Vaccine passports are on the rise. What are they? How will they affect our “return to normal” and a future that includes unvaccinated populations?

Both controversy and confusion are growing around the use of vaccine passports. The term “passport” conjures concerns about privacy and government mandates to get vaccinated. What is the deal with vaccine passports? I’ve been speaking with experts, including some at Change Healthcare at a CNBC Events talk, digging into the angles and sharing my learnings in TV reports. What I learned was that the vaccine passport debate is not new, going back to the 19th century, according to NPR, but its proposed application is novel and sometimes controversial.

What is a vaccine passport?

A vaccine passport is digital proof showing that you have had the Covid-19 vaccination. While you can also show the white slip of paper you receive after getting inoculated, those can be easily forged and lost. It is also not convenient for an outside party to quickly validate large quantities of these documents. Think about how long it could take to get into a basketball game if we each brought a slip of paper to be examined. That’s where the digital passport comes in.

“The digital health pass is an electronic version of the index card that you get when you get your full immunization,”

 Tim Paydos, a vice president of government industry solutions at IBM in an interview with NPR

The vaccine passport relies upon a QR code with your stored basic information that a business, airline or healthcare provider can scan to quickly check your vaccination status. It is the same technology that is used when downloading movie tickets or airline boarding passes to your phone.

Full medical histories are not accessible, just basic vaccine details. Simply, the code can provides the basics: your name, date of vaccination, type of vaccine and location. This technology can also show details of a Covid-19 test result for those who are unvaccinated. If you were to need a booster or get vaccinated in a new location, the passport can share details with your provider.

For those without access to a cellphone, it is recommended that you take a digital photo of your vaccination record and laminate your physical copy. You can always get additional copies by going back to the site of vaccination.

While proof of vaccination is not new, requiring it for daily activities is

In the U.S., proof of vaccination for entry into schools and colleges has been routine for decades, though states differs in documentation requirements and policies. Entry into the military requires an updated vaccine history, as well. Travel to certain countries that require immunization against diseases like yellow fever have also been routine. Interestingly, NPR traces the vaccine passport debate back to 1897 plague vaccine.

What makes the Covid-19 vaccine passport different – and troubling for some- is its widespread requirement in order to participate in common daily activities that could include going to a restaurant, a concert or on a cruise. Experts speaking to the New York Times call the requirement “likely legal” and the equivalent of “no shoes, no shirt, no service,” meaning you have a choice in whether to follow requirements because of a perceived larger public benefit the policy serves.

The Biden Administration has said that it will not create national vaccine mandate nor will it develop a vaccine passport, leaving it to states to decide. Texas, Florida and Utah, are a handful of them banning passports entirely. Others, like New York, are developing their own apps using the QR code technology.

Many solutions, many potential problems

With at least 17 different companies creating a digital passport solution, many consumers are confused by the options. In fact, you don’t have a choice about which vaccine passport you use, if you choose to do so. The healthcare provider, pharmacy or vaccine location often drives the choice for consumers.

However, in order those apps to be useful, those 17+ companies need to use the same underlying technology. They should also work internationally. This will ensure that whether you visit a restaurant around the corner or one in Paris, your one vaccine passport will work. This is why a Vaccine Credential Initiative (VCI) has been created, linking health companies like Mayo Clinic, with Microsoft, Salesforce and other top names in tech to ensure your passport is safe, encrypted and works anywhere you want to use it, much like your credit card does.

According to CNBC, “The VCI said it wants to develop technology that enables individuals to obtain an encrypted digital copy of their immunization credentials that can be stored in a digital wallet of their choice, such as the Apple Wallet or Google Pay. It suggested that anyone without a smartphone could receive paper printed with QR codes containing verifiable credentials.”

What if I won’t get vaccinated or can’t?

If you can’t or won’t get vaccinated, in a growing number of venues, a negative Covid-19 test will suffice in gaining you entry. For example, at the San Francisco Giants’ Oracle Park, in order to gain admission for entry, you must: “show proof of a negative Covid-19 test…. Test results need to be received within 3 days of the first game you attend in a homestand.”

At Oracle Park, negative test results can be presented either through the CLEAR Health Pass, a digital app, or an electronic, photo or paper copy of your negative Covid-19 test result to the ballpark. To sit in the vaccinated section, you can bring a copy of the CDC card issued or a record of vaccination directly from the healthcare provider who administered the vaccine with an appropriate ID matching the name on the proof of vaccination.

But some activities though, vaccination will be required. For example, many cruise lines have mandated full vaccination for both crews and guest in order to cruise again. A growing number of countries, like Iceland, are only accepting fully vaccinated travelers.

While it is clear the “return to a new normal” is desired for the entire nation, how we do so could evolve for years to come.