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‘Vaccine passports’ may be critical for equity, but polarization could undermine efforts

Despite good progress on vaccinations in the U.S., the Biden administration and most officials are weary of requiring "vaccine passports" to prove inoculation. William Brangham discusses the related concerns with Dr. Georges Benjamin, the executive director of the American Public Health Association, and Lawrence Gostin, a professor of global health law at Georgetown University Law Center.

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  • Amna Nawaz:

    Well, the rise in vaccinations in the U.S. and other countries means travel will resume in Europe this summer. Fully vaccinated people will now be able to travel to countries in the European Union this month.

    And the E.U. is working on a digital pass, where people can prove they have had a vaccine or a recent negative COVID test. Some countries have already introduced the idea of this so-called vaccine passport, but, so far, the Biden administration and most U.S. officials are leery of requiring them here.

    William Brangham looks at the issues around all of this.

  • William Brangham:

    That's right, Amna.

    There's already a slew of different cards and apps that allow you to prove your vaccination status. In some countries, they're expected to become mandatory in order to travel, or do business, or even enter crowded indoor spaces.

    In the U.S., a number of companies are working on similar products. And while many argue these tools will help us get back to normal quicker, others have concerns over privacy, over equity, and whether this is one step closer to mandating vaccination.

    We look at some of those arguments now with Larry Gostin — he's a professor of global health law at Georgetown University Law School — and with Dr. Georges Benjamin — he's the executive director of the American Public Health Association.

    Gentlemen, thank you both very much for being here.

    Larry Gostin, to you first.

    I know you have in the past been supportive of this idea of some kind of proof of vaccination. Make the case.

  • Lawrence Gostin:

    Yes, I mean, a lot of people worry about people's rights.

    And, of course, everybody has a right to make their own decision about their own health and well-being. But they don't have the right to be unmasked and unvaccinated in a crowded place and spread infection.

    The main concern, of course, is equity. But vaccine passports will help us get back to normal more quickly, more safely, so long as everyone who wants a vaccine can get a vaccine. We can't leave anyone behind. So equity has to be front and center.

  • William Brangham:

    Dr. Benjamin, pick that up.

    Larry is saying, look, this is a great tool to get us back to where we all want to be.

    I know you have some particular concerns about this. What are those?

  • Dr. Georges Benjamin:

    Well, let's start about the equity concern.

    As you know, there are many people who have not had the opportunity to be vaccinated. And particularly in the United States, we have enormous disparities that still exist in getting vaccinated. Secondly, while there are people that have cell phones, everybody doesn't have a cell phone.

    And, in fact, the vast majority of people not only in the United States, but around the world, are going to be using that paper card. And that paper card, of course, quite frequently cannot be validated in any kind of meaningful way.

  • William Brangham:

    Larry, let's pick up on some of those questions.

    Dr. Benjamin is saying, OK, look, not everyone who wants a vaccine has gotten one yet. And we know that that's true, and especially true with certain minority populations in the U.S. So, if we start to roll out a passport now, those people run the risk of being further alienated.

  • Lawrence Gostin:

    They are.

    And the last thing we want to do is give more privilege for the already privileged. And so we have to deal with equity. So, for example, a business or a university, and many universities and some businesses have announced that they will be using proof-of-vaccination systems.

    So long as they would say to everyone, listen, if you don't have a vaccine, or you can't get one, we will give it to you for free, we will offer it to you, that means that everybody who wants a vaccine can get a vaccine.

    Georges is absolutely right. Equity is crucially important. But I do feel that we have a very high level of vaccination coverage. We will get to even higher. We have ample supply now. And it will grow even more. And it will be a way to make all of our communities safer and healthier, and also a way to comply with recent CDC guidance, which makes a sharp distinction between vaccinated people and unvaccinated people.

    And so, if we want to follow that guidance, who needs to wear a mask, who needs to socially distance, you have to have a means to determine a person's vaccination status.

  • William Brangham:

    Dr. Benjamin, what about that?

    I mean, as Lawrence Gostin is saying here, if mask mandates are dropping, which we know they are, and I'm a child or an immunocompromised person, I have a huge incentive to want to know if I'm inside of a crowded space with a person who's got a vaccine or not.

    I mean, at its base, I know you appreciate the need for this kind of thing. But you're just concerned as to how this might get rolled out and when; is that right?

  • Georges Benjamin:

    Yes, I'm very concerned about us being premature in this.

    And the truth of the matter is, you're never going to really know who's vaccinated unless you paste it on your forehead. You're trusting that the card that someone showed you, the app that they showed us is accurate.

    We as a nation have a long history of misusing health information for nefarious purposes. There's a risk of people being discriminated against because of employment, people being asked not to come into a particular establishment, a business establishment, because they cannot show that they're vaccinated.

    So there's a there's an enormous risk of misuse.

    Now, having said that, I have always been a strong supporter of ensuring that kids in school are all vaccinated. And I certainly show my yellow fever vaccination card when I go out of the country. But we have an established understanding of the science in that.

    And with all the variants that are coming here, we're probably going to have to then document this each and every year, because of the fact we're probably going to have to get booster shots at some point.

  • William Brangham:

    Lawrence Gostin, we know that the WHO is developing some kind of a vaccination records app.

    Do you wish the CDC and/or the Biden administration were taking some initiative to help that process along here in the U.S.?

  • Lawrence Gostin:

    WHO realizes we need to have uniform and stringent technical guidance.

    Now, I am critical of the Biden administration. They have done a wonderful job getting vaccines into people's arms and following the science. And I give them really high grades for that. But they can't abdicate the responsibility to provide sound technical advice and scientific guidance to businesses and states and even schools that want to develop proof-of-vaccination systems.

    That way, if we do roll it out, it can be of uniformly high quality. Otherwise, there will be a free-for-all.

  • William Brangham:

    Dr. Benjamin, I want to touch on a few of the other concerns. There are these privacy concerns, which I have mentioned, that people are worried about dumping their information into some kind of an app that might be owned by a private company. But there's also this — the concern over partisanship.

    And we have certainly seen this erupt over masks, over vaccines themselves. We know two Republican governors have already said that any attempt to put forward a vaccine passport in their state will be prohibited.

    Do you share the concern that, if we do push this effort, that this will further politicize the vaccine effort more broadly?

  • Georges Benjamin:

    I have a real concern of that.

    And I think that one of the things we absolutely have to do is try to come to some consensus around this. And I think the — these technologies are wonderful. And I absolutely love the fact that I have a cell phone that I can show my past to get on the plane. I love it, the fact that it gives me preferential treatment as I go through the security line.

    That's wonderful. That's voluntary. And having a health certificate that I would voluntarily one to share is not a bad idea.

    And Dr. Gostin — Mr. Gostin is absolutely correct that we need to have uniform technical guidance. No question about that. The problem is that, today in America, we have become so polarized, that I'm afraid that this may be taken in the wrong direction, and actually undermine our vaccine confidence.

    So, we need to spend the time getting some consensus between red states and blue states that this is OK. And then we need to make sure we understand the science better and where these variants are going. And then, maybe sometime in the future, this might not be a bad idea.

  • William Brangham:

    Larry Gostin, last question to you.

    Do you share that concern over partisanship? You did make the point that public schools everywhere require kids to prove they have been vaccinated. Do you think that that will not be an issue here?

  • Lawrence Gostin:

    No, I mean, partisanship seems to be an issue with almost everything we do in the United States and certainly with COVID-19, from masks, and now vaccinations.

    But the science is really strong that this can be done well and can get us back to normal. We just need to focus on equity.

  • William Brangham:

    All right, Larry Gostin, Dr. Georges Benjamin, thank you both very much for being here.

  • Georges Benjamin:

    Thank you.

  • Lawrence Gostin:

    Thanks. Appreciate it.

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