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A health worker administers a dose of a COVID-19 vaccine at Yaba Mainland hospital, in Lagos, Nigeria, on March 12, 2021.Sunday Alamba/The Associated Press

African leaders and health experts are voicing concern that millions of people could be excluded from travel to Europe because the European Union’s new vaccine passport system does not recognize the COVID-19 vaccine brand that is most commonly used in Africa – and has been used in Canada too.

The EU’s vaccine passport, a digital certificate known as the Green Pass, recognizes only the vaccines that have been authorized for use in Europe. It does not recognize a common AstraZeneca brand, Covishield, manufactured by the Serum Institute of India under license from AstraZeneca.

Covishield has been the backbone of the COVAX program, the main supplier of vaccines to lower-income countries. It has also been purchased by several high-income countries, including Canada.

Of the 89 million vaccines distributed by the COVAX program so far this year, more than 90 per cent are Covishield doses, because of an early agreement between COVAX and the Serum Institute. Most of these have gone to lower-income countries in Africa, Asia and Latin America.

The controversy over Covishield’s lack of recognition by the EU Green Pass system is another sign of mounting worries that vaccine passports will be used by wealthy countries to discriminate against some travellers and to create new barriers for visitors from poorer countries.

In a statement this week, the African Union and the Africa Centres for Disease Control and Prevention expressed their worries about the Green Pass.

The current guidelines for the EU system would “put at risk” the equitable treatment of people in the countries that received vaccines from COVAX, including the majority of African countries, the statement said.

“Under such regulations, persons who received Covishield, despite being able to demonstrate proof of vaccination, would continue to be subject to public health restrictions, including limitations of movement and testing requirements, with considerable administrative and financial implications,” the statement said.

The statement noted that the Serum Institute might not apply for EU market authorization, since it is primarily producing vaccines for India and lower-income countries. This would mean that the inequalities in access to European travel “would persist indefinitely,” it said.

The EU’s Green Pass system, which is being officially launched on Thursday, has been touted as a convenient way to ease travel to European countries for vaccinated visitors. Many countries in Europe, including Germany, Greece and Spain, have already begun issuing the Green Pass certificate, even before the formal launch of the system.

But the Green Pass system recognizes only one version of the AstraZeneca vaccine: the Vaxzevria version, which is manufactured in Britain and other sites around Europe and has been approved by the European Medicines Agency. It does not recognize the Covishield version.

The Canadian government announced this year that it had secured two million doses of Covishield directly from the Serum Institute of India, with 500,000 of those doses arriving in March. It has also purchased or ordered 1.9 million AstraZeneca doses from COVAX, although the manufacturing location of these doses is not listed in federal vaccine dashboards.

Cecely Roy, a spokesperson for Procurement Minister Anita Anand, said on Wednesday that none of the doses purchased from COVAX are Covishield doses. Instead, they were allocated to Canada from an AstraZeneca facility in South Korea under the COVAX program, she said. There is no indication in EU documents that the South Korean facility has EU regulatory approval, so the same travel issues could apply.

Despite the possible Green Pass restrictions, Canada might soon be exempt from the restrictions because of another new policy decision. European Union officials agreed on Wednesday to add 11 countries, including Canada, to their list of states from which non-essential visitors will be allowed. The change is expected to take effect in the next several days. Individual EU countries, however, could still enforce travel restrictions.

The Globe and Mail asked Tammy Jarbeau, a spokesperson for the Public Health Agency of Canada, whether the federal government has any concern that the Green Pass could discriminate against Canadians who received the Covishield vaccine. She replied by citing an agreement between Canada and the EU this month to work jointly toward “global co-ordination” for a “common international system to resume safe international travel.”

She also noted that Canada’s Chief Public Health Officer, Theresa Tam, has called for international discussions so that countries can accept each other’s vaccine data for travel purposes.

The chief executive of the Serum Institute of India, Adar Poonawalla, said this week that he is trying to resolve the potential threat of EU travel restrictions on those who received Covishield. “I have taken this up at the highest levels and hope to resolve this matter soon, both with regulators and at a diplomatic level with countries,” he said on Twitter.

The World Health Organization said in April that it does not support the use of vaccination passports as a requirement for travel entry or exit. It cited two reasons: the danger of discrimination against people who aren’t able to get access to a specific vaccine, and the uncertainty over whether vaccination prevents the transmission of COVID-19, even if it reduces the chances of illness.

The exclusion of Covishield from the pass could also contribute to vaccine hesitancy in Africa, creating the impression that Covishield is somehow inferior to the vaccines approved in Europe.

In India, Covishield accounts for about 88 per cent of the 322 million vaccine doses administered so far, and there has been widespread concern about the new EU travel rules.

There are similar concerns from countries that have relied heavily on Chinese or Russian vaccines, which are also among the vaccines that have not been approved by European regulators.

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