The COVID-19 vaccination card looks almost vintage: A rudimentary, wallet-sized ticket of sorts, with some handwritten information and dates of inoculation. It's also a reminder to get your second dose.
But its existence has stirred a lot of discussion about how this proof of vaccination might be used for other COVID-19 pandemic purposes.
We asked regional medical experts about the card and what you'll need to do with it.
Here's who we asked:
- M. Sara Rosenthal, Ph.D., professor and director of the University of Kentucky's Program for Bioethics.
- Dr. Robert Frenck, principal investigator of the National Institutes of Health-sponsored Vaccine Treatment and Evaluation Unit and director of Gamble Vaccine Research Center. He's leading the COVID-19 vaccine trials at Cincinnati Children's Hospital Medical Center.
- Sharona Hoffman, a health law professor and co-director of the Law-Medicine Center, Case Western Reserve University in Cleveland.
- Dr. Carl Fichtenbaum a University of Cincinnati College of Medicine professor in the division of Infectious Diseases.
Question: What is the point of having a COVID-19 vaccination card?
Rosenthal: A COVID-19 vaccination card is proof of vaccination and serves the purpose of being an “immunity passport” – what many in the fields of medicine, public health and bioethics believe would be a critical document that would enable the vaccinated public to return to normal activities, and enable the economy to re-open.
Frenck: I have not heard of people talking about a specific COVID-19 vaccination card. However, my guess is that it would be used like any other vaccination card; prove that you have been immunized and thus should be at very low risk of getting the infection. Although I don’t know the last time it was enforced, you can be asked to show proof of yellow fever vaccination when you return to the U.S. from a yellow fever zone.
Hoffman: The COVID-19 card simply reminds people that they need to get the second dose and tell them on what date they should obtain it. It is different from what is being called an “immunity passport.”
Fichtenbaum: To provide documentation of vaccination since it may not go in their medical record. Patients need documentation of their vaccines for everything.
Q: Should we all be carrying these cards once vaccinated?
Rosenthal: In my opinion, absolutely! And it may become the norm in the future for other infectious diseases that are seen as a public health threat. Pre-COVID, many schools and other extracurricular activities for children required parents to provide proof of vaccination for their children. It’s not a new concept.
Frenck: The only reason I could see to carry the cards is if you would be excluded from somewhere or something if you could not demonstrate that you were vaccinated. At least at the present, it is not mandatory to be vaccinated against COVID-19.
Hoffman: It will probably be a good idea to carry proof that you’ve been vaccinated. Presumably, some employers and places of business (including airlines) will ask for proof of vaccination once vaccines are widely available to the public.
Fichtenbaum: I don’t think this is necessary at this time. It may be in the future that individuals may need to provide proof of vaccination to their health care provider or others, for example, employers.
Q: Do we also need to have a digital version of our individual cards?
Rosenthal: I can’t address the delivery system of such cards, but it is certainly plausible that we may develop “proof of vaccination” apps that would not just be for COVID-19, but a range of infectious diseases, including childhood vaccines, which would help parents enroll their children in a variety of activities.
Frenck: I definitely think you would want to have the card be digital as that way the information could be backed up and reprinted if the card was lost. The digital vaccine card would be a great thing to do for all vaccines, just like the military did.
Hoffman: Digital proof will also be a good idea. That will make it unnecessary to carry a card around and worry about losing it.
Fichtenbaum: It is always handy to be able to show people your health information without having to look for it. A picture of your card might suffice for most.
Q: What do you think about the value of showing proof-of-vaccination?
Rosenthal: In the same way that most businesses now require masks in order to operate during COVID-19, post-COVID, you may not be allowed to patronize various businesses without your immunity passport. A reopening of the economy and a return to normalcy will depend on community protection from COVID-19.
Frenck: I see proof of vaccination being used by children to attend school. Unless COVID vaccines were made mandatory, I am trying to think how a COVID vaccine card would be helpful. I don’t think any business would require that right now, because they’re having so much pushback right now.
Hoffman: We don’t know yet exactly what the value will be. In part it might depend on how easy it is to create “fake proof.” But if the proof-of-vaccination is reliable, it will probably enable you to enter venues and engage in activities that would otherwise not be available to you. In addition, some employers may require employees to be vaccinated in order to keep their jobs.
Fichtenbaum: At present, there is very limited value. I think it is an important thing for an individual’s own health information like documenting all other vaccinations.
Q: Will people have more access to things or more ability to go places without masks, or more ability to travel and/or other things?
Rosenthal: Absolutely; the immunity passport would truly be your passport to resuming normal social activities, especially air travel. The public already accepts many liberty restrictions and requirements for public health and safety: seatbelts, no smoking in public spaces, all the security rules for air travel implemented post 9/11. Now, post-COVID, proof of vaccination will likely be required for any air travel, border crossings, admittance to resorts, cruises, etc.
Frenck: At this point, I don’t see society allowing movement to be restricted based on COVID vaccination status. I don’t think our government has any interest in doing this. If it’s a private business, … private enterprises can have rules that are different, as long as they’re legal.
Hoffman: I think so. (See above answer.)
Fichtenbaum: At present, there is insufficient data to allow people who are vaccinated to change their social distancing behaviors, use of masks or travel. And I personally don’t think any commercial establishments having people show proof of vaccination to come to their establishment, use their business, etc. We don’t do this for any other health condition. This would be unprecedented
Q: In your expert opinion, is it OK to establish these types of rules for people with vaccine cards or proof-of-vaccination vs. those who do not have such proof? Why or why not?
Rosenthal: Yes, while there is certainly debate in the bioethics community about whether immunity passports could set up more social disparities or exacerbate existing ones, I strongly support immunity passports for COVID-19 on the basis of public health ethics, whereby we have an obligation to protect the public from known harms and imminent danger, harm reduction and harm prevention, and this should be balanced with ensuring free COVID-19 vaccinations, which are now being offered in all developed countries, including the United States.
Frenck: To me, having a vaccine card only makes sense if the admittance to areas would require vaccination. Like, you can only go in to visit a person in a care facility if you can demonstrate that you are immune against COVID. The problem I see with that plan is that people will be start a counterfeit ring to have documentation of being vaccinated. People will just make up cards. It would have to be some sort of a national kind of thing, or international data system.
Hoffman: Yes. The government has broad public health powers, including the power to order vaccinations. In addition, private businesses can establish their own rules for how to operate their business. For example, they can say “no shirt, no shoes, no service.” Requiring masks or proof of vaccination is also within their rights. In addition, the Equal Employment Opportunity Commission just issued guidance stating that employers have a right to require employees to get vaccinated. In all cases, exceptions must be made for people who have a medical reason or a sincerely held religious belief that prevents them from getting vaccinated. So you might need either proof of vaccination or proof that you have a legitimate reason to avoid it.
Fichtenbaum: I think proof of vaccination is more for an individual’s medical record and history and, in some circumstances, may be tied to their work in certain environments (e.g., health care workers) like influenza vaccinations are required for health care workers in many institutions.
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