Explained: Why vaccine passports are discriminatory towards more than half of the world

External Affairs Minister S Jaishankar has said testing people before and after international trips for the coronavirus disease (COVID-19) should be a good enough basis for travel, reigniting the debate over how vaccine passports could be discriminatory against a section of the world’s population.

“If people who are tested before for international travel and tested on arrival is a good enough basis for travel but some countries have now introduced the issue of vaccination. So, we will have to reach obviously some understanding. I discussed today how do we make sure that we are not discriminated against and how do we reach understandings between ourselves about the travel of our citizens to each other’s countries," Jaishankar said in Moscow on Friday.

What are vaccine passports?

​“Vaccine passports," or vaccine certificates, are documents that show you were vaccinated against Covid-19 with vaccines recognised in the region you plan to visit. In most places where these have been deployed, people who have been fully vaccinated either get a letter with a QR-code they can scan with their phones or they can contact their doctors or pharmacies to retroactively get the digital pass.

Many countries across the world hope that now since vaccines have been available for a few months, a vaccine passport will allow people to cross borders more easily, with less need for quarantine.

That the virus spreads via contact and is mutating dangerously in several parts of the world with still high levels of infections, makes the efficacy and need of a vaccine passport almost a no-brainer for countries that have reached high levels of immunity.

However, presenting the moral case for vaccine passports isn’t as straightforward as might appear to the western world.

Passport to an unequally vaccinated world?

Positing the following data points:

1. While the US, the UK and several other developed nations are pretty far down the road of vaccinations, many other nations are not – fewer than 1 percent of people in low-income nations have received at least one dose.
2. A world vaccine tracker by the New York Times states that more than 3.35 billion vaccine doses have been administered worldwide, equal to 44 doses for every 100 people. However, 85 percent of the shots have been administered in high- and upper-middle-income countries. Only 0.3 percent of doses have been administered in low-income countries.
3. Less than 25 percent of the global population has received at least one dose, while only 11.9 percent are fully vaccinated, thereby even being eligible for these so-called free pass to travel the world.

The issue is further complicated with the presence of more than 200 vaccine candidates, and over two dozen shots having been authorised around the globe. But not all countries recognise every vaccine candidate currently in use.

For example, Covishield – widely used in poorer countries via World Health Organisation’s Covax vaccine programme – is the made-in-India version of the Oxford-AstraZeneca vaccine. But the European Union’s drug regulator does not recognise Covishield.

The larger inequality due to these facts poses real ethical concerns when it comes to the concept of vaccine passports.

As Yara Asi at the University of Central Florida explains , the premise is simple: Proof of being immunized against COVID-19 could be a prerequisite for engaging in leisure activities and travel. “Given the global imbalance of vaccine availability, it is not difficult to imagine a situation where the citizens of rich countries may regain their rights to travel to environments where local populations are still in some form of lockdown.”

Concerns raised

Mobility is an important aspect of the economic construct in the new world order, and as such, leisure tourism only makes up a fraction of the reasons for which people undertake inter-country travel.

According to an article in The Conversation on March 13, rich countries have ordered almost all of the currently available vaccines, meaning that the average citizen in a high-income country is much more likely to receive a vaccine than a health care worker or high-risk citizen in lower-income countries.

This means that those who are vaccinated can enjoy the freedom to move about their community, and thereby can have access to larger opportunities, while others remain in lockdown.

It is also likely that demographic groups with higher levels of trust in authorities and medical institutions are the most willing to be vaccinated, and this may adversely affect marginalized communities. A recent study found that Black Americans – who have legitimate reasons to distrust the medical establishment – were the least likely of any racial group in the U.S. to say they’d get vaccinated against the coronavirus.

Although a comparable study that maps vaccine access for minorities and underprivileged groups in Indian context is missing, the government data did reveal that more men got vaccinated than women.

This potential to further divide the global rich from the global poor is a significant concern. Once economies start to “open” and those with vaccine passports are able to go about their business, as usual, the underprivileged may get left behind. They may find it increasingly difficult to reach pre-pandemic income levels and the urgency to deal with COVID-19 in marginalised communities may also dissipate.

Why India opposes vaccine-based travel lists?

Dr Harsh Vardhan, the former Union health minister, told a G7 health ministers’ conference last month that vaccine passports would be discriminatory to people in the developing world since such countries have so far been able to vaccinate a far smaller share of its population than the wealthier countries.

“At this stage of the pandemic, it is pertinent to also discuss India’s concern over the idea of a vaccine passport. Considering the fact of the lower levels of vaccination of the population in developing countries in contrast to the developed countries and given the still-unaddressed issues related to equitable and affordable access, supply and distribution of safe and effective vaccines, India would propose that the implementation of a vaccine passport will be hugely discriminatory and disadvantageous to the developing countries. India would suggest that the same should be implemented duly taking into consideration emerging evidence of the efficacy of vaccines and under the over-arching coordination by WHO duly attending to the anomaly of access and affordability as it exists today,” Vardhan had said.​