Published: 15 April 2021
As vaccination efforts accelerate, the hype and confusion surrounding the relative use cases and benefits of health passes and digital vaccine certificates is growing. Executive leaders need to understand the differences between, and the utility of, these solutions to inform reopening strategies.
The negative impact of the COVID-19 pandemic on global economies has been profound, and governments and enterprises are investigating various options to accelerate safe reopening. Verifying the current health status of a citizen, resident, employee or customer provides one avenue for supporting these efforts.Many enabling digital solutions are emerging in the market. The capabilities of these solutions vary widely and the lack of an industry standardized nomenclature is creating confusion. Terms such as health pass, health passports, vaccine passports and digital vaccine certificates are used interchangeably. This hampers the development of an information framework and the system and data requirements to compare solutions.
A digital vaccine certificate is a digital vaccinationrecord that supports access, control and sharing by the consumer of verifiable vaccination information. Digital vaccine certificates contain protected health information (PHI) and are a form of digital personal health record. Issuers of a vaccine certificate are most often entities authorized to administer vaccines or the public health authority where person-level immunization records reside — often in an immunization information system (IIS).
A health pass (also referred to as a health passport) provides a digital means to verify an individual’s health status against set criteria defined by the verifying enterprise. These solutions do not transfer PHI to the requesting entity. Rather they access trusted sources to verify credentials, the output from which is an indicator of adherence to the criteria (e.g., through a color-coding system, where green indicates fully meets criteria and red indicates does not meet the criteria). Capabilities vary between solutions and include verification of vaccination status, laboratory test results, temperature and self-reported health declarations (seeFigure 1). Health passes can be accessed digitally, through an app on a smartphone or as a paper-based solution; for example, through a printed bar code (typically a quick response [QR] code).
Neither of these solutions currently imply proof of immunity, therefore they do not provide complete assurance that an individual will not transmit or be vulnerable to contracting COVID-19. As such, they do not eliminate the risk of disease transmission — rather they serve to reduce risk.
Governments and enterprises began pilots in 2020 of digital vaccine certificates and health passes to support safe reopening of workplaces and schools, allow public gatherings and events, and return to travel:
At a citizen level, residents in Los Angeles County in the U.S. can upload a COVID-19 vaccination certificate in the Apple Wallet app and in Google Pay for Passes.
China began using health passes in February of 2020. Known as “Health Code,” these solutions are being used to support reopening and domestic travel.
Israel’s “green pass” solution, issued to citizens who have received a COVID-19 vaccination or recovered from COVID-19, enables access to businesses, including gyms, hotels and restaurants.
To facilitate safe, free movement inside the European Union, the European Commission has proposed a “Digital Green Certificate” providing proof that an individual has been vaccinated against COVID-19, has received a negative test result or has recovered from COVID-19.
New York State’s Excelsior Pass, developed in partnership with IBM, was successfully beta-tested at two sporting event venues and is now available to citizens and businesses on a voluntary, opt-in basis.
For airlines, health passes are a key component of their strategy for returning to wide-scale international travel. For example, Qantas has commenced trialing the CommonPass and International Air Transport Association (IATA) Travel Passsolutions.
The safest road to reopening remains littered with unknowns and, as with the rest of the pandemic, best practices will emerge over time. For digital vaccine certificates and health passes, the adoption and long-term success of these solutions is dependent on four key factors:
The efficacy of digital vaccine certificates in supporting safe reopening of society is, as yet, unproven, and there are many risks associated with their deployment. These include the potential for discrimination against certain individuals or groups of individuals and compromising vaccination goals by imposing measures that erode trust in groups of individuals, such as those who are vaccine hesitant. In light of this, and the rapidly evolving solution landscape, CIOs and executive leaders must evaluate solutions in the context of a comprehensive reopening strategy. Undertake small pilots that are adaptable to emerging policy decisions and lessons learned from other similar pilot programs.
Evidence
What is a Green Pass?, Ministry of Health, Israel.
Coronavirus: Commission proposes a Digital Green Certificate, European Commission.
Governor Cuomo Announces Launch of Excelsior Pass to Help Fast-Track Reopening of Businesses and Entertainment Venues Statewide, New York State.
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