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A nurse signals for a dose of the Moderna COVID-19 vaccine at a vaccination centre in Brampton, Ont., on March 4, 2021.CARLOS OSORIO/Reuters

A long-simmering COVID-19 issue is starting to boil over, and that is the question of whether vaccinations should come with “vaccine passports.” These would be certificates allowing immunized people to travel to other countries or to the gym around the corner while everyone else remains locked out, awaiting their turn to be injected.

The European Union is set to propose a “digital green pass,” designed to revive the continent’s tourism industry. The pass would be stored on a smartphone and would serve as proof that a person has been vaccinated or has received a negative COVID-19 test, so they could travel between EU member countries unhindered.

Israel, with the world’s highest vaccination rate to date, already has a green pass that allows fully inoculated people to go to bars, restaurants, gyms, hotels and clubs.

Tracking Canada’s COVID-19 vaccine rollout plans: A continuing guide

Coronavirus tracker: How many COVID-19 cases are there in Canada and worldwide? The latest maps and charts

Moderna, Pfizer, AstraZeneca or Johnson & Johnson: Which COVID-19 vaccine will I get in Canada?

Canada pre-purchased millions of doses of seven different vaccine types, and Health Canada has approved four so far for the various provincial and territorial rollouts. All the drugs are fully effective in preventing serious illness and death, though some may do more than others to stop any symptomatic illness at all (which is where the efficacy rates cited below come in).

PFIZER-BIONTECH

  • Also known as: Comirnaty
  • Approved on: Dec. 9, 2020
  • Efficacy rate: 95 per cent with both doses in patients 16 and older, and 100 per cent in 12- to 15-year-olds
  • Traits: Must be stored at -70 C, requiring specialized ultracold freezers. It is a new type of mRNA-based vaccine that gives the body a sample of the virus’s DNA to teach immune systems how to fight it. Health Canada has authorized it for use in people as young as 12.

MODERNA

  • Also known as: SpikeVax
  • Approved on: Dec. 23, 2020
  • Efficacy rate: 94 per cent with both doses in patients 18 and older, and 100 per cent in 12- to 17-year-olds
  • Traits: Like Pfizer’s vaccine, this one is mRNA-based, but it can be stored at -20 C. It’s approved for use in Canada for ages 12 and up.

OXFORD-ASTRAZENECA

  • Also known as: Vaxzevria
  • Approved on: Feb. 26, 2021
  • Efficacy rate: 62 per cent two weeks after the second dose
  • Traits: This comes in two versions approved for Canadian use, the kind made in Europe and the same drug made by a different process in India (where it is called Covishield). The National Advisory Committee on Immunization’s latest guidance is that its okay for people 30 and older to get it if they can’t or don’t want to wait for an mRNA vaccine, but to guard against the risk of a rare blood-clotting disorder, all provinces have stopped giving first doses of AstraZeneca.

JOHNSON & JOHNSON

  • Also known as: Janssen
  • Approved on: March 5, 2021
  • Efficacy rate: 66 per cent two weeks after the single dose
  • Traits: Unlike the other vaccines, this one comes in a single injection. NACI says it should be offered to Canadians 30 and older, but Health Canada paused distribution of the drug for now as it investigates inspection concerns at a Maryland facility where the active ingredient was made.

How many vaccine doses do I get?

All vaccines except Johnson & Johnson’s require two doses, though even for double-dose drugs, research suggests the first shots may give fairly strong protection. This has led health agencies to focus on getting first shots to as many people as possible, then delaying boosters by up to four months. To see how many doses your province or territory has administered so far, check our vaccine tracker for the latest numbers.

Sweden and Denmark are developing their own versions, which would be required for travel and possibly for attending concerts and sporting events. China says it is working on a passport, too, while the United States hasn’t ruled out the possibility.

In early February, the World Health Organization said it was opposed to vaccine passports for international travel, largely because the effectiveness of vaccines at reducing the transmission of COVID-19 was still poorly understood.

But as evidence grows that vaccines reduce not only illness but also transmission, and are also effective against the new and more infectious variants of the virus, a growing number of countries see the passports as a way of safely reopening their economies sooner rather than later.

The EU and other governments are calling on the WHO to develop an international standard for vaccine certificates that would make them acceptable at border crossings around the world. The WHO has set up a working group to do just that. This has set off a debate about the ethics of vaccine passports. Critics bluntly call them an attack on civil liberties, a source of discrimination and an invasion of privacy.

They are concerned about someone being refused a service or the right to travel simply because their number hasn’t come up in the worldwide vaccination lottery – a worry exacerbated by the fact that wealthier countries are getting vaccines ahead of poorer ones, potentially turning many people into second-class citizens when it comes to international travel. Others, however, point out that it would be irrational to ignore the decreased infection threat posed by a vaccinated person, and to prevent them, in the name of equity, from travelling or eating in a restaurant until everyone can travel or eat in a restaurant. Lockdowns and business shutdowns, even when necessary, are severe curtailments of basic liberties. “A strong presumption should be in favour of preserving people’s free movement if at all feasible,” the British medical journal Lancet said this week.

And beyond all that, there are the practical benefits. Vaccinated people armed with digital passports could kickstart ailing tourism economies around the world this summer, revive airlines and facilitate long-postponed family reunions.

This is going to be difficult for countries to ignore. “We expect,” two researchers wrote this week in the Canadian Medical Association Journal, “that immunization passports will be imminently introduced for international travel.”

But who will manage them? If governments don’t act in concert with one another and the WHO, private companies, such as airlines, could create their own systems, the authors conclude, “potentially leading to problems related to equity, privacy and coercion.”

All of which means Canada has to get on board with what appears to be an inevitability. Once again, this country will be playing catch-up on a key COVID-19 development.

For starters, Ottawa and the provinces are not doing a good job of keeping track of who is fully vaccinated. There is a worrisome inconsistency in how records are kept from province to province, and there is no centralized database.

Once the data are collected, the federal government will have to ensure it meets the best standards in terms of security, authentication, privacy and data sharing, and that it addresses any ethical concerns around coercion and discrimination. There is no evidence Canada is currently in a position to begin doing anything of that.

It could leave Canadians stuck at home this summer, while the rest of the world comes back to life.

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