WHO Special Envoy Expects Some Form Of A ‘Vaccine Passport’ In The Future – But Vaccine Shortages Are An Immediate Hurdle International Health Regulations 16/02/2021 • Madeleine Hoecklin Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Countries and health authorities debate the implementation of vaccine passport programs domestically and internationally to boost economy and prevent further spread of virus variants. A World Health Organization (WHO) Special Envoy for COVID-19 has suggested that ‘vaccine passports’ could prove to be an important part of future international travel regulations to stop the spread of COVID-19 and its variants. A growing number of countries around the world are in fact already racing ahead to create vaccine passport systems – accompanied by some bilateral travel deals. Officially, however, WHO has been reluctant to move quickly on the issue – until it becomes clear that vaccination really inhibits COVID transmission and vaccines become more available to the billions of people around the world who can’t access them at all right now. “I am absolutely certain in the next few months we will get a lot of movement and what are the conditions around which people are easily able to move from place to place, so some sort of vaccine certificate no doubt will be important,” said David Nabarro, who is a WHO Special Envoy for COVID-19, in an interview with Sky News on Monday. Such passport programmes would create a “bubble” to help restart international travel, Nabarro said – particularly in light of the new risks posed by evolving SARS-CoV2 variants and the fact that the virus is “going to be with us” for the foreseeable future. “We’ve got to be quite vigilant from now looking forward, both inside our countries, because variants can appear inside our own borders, but also [outside] because sometimes variants can be brought by people from other places,” said Nabarro. Speaking Tuesday with ITV’s Good Morning Britain, Nabarro added that “I shan’t be surprised if some system for COVID will emerge – but it will require a lot of hard work. First of all, governments have to agree on what they are going to do, and we also have to bear in mind that similar certification should be there for people who have had the disease and can show that they have antibodies against the virus.” While the extreme shortage of vaccines remains a challenge to the immediate implementation of an international vaccine passport system, Nabarro said he expects the global vaccine supply to expand dramatically over the coming year: “Yes, I think that is a reality, those of us who have not yet been in the position to be vaccinated will perhaps not be able to travel as widely as those who have, for a bit. But I want to stress that the current situation of extreme shortages of vaccines, will, I believe remedy itself in the coming months, as more vaccines come on stream and as more manufacturing sites are opened up to make vaccines.” How could vaccine passports work? The @WHO’s @davidnabarro says he wouldn’t be surprised if an international system for Covid vaccines came into place. He says there should also be an ‘immunity passport’ for those who have had the disease and can show immunity. pic.twitter.com/c6G3FZajVu — Good Morning Britain (@GMB) February 16, 2021 COVID Vaccine Passports Already Happening – Iceland Was the First An expanding array of countries across Europe, as well as a few nations in Asia, Africa and the Middle East – are already racing ahead with plans for digital vaccine passports, and mandatory vaccines for entering travelers. Leaders include Iceland, Poland, Sweden, Denmark, and Israel – while the United Kingdom and the United States are also considering systems. In late January, Iceland became the first European country to provide citizens with vaccination certificates and to update its guidance on entry restrictions accordingly. People with a certificate of vaccination against COVID-19 with a vaccine authorized by the European Medicines Agency (EMA) or WHO are exempt from the testing and quarantine requirements upon arrival. Poland launched a digital vaccine passport last month, which “will confirm that the person has been vaccinated and can use the rights to which vaccinated people are entitled,” said Anna Golawska, Poland’s Deputy Minister of Health, to reporters. And Israel is about to initiate a vaccine passport system next week exempting vaccinated arrivals from mandatory quarantine. In an effort to restart mass events and incentivize more people to get the jabs, the Israeli system will admit people only who can show proof of vaccination or COVID-recovery to local cultural and sports events, and even restaurants and gyms. Denmark and Sweden have also announced that they have digital passport systems in the works, which will be used not only for traveling, but also for large in-person events and dining out. Sweden plans to establish the program by June, while Denmark set an ambitious goal to rollout the project by the end of February. “This is fundamental because if we want to start to export again and trading again, see business people meet again, things like the corona passport are fundamental to making that happen,” Jeppe Kofod, the Danish Foreign Minister, told CNN. “If you start when COVID-19 has left society, it will be too late. With this project we’re very positive we will have a summer of joy, football, of music. So better to get started sooner, now, to plan,” said Lars Ramme Nielsen, Head of Tourism in Denmark’s Chamber of Commerce, in an interview with CNN. In The Philippines, a bill creating a vaccine passport system is before the Senate. And in Africa, Mauritius may become the first country to require proof of COVID vaccination for tourists to enter. EU Countries Call for International Agreement – Based on Yellow Fever Vaccination Requirements in WHO International Health Rules The WHO’s International Health Regulations have a precedent for COVID-vaccine passports. Existing IHR requirements allow countries where yellow fever is endemic to require proof of yellow fever vaccination by entering travelers – and almost all countries strictly adhere to that principle. According to the national pandemic strategy plan released by President Biden on his first day in office, the United States is investigating the feasibility of including COVID-19 vaccination into the International Certificates of Vaccination or Prophylaxis (ICVP) documentation, the IHR system set up to document yellow fever vaccination status. Spain, Greece, and Cyprus have also recently expressed support for an internationally recognized immunity passport, particularly to ensure EU member states have a unified approach and a common understanding of vaccination certificates. “Spain will support any tool that facilitates the recovery of safe travel and mobility,” Reyes Maroto, Spain’s Industry, Commerce and Tourism Minister, told journalists on Thursday. In a letter to Ursula von der Leyen, President of the European Commission, Greece’s Prime Minister, Kyriakos Mitsotakis, proposed a coordinated system and a common European certificate to “facilitate transport and therefore a gradual return to normality.” Von der Leyen seems to have welcomed the concept of a mutually recognized EU certificate for those who have received the full vaccine course, calling it a “medical requirement” to have a certificate. Ursula von der Leyen, President of the European Commission, at a visit to Portugal in January. “Whatever is decided – whether it gives priority or access to certain goods – is a political and legal decision that should be discussed at a European level,” she said to the press during a European Commission visit to Portugal in January. While Awaiting International Agreement – Some Countries Make Bilateral Travel Deals Meanwhile, some countries are not waiting for international action; a travel agreement between Cyprus and Israel was signed on Sunday, allowing vaccinated citizens to travel freely between the two countries. It was considered a “huge achievement” by Savvas Perdios, Cyprus’ Deputy Tourism Minister. “Israel is effectively one of the most important markets for us in terms of tourism and this agreement will certainly boost our economy,” Perdios told a state radio agency on Monday. The implementation of a vaccine passport scheme is currently under consideration in the UK, however, various officials have given differing accounts of the potential scope and details of the programme. “Inevitably there will be great interest in ideas like, can you show you’ve had a vaccination against COVID – just like you have to show you’ve had a vaccination against yellow fever or other diseases – in order to travel somewhere,” said Boris Johnson, Britain’s Prime Minister, at a press conference in South London on Monday. “I think that is going to be very much in the mix down the road.” Boris Johnson, Britain’s Prime Minister, at a press conference on Monday. While Johnson ruled out using vaccine passports domestically, Dominic Raab, Britain’s Foreign Secretary suggested that using the passports locally could also be considered as part of discussions about the mechanisms for reopening the country. “Whether it’s at an international, domestic or local level, you’ve got to know that the document being presented is something that you can rely on and that it’s an accurate reflection of the status of the individual,” said Raab in an interview with LBC. “I’m not sure there’s a foolproof answer in the way that it’s sometimes presented, but of course we’ll look at all the options,” he added. By contrast, last week, Nadhim Zahawi, Britain’s Minister for COVID Vaccine Deployment, insisted that there was no plan to introduce a vaccine passport. “Vaccines are not mandated in this country…that’s not how we do things in the UK,” said Zahawi in an interview with the BBC. “We yet don’t know what the impact of vaccines on transmission is and it would be discriminatory.” Concerns About Discrimination and Lack of Evidence on Transmission Leading voices in France and Germany, however, have voiced concerns about vaccine passport systems. They point to the fact that there is still insufficient evidence that vaccines hinder disease transmission. It may also be too soon, in light of the likelihood that new vaccines may have to be developed, or existing ones updated to address the SARS-CoV2 variants – which are highly transmissible and potentially linked to higher hospitalizations and deaths. But more fundamentally, the issue pits values of individual freedom – against values that stress the importance of vaccination in normalizing travel and economies as part of a braoder whole-of-society approach. Germany’s Ethics Council advised against giving vaccinated individuals special freedoms as it would be “unacceptable” to lift restrictions on an individual basis and it may encourage others to not comply with public health measures. “Lifting civil liberty restrictions prior to [the reduction in case numbers] exclusively for vaccinated people, could at most be justified if it were sufficiently certain that they could no longer spread the virus,” the council said, however that evidence does not yet exist. In addition, in France, which has fairly high rates of vaccine hesitancy, the population may perceive a vaccine passport program as an effort to make vaccination mandatory. Officials have also noted that so far only a limited portion of the population have had access to a vaccine. “We are very reluctant,” said Clément Beaune, France’s European Affairs Minister. “It would be shocking, while the campaign is still just starting across Europe, for there to be more important rights for some than for others.” “Until we have entered a phase of vaccination for the general public, telling people their activity is limited while access to vaccines is not generalised doesn’t work,” Beaune told Franceinfo in January. WHO Hesitant About Pushing Ahead Rapidly On Vaccine Passports – But Leaves Door Open For Future As of mid-January, WHO’s International Health Regulations Emergency Committee also was advising countries against introducing requirements of proof of vaccination as a condition for international travel and entry into countries. “At the moment, we are lacking critical evidence regarding whether or not persons who are vaccinated could continue to be infected, or continue to transmit disease, and…nobody in the world beyond health workers and very vulnerable people have access to the vaccine,” said Mike Ryan, Executive Director of WHO’s Health Emergencies Programme. “The scientific evidence is not complete and there aren’t enough vaccines and therefore, we shouldn’t create an unnecessary restriction to travel until such time as we have the evidence and the vaccine is available,” Ryan added. Speaking at a press briefing on Monday, Ryan re-iterated that WHO official stance, saying, “the vaccine is not widely available would actually tend to restrict travel more than permit travel” and there is still not enough data to understand “to what extent vaccination will interrupt transmission”. However, Ryan left the door open for the future saying that once COVID-19 vaccinations are widely available, and there is clarity about transmission dynamics, “disease vaccination passports can form part of a long term strategy for disease control and for the prevention of the disease potentially moving from one place to another, as we’ve seen with yellow fever vaccination requirements, which have been in place for a large number of decades now.” Image Credits: Flickr – Marco Verch, European Commission, ITV News. 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