Show us your papers

Cruise ships won’t be floating in Miami’s harbors if Florida doesn’t make an exception for them in the state’s ban on vaccine passports. The CDC recommends that cruise lines vaccinate a significant portion of their crew and require most of their guests to be vaccinated as well. If the industry pulls up its anchor and leaves Florida, the state stands to lose billions in tourist revenue.

The vaccine spat in Florida is part of an ongoing debate over whether vaccine passports pose more problems than solutions, or even if they’re needed at all. The Biden administration says it won’t support legislation for a national vaccine passport, and several states (such as Alabama, Indiana, Florida, and Texas) cited government overreach in banning them. But some, such as New York, are considering such passports as a viable option for reopening more parts of their economies.

The Supreme Court ruled in 1904 in Jacobson v. Massachusetts that the government can mandate vaccines to protect public health after a man refused to be vaccinated against smallpox. But it must do so in ways that impose the least burden on citizens. (Private organizations can require a vaccination with reasonable accommodations for those with disabilities and strongly held religious beliefs.)

Proponents of vaccine passport argue that they are less restrictive than more blanket lockdowns. Others say more such measures are no longer necessary as the number of COVID-19 cases falls. Vaccine passports are “a solution chasing a rapidly vanishing problem,” said Ed Haislmaier, an expert on healthcare policy with the Heritage Foundation.

But vaccine passports also create practical problems, Haislmaier said. Creating secure documents is one issue. Companies accessing private medical documents would be subject to medical privacy laws that complicate app development and implementation.

New York City is testing Excelsior, a vaccine passport app backed by IBM. Japan Airlines and Qantas airways are testing another app, CommonPass. Both offer digital proof of vaccination to show at gatherings and airports, but neither is on the market yet. The PathCheck Foundation at MIT partnered with the design consultancy Ideo to create a paper card, said the MIT Technology Review. All are still in the testing or development phase.

Overseas, Israel has already begun using vaccine passports. The country introduced the “Green Pass” on Feb. 21, allowing vaccinated people to access their vaccination record to go to restaurants, concerts, and other public gatherings. Citizens can also print a vaccination certificate from the Health Ministry website or via the Ramzor app. But the website crashes daily, and the app is posing privacy issues because help inquiries go to a private Gmail address.

Implementing a system like the Green Pass in the United States would be difficult without a universal identity record or a cohesive medical system, said the MIT Technology Review.

Japan may require a COVID-19 vaccine for entry because of the upcoming Summer Olympics, Haislmaier said. Their healthcare system is currently overrun, so an influx of cases would add to the burden.

Currently, the WHO requires vaccination against yellow fever before entry into some African countries, so there is a precedent for vaccine passports in international travel. “If you want to travel to a country, they control their borders,” Haislmaier said. The main difficulty is trying to find a system that is both secure and that multiple countries can implement.