and must be treated with the utmost care. Best practices for data security should be followed with any implementation of vaccine passports, and any information that is shared should be minimized. But the sharing of vaccination status is needed to achieve public safety in the absence of herd immunity. We just have to do it correctly.
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