Vaccine passports explained

Editors note: This Q&A on vaccine passports is adapted from a CBC interview with Dr. Seema Marwaha broadcast on multiple CBC radio stations.

What exactly is a vaccine passport?

What is meant by “vaccine passport” isn’t always clear. Essentially, it is official proof of immunization you might be asked to show when taking part in higher-risk activities like attending a large group event or traveling internationally. In some places, it is a physical card you carry (like a passport or Nexus). In some places, it is a digital QR code. Sometimes it’s both.

It is meant to be a consistent, reliable and secure way to provide proof of immunization if asked. Regardless of the form, if implemented, having this official proof of vaccine would afford you some benefits – like skipping quarantine requirements when traveling, for example.

What’s the status of vaccine passports in Canada and the U.S. right now? 

Manitoba has both a physical and digital version of an immunization card. It can be used as proof of immunization for non-medical services like travel, sports/entertainment and restaurants/bars. Its website indicates that in the future, people may be denied access to certain activities without presenting this card. 

Quebec is open to implementing a similar system but wants to wait until all residents have had the opportunity to receive both vaccines. Its health minister has indicated it will be used to limit access to high- and moderate-risk leisure activities – like bars, gyms and contact sports – but only if there are outbreaks or high case rates to control. 

So far, Ontario, Saskatchewan and Alberta have indicated they will not implement any passport system at this time. 

The federal government is working on some type of vaccine passport for international travel but how this would work is not yet certain. 

New York State’s Excelsior Pass allows participating businesses to scan an individual’s digital pass as proof of vaccination. However, numerous U.S. states have actively banned requiring proof of vaccination to access specific services and events. So it’s clear this practice is not without controversy.

What additional activities can fully vaccinated Canadians do now that partially and unvaccinated Canadians can’t?

Right now, the benefit is clearly seen in international travel.

Returning travelers can skip their quarantine, hotel stopover and the day-8 testing requirement if they show proof of having received two doses of one of the vaccines approved in Canada, with the second dose having been administered at least 14 days before they arrived. 

Returning travelers must upload proof of vaccination to the ArriveCAN app at least 72 hours before they travel and show the receipt to Canada border services upon arrival. They are still required to take a COVID-19 test within 72 hours of arriving at the border and have proof of a negative result. They also must have a quarantine plan in case they do not receive an exemption. 

The European Union has introduced a version of a vaccine passport that seeks to ease movement between countries, exempting those who hold one from quarantine or testing requirements when crossing a border into a participating country.

One issue internationally is that because countries have approved different vaccines, some fully vaccinated individuals may have their travel complicated because they are not considered fully vaccinated depending on the vaccine they received.

From an ethical standpoint, what are some of the concerns around vaccine passports?

Vaccine passports have long been a contentious topic. From a public health standpoint, it makes sense to only allow those who have been fully vaccinated to attend high-risk gatherings like sporting events or travel. It could also be an incentive for people to get their vaccines if they are on the fence.

But the concept of vaccine passports brings a whole host of privacy concerns regarding personal health information as well as questions around the ethics of requiring vaccine confirmation for certain privileges.

There are a lot of calls for COVID vaccines to be mandatory in health-care workers specifically. The case over how far health-care institutions can go to protect patients and others against the coronavirus has been closely watched. More than 150 employees at a Houston hospital system who refused to get a COVID-19 vaccine have been fired or resigned after a judge dismissed an employee lawsuit over the vaccine requirement. Whether a similar instance can happen in Canada is open to debate, according to some employment lawyers. Both the Ontario Medical Association and the Ontario Nurses Association are calling for mandatory COVID vaccines for health care workers. 

I think if we do see multiple waves here in Canada as is happening in other parts of the world, AND we want to continue to remain open, some form of vaccine passport may be an inevitability. While not getting vaccinated is a choice, choices might have consequences.

In your view …. will implementing vaccine passports encourage more people to get their shot? Or would it alienate Canadians who don’t have access?

This approach is likely to affect people differently depending on their vaccine-related views. There are people on the fence or who have no urgency to get the shot but no strong feelings against it. Passports and restrictions might motivate them to get the shot. But for people who are more libertarian or mistrustful of vaccines, this approach might cause them to dig in their heels even more because it is more heavy-handed.

If I have family members or friends who are unvaccinated, how do I convince them to get it?

This is such a tough question. The last 20 per cent will be difficult to reach and the last 5-10 per cent even more difficult.

Not all people who are unvaccinated at this point are “anti-vax” – some still lack access to the vaccine because of language, precarious employment, no health insurance or physical disability just to name a few. We need to put in immense effort to meet them where they are to get them vaccinated.

Some people are hesitant because of their own health or concerns that the surveillance for side effects is ongoing.  Regardless of their reasoning, it’s important to meet them with empathy and listen to their concerns. Debunk any false myths if possible. They may need individual, one-on-one conversations to address their specific concerns. But shaming them or trying to force them to go often amplifies their resistance to getting the jab.