Vaccine Passports and Discriminatory Concerns

Following the characterization of voter ID laws as discriminatory towards those lacking sufficient time, wealth, or access to transportation; criticisms have been leveled against vaccine passports for similar reasons. The implementation of a vaccine passport – “proof that a person has been immunized against COVID-19” – offers more questions than answers. Will they be implemented domestically? Internationally? By private businesses or the government? Will these vaccine passports discriminate against BIPOC, low-income individuals, or people with disabilities? With so many questions arising from the idea of vaccine passports, it is worth analyzing how they may be implemented and the various consequences of their implementation. 

Unlike purchasing an ID, the United States government has mandated that all COVID-19 vaccines are free. Importantly, pharmacies and other vaccination centers may not inquire into one’s immigration and health insurance status. While this is no doubt an incredible step to permit equitable distribution to low-income individuals, wealthy individuals have been vaccinated at much higher rates than their low-income counterparts. Unsurprisingly, the distribution of the vaccine has disproportionately affected black and Hispanic Americans, as they are being vaccinated at much lower rates. To be vaccinated still requires transportation to a medical location – a luxury many Americans cannot afford. However, various private businesses such as Uber and Lyft have announced partnerships with pharmacies like Walgreens to provide free transportation to and from vaccination sites. Additionally, President Biden has now mandated that vaccination will be classified as paid time-off, allowing low-income individuals to now be vaccinated during work hours.

But the United States is now in a different stage of the vaccination process. While booking an appointment months ago would require access to high-speed internet, it is now much easier to secure vaccination appointments online; furthermore, many clinics now offer walk-in appointments. So, while vaccine passports – if implemented – will still discriminate against lower-income individuals lacking transportation to medical facilities or Internet access, the increased speed of vaccine rollout and attempts at equitable distribution have lessened the discriminatory worries against less wealthy individuals. 

In addition, the various racial disparities at the onset of vaccination availability have begun to narrow. However, that is not to say that the disparities are now nonexistent. According to the Bloomberg US Vaccination Demographics, not a single state has a greater percentage of black residents vaccinated than white residents. Yet, since February, only two states – Rhode Island and Illinois – have had increasingly unequal distribution of vaccines to black Americans. The entirety of the public health field has long discriminated against people of color within the United States. This trend of increasingly equitable distribution represents a shift in the right direction towards health equity and lessens the discriminatory concerns of a vaccine passport against BIPOC.

Oddly enough, it may be such that as more data becomes available, vaccine passports will not meaningfully discriminate across any such races or classes, but solely those who are anti-vax. While data as of now demonstrates that black and brown Americans are being vaccinated at lower rates than their white counterparts, as vaccination access becomes more readily available, a different trend may occur. Various polling data shows that 41% of Republicans will not get a COVID-19 vaccine; 47% of Trump supporters say they will not. In Texas, it is the white male Republicans who are refusing at the highest rates to be vaccinated. Surely, there is the possibility that more of these individuals are convinced to take the vaccine, or that different demographics will refuse the vaccine at higher rates. But, all of these demographics have widely available vaccine access. If it is only those who refuse to get a vaccine – which has been proven safe and effective at combating COVID-19 in numerous trials – who will be affected by vaccine passports, then there is little to worry about in terms of discrimination.

However, implementing a vaccine passport carries more concerns than solely economic and racial discrimination. Many have argued that since COVID-19 vaccines distributed in the United States are only FDA approved for emergency use, it would be unfair to require a vaccine passport. Certain individuals are unable to be vaccinated due to health conditions. Per usual, many have religious or philosophical objections to vaccination. The idea of a vaccine passport is far from perfect and there are legitimate concerns: possibly most pressing are the implications of requiring vaccine passports to travel to and from developing and low-income nations.      

It would be remiss to solely focus on the United States when discussing the idea of a vaccine passport. The Global North has hoarded COVID-19 vaccines with nations such as the United States, the United Kingdom, the European Union, and China having amassed and distributed the most. According to the WHO, 87% of vaccines have gone to higher-income nations. While economically and racially discriminatory concerns may be mitigated domestically, it is lower-income, typically black and brown nations that have received the fewest COVID-19 vaccines – in addition to being at deadlier stages in the pandemic. If vaccine passports will be mandatory to travel into the United States, very few individuals from developing countries will be allowed in.

Allowing the free movement of people across the United States, European nations, and other vaccine-hoarding states will only cause more international economic inequality. If only Western nations may benefit from tourism, increased trade and consumption, and the complete re-opening of economies, developing nations will continue to suffer from Western Exceptionalism – this time in the stockpiling of vaccines. While concerns may justly be raised over the ‘white savior’ nation of the United States graciously giving vaccines to developing nations, there are few other alternatives. Private corporations and developers will sell to the highest bidder, and the Global South simply lacks the monetary resources to pay. Reduced access to vaccinations prevents a return to in-person education in developing nations where this may be crucial to future economic development.

The international implications of a vaccine passport will, at the current moment, serve to harm sustainable development and the economic well-being of developing nations. However, domestic vaccine passports may have some benefits. Showing proof of vaccination to attend large-scale, mass-gathering events offers a great degree of safety for the general public. Federally, the Biden administration said it has no plans to move forward with a vaccine passport: this idea will likely be included within the private sector. So, as the conversation around vaccine passports has generally been based on terms of international travel, the idea of a domestic vaccine passport may present itself as a more realistic outcome in the short term.

So, what is the verdict? Well, the entire concept of ‘vaccine passports’ must be broken down into smaller categories. Requiring these immunization passports for international travel will continue to negatively affect the economies and populations of developing nations losing out on the various economic benefits. Yet, domestic vaccine passports for private industries appear to have some benefits. While the federal government has taken excellent steps at providing equitable distribution, transportation costs must be eliminated to provide for truly fair dissemination to low-income individuals. Internationally, Western nations that have amassed COVID-19 vaccines must distribute them to lower-income nations more in need of vaccinations. When various inequities of distribution in income and by race – both domestically and internationally – have been extensively mitigated or eliminated, vaccine passports could represent a useful method of ensuring safety during this public health crisis.