Hiltzik: the virtues of vaccine passports


It was a bright yellow brochure that I carried everywhere and at some national borders it was scrutinized more closely than my government issued passport.

It was my vaccination certificate, showing the dates I received vaccinations or screenings for more than half a dozen diseases.

In sub-Saharan Africa, where I traveled as a Times correspondent in the 1980s and 1990s, yellow fever, polio, meningitis, hepatitis, measles, and tuberculosis were included.

It is not until a political party or faction of a party takes the issue and makes it political that you suddenly see people lining up on different sides of the debate.

David Studdert, Stanford University

They were all endemic in many of the countries I covered. Without the vaccine passport, yes, that’s what it was, it is almost certain that I would have been banned from leaving the airport and placed on the first plane out of the country.

The vaccination rules were rigorously enforced because those diseases were endemic in the countries I visited. Today, COVID-19 is more than endemic; it is a pandemic, of course. And that’s what makes the political debate over COVID vaccine “passports” so bizarre.

Make no mistake: in the United States, the debate is being driven almost entirely by ideology and partisan politics. Conservatives and Republicans have embraced opposition to vaccination requirements as the latest flash point in their culture war.

In an opinion piece published Monday, right-wing Senator Rand Paul (R-Kentucky) called vaccine passports “the latest takeover … that would determine your social suitability to participate in your everyday life.” He called the prospect of a government mandate “comprehensive on vaccine fascism.”

Florida Governor Ron DeSantis, whose desperation to be a front-line culture warrior appears to be tied to his quest for the 2022 Republican presidential nomination, issued an executive order Friday purporting to prohibit Florida businesses from requiring documentation. of the COVID vaccine through a “vaccine passport” or other form prior to admitting or caring for clients.

If the order has teeth it is cloudy. The penalty for companies in violation is ineligibility for state grants or contracts, and the order says it does not prevent companies from “instituting COVID-19 screening protocols … to protect public health.”

In any case, it is questionable whether any company or state should follow DeSantis’ lead. Florida is currently ranked 12th among all states in its most recent seven-day average of coronavirus cases per capita and 10th in deaths per capita. Your rates in both categories are increasing.

“I find the politics a bit unsettling,” says David Studdert, a healthcare law expert with a dual designation at Stanford medical and law schools.

In a recent article in the New England Journal of Medicine on policies and ethical considerations related to vaccine passports, Studdert and his co-author acknowledged that requiring proof of vaccination today would be “morally questionable.”

That’s largely because vaccine supplies are still inadequate, some age groups are not yet eligible, and vaccination rates in low-income and ethnic communities are lower than those of economically privileged and white Americans.

However, those divergences “are not going to be there for long” as the vaccination rate improves across the board and all adult Americans become eligible, Studdert told me.

Until recently, Studdert says, American views on vaccine-related work or trade restrictions appeared not to be political. In a poll he and his co-author, Mark A. Hall of Wake Forest University, conducted in June, about half of those surveyed favored privileges for immunized people.

Support was greater for “using passports or certificates to allow return to high-risk jobs or attendance at large recreational events than for returning to work in general,” the authors found.

Most interestingly, the opinion had nothing to do with race, age, education level, or partisan leanings. “The division was down the middle,” says Studdert.

But that could have been because the issue was in a “pre-political” stage at the time: vaccines still seemed to be many months away. “It’s not until a political party or faction of a party takes the issue and makes it political,” says Studdert, “that you suddenly see people lining up on different sides of the debate.”

Despite conservatives warning that vaccine passports will herald the government’s foray into our private lives, requiring proof of immunization for certain purposes is nothing new.

Families with children are certainly familiar with the vaccination requirements for school: Florida, like other states, requires testing of multiple doses of various vaccines before children can enter the K-12 system, for example. Businesses of all kinds reserve the right to deny service to customers who do not meet their standards of dress or behavior.

These rules are generally allowed by law as long as they are not applied to discriminate against certain protected groups. Federal law prohibits businesses from refusing to serve customers because of race, religion, or national origin, and the Americans with Disabilities Act prohibits discrimination against the disabled.

Americans were evenly split on vaccine passports

Americans were evenly split on vaccine passports, according to this poll conducted last June, but the issue has since become politicized.

(Hall and Studdert, NEJM)

Distrustful of a political backlash, the Biden administration has rejected any intention to create or maintain a central vaccination database. Your role is more likely to set guidelines and exercise oversight to ensure that the issuance of vaccine tests is not subject to fraud or other irregularities.

The drive to obtain passports or vaccine certifications is more likely to come from the private sector itself. Businesses will want to show that they are doing everything they can to keep facilities healthy, in part because many customers will be wary of sponsoring those who don’t, be they airlines, retail stores, or entertainment venues.

That’s the rationale behind the first state-sponsored vaccine certification, the Excelsior Pass, launched by New York State in late March. The app-based pass allows users to upload their vaccine certifications and display a code at the door of participating companies to enter.

Anyone traveling outside of the US may not be able to avoid vaccine passports. They are already in use in Israel and are being considered in Europe. Once the immunization tide reaches a critical mass in the US, it’s a safe bet that they will be welcomed by the private sector here as well. Companies will not be very happy when companies like DeSantis tell them that they cannot take steps to protect their workers and customers.

The lesson of automobile safety mandates is instructive. Detroit automakers resisted federal mandates for shoulder harnesses and airbags for years, arguing that they would increase car prices and that American consumers didn’t care about safety. The rules went into effect in the 1970s, and it wasn’t long before Detroit began using the safety of its vehicles as a point of sale.

Conservatives campaigning against vaccine certifications are making the same calculation: that Americans care less about their own safety than some nebulous variety of “vaccine fascism.” That is a bad bet, and companies and politicians would do well to place their bets the other way around.



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