Green passes and dark inequalities: the push for COVID immunity passports

Sensible, ideal, wonderful – if you happen to be in the European Union. This is the air of confidence surrounding the March 17 proposal for a digital COVID immunity passport, or what is officially being called the Digital Green Certificate.

The Digital Green Certificate is actually a bundle of three: vaccination certificates stating the brand of vaccine used, data and place of inoculation and number of doses administered; negative test certificates (either a rapid antigen test or a NAAT/RT-PCR test); and medical certificates for those who have recovered from COVID-19 in the last 180 days.

The measure is discrimination made sound, preference made prominent. The essential requirement to obtain such a pass is evidence that you have been vaccinated by a jab with a vaccine approved by the European Medicines Agency. But the European Commission did append a qualification to this requirement. Member states could decide whether to accept vaccines that the EMA had yet to approve. Not in itself reassuring, given the varied approaches European states have taken to the international vaccine market.

Such administrative and bureaucratic impositions are the stuff of nightmares for ethicists and philosophers. For those in economics, business and management, it is an eminently sensible idea that will enable people to move within Europe, preferably in time for summer.

The director of Eagle Travel, David Reculez, put the case for the defence. "For us, the travel agencies, the new certificate is really a good hope because it will definitely help people to travel again." People wanted to travel in a safe way without being hampered by "hard rules or quarantine".

Countries with tourist-heavy economies – Greece, Spain and Croatia, for instance – are enthused. On February 23, Greece's Digital Governance Minister Kyriakos Pierrakakis announced the use of vaccination passports. Agreements have been struck with Israel, Cyprus and Serbia to enable a generous flow of vaccinated residents this summer. Prime Minister Kyriakos Mitsotakis has had the ear of the EU President Ursula von der Leyen, pushing for a unified EU position on the matter, despite his country's separate bilateral efforts.

France, Germany, the Netherlands and Belgium are, to various degrees, opposed and sceptical. France's minister of state for tourism, Jean-Baptiste Lemoyne thought "the idea of restricting movement to only people who are vaccinated" a "premature" debate given that only "4 to 5% of the European populace had been vaccinated." The country's minister for European Affairs Clément Beaune found it "shocking, while this vaccination campaign is still underway in Europe, that there would be more rights for some people than for others. This is not our conception of protection and access to vaccines."

A number of health practitioners and bioethicists hold similar concerns. Sarah Chan of the Usher Institute for Population Health Sciences and Informatics in Edinburgh makes a convincing case for the prosecution. "I think vaccine passports have the potential to be unnecessarily divisive. It's likely to lead to negative consequences, particularly in being unfair and creating inequalities."

In February, the World Health Organization (WHO) warned that "there are still critical unknowns regarding the efficacy of vaccination" including combating variants of SARS-CoV-2; the duration of protection following vaccination; the timing of booster doses and whether vaccination offered protection against asymptomatic infection.

Prioritising vaccinations for travel "could result in inadequate supplies of vaccines for priority populations considered at high risk of severe COVID-19 disease." To introduce "a requirement of vaccination as a condition for travel has the potential to hinder equitable global access to a limited vaccine supply and would be unlikely to maximize the benefits of vaccination for individual societies and overall global health."

We can already see the green pass concept deployed in Israel. The incentive to do so is clear. "With the green pass," encourages the voiceover of an advertisement promoting the idea, "doors simply open in front of you … We're returning to life."

The country has been using an app to show who has been fully inoculated against coronavirus or those who have recovered from infection. For both vaccinated individuals and recovered coronavirus patients, the pass is valid till June 6, 2021. It acts as a form of exclusive access, a mark of approval should you wish to go to concerts, theatres, gyms and hotels. Hoteliers such as Armin Grunewald, whose establishment can be found near the Sea of Galilee, told the Guardian that, "People were looking happy and liberated".

Cryptographers and students of information security were less merry. The Ramzor app has been blighted by problems since it was launched. In the view of computer scientist Orr Dunkelman, based at Haifa University, it unnecessarily reveals information such as the date a person recovered from COVID-19 or received a vaccine. It also employs an old encryption library susceptible to security breaches. Ran Bar Zik, software columnist for Haaretz, goes so far as to call it "a catastrophe in the making," suggesting a paper vaccination form instead.

In February, the Knesset approved a law allowing the Health Ministry to provide the name, national identification number, phone number and address of any citizen who can be vaccinated but has not received a jab, to a range of authorities. These include the Education Ministry and the Welfare Ministry. At the time of its passage, Tamar Zandberg of the Meretz party suggested that, "Disclosing such information is a slippery slope, and damage's people's privacy."

An uncomfortable spectre is unfolding. While paperwork certifying good health has been a feature of transport and travel – the WHO's Yellow card showing certified vaccinations for such infections as cholera, plague and typhoid being a most known example – COVID-19 green certificates are another matter. Epidemiologist Christopher Dye and sociologist Melinda C. Mills, writing in Science, remark that, "The greatest risk is that people for whom vaccination is unacceptable, untested, inaccessible, or impossible are denied access to goods and services." They consider the various instances where inequity can manifest: ethnic minorities reluctant to take the jab; a lack of data on vaccine efficacy for people at risk (pregnant women for instance); unreachable, undocumented migrants; the digital technological divide; and eligibility requirements.

In a global sense, the unvaccinated in the COVID-19 age risk becoming the great modern unwashed, derided or ignored, socially and politically excluded. The effect is analogous to depriving people of passports, alienating them from citizenship citing biomedical grounds. Dye and Mills are optimists confident that such passports can "be guided by exemplary science, appropriate technologies, and fair use for all." But as with previous categories of the invisible and the undocumented, verifiable vaccination passes loom as rigid hierarchies of compliance, surveillance and division.