With the commencement of COVID-19 vaccinations around the world, including in Malaysia, the discussion on vaccine passports is beginning to gain traction. A vaccine passport is essentially a documentary proof or certificate that the holder has been inoculated against certain infectious diseases. The concept of vaccine passports is actually not new – proof of vaccination against yellow fever and cholera in the form of a “Yellow Card” issued by the World Health Organization (“WHO”) has been required by some countries before visitors are allowed in. As the global vaccine rollout continues to pick up momentum, many are hopeful of returning to the “old” normal whilst anticipating the resumption of international travel.

“Digital Green Certificate” – Pass or No Pass?

It is interesting to see that several countries have hopped on, or are contemplating on hopping on, the vaccine passport bandwagon. Iceland has in fact been quick to issue digital vaccine certificates to its citizens who have been fully vaccinated against COVID-19. 1

On 17 March 2021, the European Commission (“the Commission”) published a legislative proposal to create a “Digital Green Certificate” (“the DG Certificate”), with the key aim of facilitating free movement within the European Union (“EU”) during the COVID-19 pandemic. The proposed regulation by the Commission seeks to introduce a framework for the issuance, verification and acceptance of interoperable certificates on vaccination, testing and recovery in respect of COVID-19.

Key features of the DG Certificate are as follows:

  1. The DG Certificate will cover three types of certificates, namely (a) the vaccination certificate; (b) the test certificate (NAAT/RT-PCR test or a rapid antigen test); and (c) certificates for persons who have recovered from COVID-19. In other words, it will be used as a digital proof that a person has been vaccinated against COVID-19, received a negative test result or recovered from COVID-19;
  2. In order to facilitate free movement as intended, the DG Certificate will be valid in all EU Member States. As such, the individual States are expected to consider a person’s COVID-19 status and accordingly adjust its existing movement restrictions such as requirements to undergo quarantine/self-isolation or be tested for COVID-19 infection;
  3. Crucially, the DG Certificate will not be a pre-condition to free movement, which is recognised as a fundamental right in the EU. This means that a person who has not been vaccinated is nevertheless able to travel to another country within the EU;
  4. The DG Certificate will be issued, free of charge, in digital and/or paper version, with an accompanying QR code that contains necessary key information and a digital seal to ensure authenticity of the DG Certificate;
  5. Where EU Member States accept proof of vaccination in order to waive restrictions such as quarantine or testing, they should accept, under the same conditions, valid vaccination certificates issued by other EU Member States. However, this obligation is limited to vaccines which have received EU-wide marketing authorisation. At present, the Commission has given conditional marketing authorisation in respect of four vaccines developed by Pfizer-BioNTech, Moderna, Oxford-AstraZeneca, and Janssen Pharmaceutica NV.2 Member States may however extend this waiver to EU travellers who have received other types of vaccines; and
  6. The DG Certificate will only include a limited set of essential information: name, date of birth, date of issuance, relevant information about the vaccine/test/recovery (as applicable) and a unique certificate identifier.

The attractiveness of a vaccine passport to eager globetrotters does not, however, come without its controversies and concerns. First, a certificate system is likely to further discriminate against low-income nations that have disproportionately low access to vaccines and are therefore unable to immunise a significant proportion of their populations. Second, privileging the vaccinated risks marginalising those who resist vaccination for religious, philosophical or even personal reasons. Third, making vaccine passports a pre-condition to international travel will prejudice those who are unable to be vaccinated on medical grounds, although this can be mitigated to an extent by imposing quarantine requirements instead.

Although the EU is pushing for the DG Certificate to be travel-ready by summer 2021, it is interesting to note that the WHO had expressed its reservations on the concept of vaccine passports earlier this year, in advising that “[a]t the present time, do not introduce requirements of proof of vaccination or immunity for international travel as a condition of entry as there are still critical unknowns regarding the efficacy of vaccination in reducing transmission and limited availability of vaccines.” 3 Despite acknowledging the growing evidence on the efficacy of vaccines in reducing the transmission of COVID-19, the WHO reiterated its position in its statement on 19 April 2021 that proof of vaccination as a condition of entry could deepen inequities and promote differential freedom of movement.4

Two-Way or Nay

Despite the seemingly necessary nature of vaccine passports as an effort to revive the battered travel industry worldwide, the practical implementation of this “travel pass” is fraught with challenges. To start with, countries are likely to have differing visions and protocols when creating their own vaccine passports.

Further, the type of COVID-19 vaccine administered to a population differs from country-to-country. Some countries may recognise a COVID-19 vaccine produced by a particular manufacturer, which may not be recognised in another country. For example, China currently only approves its own Chinese-produced vaccines, namely Sinovac and Sinopharm5 whilst Saudi Arabia approves only the Pfizer-BioNTech and Oxford-AstraZeneca vaccines so far.6 Reconciling the differences in the preferred vaccine(s) chosen among countries to pave the way for vaccine passports may prove to be arduous, especially if a person has already been inoculated with a vaccine that is not recognised by the country he / she intends to visit.

To prevent the issues raised in the preceding two paragraphs from becoming intractable problems, broader discussions between authorities across the globe need to take place so that a uniform set of technical and pharmacological guidelines and protocols can be agreed upon universally as the basis for the issuance of vaccine passports.

Notwithstanding the foregoing, it is clearly a Herculean task to strike a balance between combatting the coronavirus and pre-empting another period of economic strain due to the closure of international borders. Country leaders should instead consider the mutual recognition of COVID-19 vaccination certificates between countries with low infection rates in a bid to resume trade and facilitate cross-border travel. Close to home, Malaysia has been putting in efforts to work together with Singapore7 and Australia8 on such mutual recognition. However, plans may now be delayed due to the recent surge in COVID-19 cases in Malaysia.

As COVID-19 variants continue to emerge rapidly and spread across the globe, the road to developing the equivalent version of a “Yellow Card” is unfortunately neither clear nor simple. To exacerbate this issue further, it is not conclusive yet whether the existing vaccines are effective against the new coronavirus mutations. Although many countries have procured a mixture of vaccines for their respective population, it remains to be seen whether a single and standardised vaccine passport that is recognised and valid globally will be devised in the near future.

The battle is far from over – only time will tell whether the concept of a vaccine passport will be the ultimate golden ticket for travellers until the WHO declares the end of the COVID-19 pandemic.

Postscript

It has been reported earlier today that the European Parliament had on 20 May 2021 agreed with all 27 EU Member States on the vaccine passport proposals and that the proposed regulations will be presented for adoption by the European Parliament at its next plenary session scheduled for 9 June 2021 and thereafter to the Council of the EU. Details of the extent to which the Commission’s legislative proposals of 17 March 2021 have been modified are unavailable at the time of writing but the following have emerged from a media report.

First, that the travel pass will be known as the “EU Digital COVID certificate”, and not the DG Certificate, as originally proposed. Second, it now appears that only vaccines approved by the European Medicines Agency will be accepted. Third, that those with one vaccine dose will be able to apply for the certificate.

Last, but by no means the least, any EU Member State government may impose extraordinary restrictions on certificate holders by giving 48-hours’ notice to the Commission and other EU Member States if the health situation within that EU Member State deteriorates, based on the data of the European Centre for Disease Prevention and Control.9