In the third and final part, we will look at the ethical risks and obstacles that need to be considered in the implementation of a vaccine passport. As will become apparent, these risks can also overlap with the economic, scientific and technological risks and obstacles discussed in part two. When exploring the ethical considerations it is easiest to divide them widely into two sections – ‘discrimination and inequality’ and ‘privacy’.
Discrimination and Inequality
One of the first ethical issues in the event of any mandatory vaccine passport, in particular if they are required to access public services, is that of vaccine prioritisation and supply. In the EU for example, as of 23rd February, only 3% of citizens have received a COVID-19 vaccination due to issues with supply.1 In the UK, those offered the vaccine are being called in groups based on perceived vulnerability, meaning that young people could be unfairly discriminated against if a vaccine passport were to be implemented before the vaccine had been offered to all.2 Expanding on this, a report by the Brookings Institution has suggested that the initial ‘medical and social’ approach to vaccinations should be amended to also include ‘economic and political interests’, giving the example of a situation in which someone urgently needing to travel would be offered a vaccine.3
For those who are unable to have the vaccine, there is also the risk that the implementation of a vaccine passport could increase marginalisation. This is a particular concern amongst those who have health conditions and also for communities with higher levels of state distrust and vaccine hesitancy, such as those seen in BAME communities.4 A vaccine passport too heavily dependent on the use of smartphones could also widen the digital divide, as well as threaten to further marginalise people by limiting access to daily life for those less likely to have a smartphone. Vaccine discrimination has already made the news during the lockdown, most notably with Pimlico Plumbers whose chairman, Charlie Mullins, announced plans to rewrite the contracts of his workers to include a requirement for them to be vaccinated against COVID-19.5 Whilst it should be noted that this plan has since been rolled back, it points to a more prejudiced way in which vaccine passports could be used.6 As a result of this, the campaign group Liberty have argued that the launching of a vaccine passport scheme, without first addressing these issues, could lead to the creation of a ‘two-tier society’, with the passport being used as an unintended platform of marginalisation.7
On an international level, the use of a vaccine passport has the scope to trigger far reaching effects, especially if it becomes mandatory for international travel. The use of a vaccine passport in this way could lead to increased levels of ‘vaccine nationalism’ as governments scramble to procure vaccine supplies. The knock-on effect to this could also see an increase in global inequality in which developing countries unable to secure the vaccine are denied immigration and travel rights to developed countries.8
Privacy
The second major ethical question mark over the use of a vaccine passport is that of privacy, and the potential for mission creep in what the Ada Lovelace Institute have termed as ‘normalising health status surveillance’ through the creation of ‘long-term infrastructure in response to a time-bounded crisis’.9 To prevent this, the creation of a vaccine passport must have strictly defined terms of use detailing how it will be used and who will use it. This is essential in order to prevent the tracking of the population and the use of personal data outside of a pandemic setting, for example by prospective employees or government departments.10 Any meaningful assurance that only pertinent personal data is collected, and subsequently securely held, would need to be made at the developmental level of any potential vaccine passport app by allowing individuals to obtain a vaccination certificate without needing to provide personally identifiable or personal health information.11 As mentioned by the Chief Executive of iProov, a company currently developing a vaccine passport app, a vaccine passport only needs to hold two pieces of information ‘one is, has this person been vaccinated? And the other is, what does this person look like?’.12
Conclusion
The ethical obstacles to the vaccine passport are numerous, and if not dealt with satisfactorily, could exacerbate the socio-economic divides that have been revealed during the pandemic, as well as potentially fostering greater distrust in the government. In order to stand any chance of success, proponents of the vaccine passport must first understand what they want the passport to achieve, and then create strict terms for its use. In the words of the Royal Society’s Professor Mills ‘is it a passport to allow international travel or could it be used domestically to allow holders greater freedoms?’, or maybe for something else entirely.13
