Vaccine passports are crucial for the CDC’s new mask guidance

Now that the Centers for Disease Control and Prevention (CDC) has said that people who have been vaccinated against Covid-19 can shed their masks, there are obvious questions: How do you verify that people are vaccinated? Especially in situations in which some people can’t get vaccinated, including young children, or may remain vulnerable after, like some immunocompromised people, how can we guarantee they’re safe from the unmasked as mandates disappear?

Unlike many of the challenges we’ve faced with Covid-19 in the past year, there’s a clear answer: vaccine passports. Under this system, vaccinated people could provide proof of inoculation to unlock privileges they didn’t have before, like going into a grocery store without a mask or patronizing a restaurant with no social distancing requirements.

Other countries have successfully adopted this strategy. In Israel, which has the world’s most advanced vaccination campaign, a system of “Green Passes” has let the country almost fully reopen while seeing daily new Covid-19 cases drop by more than 95 percent and daily deaths nearly eliminated.

But America has already failed in adopting anything like the Israeli system, with little sign that will change. The CDC-stamped cards people get with their shots are easily copied or forged. President Joe Biden’s administration has rejected calls to adopt nationwide vaccine passports, instead leaving the issue to the private sector. Some states have already moved to ban the use of vaccine passports, blocking government entities — or, in Florida, even private businesses — from asking for proof of vaccination. Meanwhile, some major retailers are lifting mask mandates for those who are vaccinated largely by relying on an honor system.

Legitimate questions exist about how a vaccine passport would work in the US, but it’s worth figuring them out given what’s at stake: a quicker, safer path back to pre-pandemic normal. By giving up on the idea entirely, America is repeating one of its core mistakes of the pandemic — opting for short-term freedom from Covid-related precautions over longer-term freedom from the virus.

The case against vaccine passports typically comes down to a narrow interpretation of freedom. People should be able to make their own choices, the thinking goes, about whether they get vaccinated, and no one should try to coerce them to get the shot. And even if someone does get vaccinated, that’s a private matter that shouldn’t be used by others to limit what a person can do.

But in a longer-term view, vaccine passports actually unlock more freedom — by safely and quickly returning to that pre-pandemic normal.

Over the past year of the Covid-19 pandemic, much of America demanded 100 percent freedom in the face of the coronavirus, rejecting measures like lockdowns, mask mandates, and test-and-trace that critics claimed violated fundamental rights. So much of the country often got close to 0 percent freedom — as the coronavirus spread and people and businesses closed down, voluntarily or by government order, for their own safety.

“Look at how much freedom people in New Zealand have had over the last year versus how much Americans have had — it’s not even a close call,” Ashish Jha, dean of the Brown University School of Public Health, told me. “The question that I have raised is, freedom to do what? I think most people care about freedom to live their lives as they wish.”

Vaccine passports work

Once a person gets vaccinated in Israel, they can get their Green Pass from the country’s Ministry of Health within minutes — through a website, smartphone app, or phone line. Israelis can then print out their scannable passes, or carry around digital versions on their phones. Under the country’s laws, certain businesses, like gyms and movie theaters, ask for the Green Passes to let people in. People with recent negative coronavirus tests and natural immunity, from previous Covid-19 infections, can also obtain a pass.

With this system, Israel has seen stunning results: Despite nearly fully reopening, Covid-19 cases and deaths in the country have fallen to close to zero.

By March, most Israelis had received at least one dose of the Covid-19 vaccine. With the Green Pass system, Israel moved to nearly fully reopen its economy — keeping in place a mask mandate and some capacity limits. At that point, Israel had more than double the daily new Covid-19 cases as the US. Since then, Covid-19 cases have plummeted by more than 95 percent — to less than 4 percent of the US’s daily new cases. Daily Covid-19 deaths in Israel now regularly come in at zero or the single digits.

Writing in the New York Times, Isabel Kershner detailed the normalcy Israelis now find themselves in as they get “a taste of a post-pandemic future.” People are dining out, going to packed concerts, and attending sports events — often without masking and with little to no physical distancing.

Replicating Israel’s system exactly in the US would be challenging. Israel has a national health care system, making the task of linking a person’s vaccine status to a Green Pass that much easier. It’s also a smaller, less sprawling country.

If a national standard is out of the question, the US could still enforce some vaccination requirements at the state level, or even in private businesses. But then enforcement becomes more difficult: In Israel, a national standard sets the expectation that a bartender or ticket taker at a movie theater will ask for proof of vaccination. If there are dozens of different private or state-based standards, all of this becomes much harder and more complicated.

Because the vaccines are only authorized for emergency use, there are also legal questions about a vaccine requirement in the US.

“There’s a logic to [vaccine passports],” David Rosner, a public health historian at Columbia University, told me. “But I think it’s trickier than just saying, ‘Yeah, it’s a good thing.’”

Still, if America could figure out the incredibly complicated task of the Covid-19 vaccine supply chain, it can figure out how to let individuals prove that they’re getting those shots.

Yet the US has already seemingly given up. While the Biden administration is reportedly working with private businesses to develop some standards for vaccine passports, it has rejected a federalized system. “The government is not now, nor will be, supporting a system that requires Americans to carry a credential,” White House press secretary Jen Psaki said.

So when reporters have asked federal officials how, for example, people can know that others now shedding their masks are truly vaccinated, the answers have largely amounted to shrugs — with assurances that at least the honest people, meaning those who are truly vaccinated, will be protected from Covid-19, even if a nearby unvaccinated person is carrying the virus around.

“The science demonstrates that if you are fully vaccinated, you are protected,” CDC director Rochelle Walensky said, in response to one such question. “It is the people who are not fully vaccinated in those settings who are not protected.”

That’s not a satisfying answer. The vaccines are medical marvels, and the evidence does show that vaccinated people are truly protected from risk of Covid-19, including the variants that have been discovered so far. But there are still reasonable questions about whether future variants could evade vaccine-induced immunity, whether that immunity is durable for very long, what happens with children and others who still can’t get vaccinated, and whether seasonality could produce new coronavirus surges like we saw in the past fall and winter. It also just doesn’t seem safe or fair that a person could lie about their vaccine status, stop social distancing and masking, and pose a risk to everyone else without any measure of accountability.

Israel shows it can be done differently.

Vaccine passports are a ticket to more freedom

The common argument against vaccine passports is, essentially, freedom: People don’t want their rights to privacy supposedly violated by having their vaccine status put in a federal database that’s then used against them. And they don’t want to have to prove their vaccine status to strangers, especially nosy employers or government officials.

Some states have already acted on this, banning government entities or even private venues from asking for proof of vaccination. In calling for a statewide ban on vaccine passports, Florida Gov. Ron DeSantis argued, “You have a right to participate in society without them asking you to divulge this type of health information like just to go to a movie, just to go to a ball game.”

But there’s another way of looking at this: Vaccine passports could be used to unlock more freedoms. New York, for example, has told private businesses that they’ll be exempted from social distancing requirements if they ask for proof of vaccination or a negative coronavirus test. Other states are leveraging similar standards for masking and social distancing, letting people drop the precaution and restrictions if they show they’re vaccinated.

As Jha put it, “Freedom cuts in both directions.” Yes, of course it infringes on some level of privacy to have to share your vaccine status with a bunch of strangers. But the alternative also hinders your freedom: Without a way to prove vaccine status, everyone from individuals to businesses to government agencies will likely be more cautious — and that will likely lead to a reduced ability for everyone to do things with any sense of safety.

We’re already seeing this in Florida. One cruise line has warned that it might have to dock in other states as a result of Florida’s vaccine passport ban, since it wants to ensure that people on board are fully vaccinated. So Floridians won’t have their privacy infringed in a narrow sense, but they’re also missing out on potential activities that they could take up if vaccine passports were allowed.

To this end, some experts argued the best way to frame and actually use vaccine passport requirements would be to make them a reward instead of a punishment. So maybe people could go into the office without wearing a mask if they prove they’re vaccinated, or maybe employers could make those who are vaccinated eligible for a pay bonus (as Amazon is doing for new hires).

“We have to make sure not to penalize people,” Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, told me. “In public health, an overarching principle is you want people to partake willingly — to be partners in this work. You try to use restrictions as a last resort.”

But if the country rejects vaccine passports on privacy grounds, it risks repeating the same kind of mistake it’s made repeatedly throughout the pandemic, resulting in less safety and freedom in the long term. Consider South Korea’s test-and-trace system: It required the public to give up some measure of privacy through apps that could track people’s location and Covid-19 status, so potential cases could be tracked down and isolated. But the result was actually much more freedom than many Americans had over the past year — as South Koreans could go to nightclubs, bars, and movie theaters with few to no restrictions and next to no concern about their risk of catching the virus.

America’s all-or-nothing thinking produced some of the worst Covid-19 outcomes anywhere in the world, as much of the US widely shut down anyway and recorded some of the highest rates of coronavirus deaths. Vaccine passports offer a chance to seize America’s one success against Covid-19 — the vaccines — and break from its awful record against the virus.

Vaccine passports could speed up America’s return to normal

America has made incredible progress on vaccines, getting at least one dose to nearly half of its population and pulling ahead of peers like Canada and the European Union. Given that the US overall did a much worse job on Covid-19 deaths than many of its peers, its achievements on the vaccination front are all the more impressive.

But in the past few weeks, this kind of progress has slowed. The daily vaccination rate averaged nearly 3.4 million in mid-April; it’s less than 1.9 million as of May 17. Canada and Europe have also caught up to America’s vaccination rates, measured as people getting at least one dose, in recent weeks.

Biden has promised that America should be able to return to normal by July 4, once about 70 percent of adults — roughly 60 percent of the country — get at least one dose. But the slowdown threatens America’s path to that return to normal.

Vaccine passports offer a way to reverse the slowdown: In promising Americans a material reward for vaccination by letting them shed their masks or stop social distancing, and actually holding people accountable for vaccination, the US could push more people to get the jab.

Some research has backed this up. A study from the UCLA Covid-19 Health and Politics Project found people would be more likely to get the vaccine if it meant they could go maskless. That included Republicans, who are now the biggest holdout group for vaccines: They were 50 percent more likely to say they’ll get a vaccine if they would no longer have to wear a mask. Meanwhile, outreach programs had little to no effect, the study found.

The key is “things that actually affect people’s lives, not just informational things,” Lynn Vavreck, principal investigator of the UCLA Covid-19 Health and Politics Project, told me.

Similarly, surveys from the Kaiser Family Foundation have found that about a third of the most vaccine-hesitant would get the shot if it were required. That kind of mandate could be enforced with a vaccine passport.

There are genuine concerns that such a mandate could backfire. Nuzzo argued that some people would have their anti-vaccine views hardened by governments trying to force them to get vaccinated. That’s why she prefers a carrot over a stick when it comes to vaccination efforts.

“We’ve not done enough work to address people’s questions, concerns, and hesitations,” Nuzzo said. “You take someone who is generally uncomfortable but willing to have a conversation, and you make it about them and an infringement on their liberties, and then they wind up getting more hardline on their views about the vaccines than they otherwise would have been.”

So, in practice, maybe a vaccine passport could be used to get better seats at a baseball game, lose the mask or stop physical distancing at a concert, or unlock activities, such as cruise ships, that weren’t possible before — incentives to a normal life, not restrictions. These are things already happening in some places, but making them truly national could up the incentive without leading to a backlash.

The goal should be to get America to normal as quickly and safely as possible. We likely won’t be at zero risk of the coronavirus anytime soon. And there are genuine threats that remain, from the variants to the possibility of a fall or winter surge. But vaccine passports offer a stronger guarantee of safety, minimizing those risks further than simply vaccinating as much of the population as possible and hoping for the best.

After a year in which America repeatedly failed to stop the spread of Covid-19, we are finally getting something right with the vaccines. We should make the best of this moment of victory — doing everything in our power to ensure we can all benefit from this medical miracle. Vaccine passports are our ticket to doing that.