Written Evidence Submitted by Paul Gliddon
The prospect of ‘Covid vaccination passports’ in the UK, which the UK government is considering as a response to Covid 19, has many implications (outlined below). Incidentally, I’m sorry that this is such a long email, but I’m sending it in case some of the following thoughts might be useful.
Obviously the UK can’t prevent other countries making a vax passport a condition of entry to their territories. But that shouldn’t automatically mean that British citizens should be required to have vax passports for activities within the UK.
If they were to be introduced, it isn't clear yet whether the government intends various organisations to have discretion over making them a condition of access to facilities/services, or whether the state would impose them on citizens more directly and more widely.
Another distinction to be made is between:
- Covid vaccination passports (which give proof of vaccination against Covid 19), and, alternatively:
- Covid immunity passports (which give proof of immunity against Covid 19, either by vaccination or by recovery from previous infection).
Many of the objections to Covid vaccination passports (‘vax passports’ for short) apply also to Covid immunity passports. Therefore the objections to vax passports discussed below can, generally speaking, be assumed to apply to immunity passports as well.
Irrespective of their exact form, vax passports within the UK would have serious consequences, including the following:
- A scheme for vax passports would be unworkable as well as unnecessary;
- Vax passports would be discriminatory and repressive;
- They would be a disproportionate response to Covid 19;
- They would also be unethical; and there would be other damaging outcomes.
Final observations below are that, internationally: there would be some irony in the prospect of other countries with high levels of 'vaccine hesitancy' requiring vax passports as a condition of entry from elsewhere; and other objections arise, which advocates of vax passports probably haven’t thought through.
A vax passport programme within the UK won’t work:
- Presumably the UK government aims to vaccinate nearly all the UK adult population (it won’t manage literally everyone).
- An optimistic timescale for vaccinating so many people in 2021 would almost certainly take up much of this year.
- Even this would be possible only in an exceptional year such as 2021, when vaccination has a huge army of cheerful volunteers, and much of the NHS effort, devoted to it. Those advantages can't be relied on to continue in future years.
- It follows that many people will have vax passports on the basis of vaccinations that are long out of date. Covid 19 mutates efficiently, and it won't be possible to inoculate people regularly enough to keep up.
- Compare the influenza vaccine, which is possible annually because we have the resources to regularly vaccinate only the most vulnerable. These limitations will apply to Covid 19 inoculations as well.
- Also, at time of writing, the vaccinations currently approved for use in the UK are not recommended for children (under-16/under-18 depending on the product) anyhow. Even if changes to this were proposed, there might be ethical objections (covered below) to such changes.
- It follows that a vax passport will have little or no practical use, as, looking ahead, beyond 2021, only a minority can have it on the basis of a recent enough (or indeed any) inoculation.
- It's uncertain whether Covid 19 vaccinations will be effective against transmission of the virus, or against future mutations, so a vax passport might be of no use anyway. Additionally, it’s uncertain how long any protection against Covid 19 from vaccination or previous infection might last (1).
A UK vax passport is unnecessary:
- If the Covid 19 vaccine works well in preventing serious illness (as it seems to) then people (including those considered particularly vulnerable) can choose to have it. Should things turn out otherwise then the vax passport would have no value anyway.
- It may be that a vast majority of the UK population accepts the vaccine, in which case there will be a high level of protection for those who wish to have it, and therefore no point in the vax passport.
- Alternatively, the vax passport will be of little use if much of the UK population doesn't accept the vaccine.
- Many premises (e.g. gyms, swimming pools, restaurants, etc) have had no identifiable, significant Covid-related risks, even during 2020 when knowledge of Covid 19 and how to respond to it was scantier than it is now. So there's no need for making access to such premises conditional on a vax passport.
A vax passport in the UK would be discriminatory:
- A vax passport would be divisive and drive inequality. There will always be an un-vaccinated section of the population: people with specific learning difficulties, and other learning difficulties, with some health conditions, and those who through personal choice don't have the vaccine. Inevitably, take-up will also be lower among expectant mothers, ethnic minorities and some other cohorts.
- It follows that a vax passport scheme would bring about a sort of vax segregation, what might be termed: ‘social vaxclusion.’ Those with the vax passport would get preferential, or even exclusive, access to facilities and services.
- This social vaxclusion would be very visible. In effect we would have (either literally or figuratively) priority queuing for those with the vax passport, with others marginalised or even excluded. There are no prizes for guessing which category would have the most pregnant women, or people from ethnic minorities or with disabilities in it.
- This would all be reminiscent of the much despised ‘free school dinners’ queue. Do we really want to make our society a regimented one where access to many activities is comparable to 'priority boarding for aircraft?’
- The mentality of some people advocating this vax passport programme should cause great concern; take Israel, which has taken a lead in such a scheme. Israel's health minister recently said that people deciding whether or not to have the vaccine must choose: ‘whether you will be part of the celebration or whether you will be left behind.’ (2) Such a discriminatory and judgmental outlook is a poor model for the UK to consider emulating.
- This mentality is building on an already worrying judgmental trend, in some quarters of UK society, of some people disapproving of those who don't have the vaccine. This mindset is now being extended to censure towards people who don’t want a vax passport.
- This is part of a wider trend of other disturbing developments, e.g. some government ministers encouraging people to ‘snitch’ on their neighbours and friends about infractions of 'the rules' and some people apparently being only too keen to act on this. This creates a divisive and suspicious culture. Who on earth would want to live in such a society? Who would want to be governed by politicians who malignly try to provoke such negative attitudes? Do we really want such corrosiveness in the UK? This also links to the next point, namely that a vax passport would be repressive and excessive.
A UK vax passport would be repressive and excessive:
- If the vax passport makes it difficult for people who refuse it to have a normal life, then this amounts to mandatory vaccination by the back door.
- An even worse prospect would be if the government tried to legally enforce a vax passport scheme.
- As an authoritarian measure, the vax passport scheme, whether state-sanctioned or otherwise, would fuel conspiracy theories, generating suspicion about the motives of those in favour of it. This might even spread to alarm about the vaccine itself, and deter people from having it. Suspicion has already been aroused by some UK government ministers previously dismissing the prospects of a vax passport but now contemplating it. In fact, a vax passport scheme was being planned in Europe before Covid 19 (see below), which may add to such suspicion.
- A vax passport would invade people's personal privacy, require them to disclose medical information to others, and to depend on the state's permission to access facilities and services. It could amount to a prototype identity card: the gateway to a ‘surveillance state.’
- Not surprisingly, therefore, the scheme has been criticised on various human rights grounds. For instance, health information in the UK and EU is classed as personal sensitive data, so making ‘health declaration’ a condition of access to services (to which people should have a right) is very problematic.
- Some journalists who oppose lockdown and other restrictions, and the vax passport, have said recently they’ll accept it as a price of being able to travel, etc. So they have been driven to despair, by about a year of repressive restrictions on their lives, into giving up their liberties. Those who might not otherwise have the Covid 19 inoculation will be taking what should be a health-based decision not on a rational health basis but because the government has worn them down, in effect: coerced them into complying with vaccination and thence vax passports.
A British vax passport would have other problems of ethics, for instance if an extension of the scheme to children were to be proposed:
- Vax passports for children would of course be based on the various Covid vaccinations, which at time of writing haven’t been through a fully evaluated trials process among minors and (at least in the case of the vaccines approved for UK use) are not recommended for children.
- The risks of Covid 19 (in terms of fatality or serious illness) to this young population, although not absolutely zero, are miniscule. This raises questions about the ethics of subjecting them to the risks of Covid 19 vaccination, either by way of initial trials or via general deployment. Although many of the known side effects of the vaccines approved for use in the UK (3) are generally considered mild or moderate, this does not necessarily mean that all the side effects should be lightly dismissed. It's understandable that people in much older and more vulnerable health-related groups, with higher rates of fatality from Covid 19, might be prepared to accept the possibility of side effects. But imposing this on children, to whom Covid 19 generally presents little threat of serious harm, is a different consideration. It's questionable whether the very slight risks to under-18s from Covid 19 justify extending Covid 19 vaccination trials or general usage into this group. Yet this is what would happen before a vax passport scheme could be extended to everybody: obviously you can't have a vax passport programme without vaccinations.
- In this respect, it may be cause for concern that early in 2021 some advocates of widespread vaccination in the UK became more vociferous in agitating for children and adolescents to have the Covid 19 vaccination. Such lobbyists admitted that there was no cost-benefit justification for this on health grounds. Instead, they argued that school closures might become less likely if minors were vaccinated. (4) The problem here, of course, is one of insisting that minors are vaccinated to avoid potential harm done to them by governments and their advisors, not because of any general health benefits. An obvious danger is that minors and their families come to view this as coercion, or even as tantamount to psychological warfare or blackmail, even if this hadn’t been intended.
Other issues with the vax passport:
- As an app, it would be inaccessible to people who don't carry smart phones, and people with repetitive strain injury and other health conditions that limit the use of technology. Smartphones can also be hacked into, which is why many people choose not to have them.
- Billions of pounds are being spent on developing vax passport technology; with that amount of money being spent, the scheme, once introduced, would not be abandoned after a few months. On the contrary, there would be pressure to retain it indefinitely.
- A vax passport would inevitably be extended to other uses beyond Covid 19: partly through mission creep, partly through an initiative to justify the money spent on it.
- A vax passport will worsen the recruitment crisis in the health and care sectors if people without the vaccination are banned from working there.
- There might be other unintended consequences. For instance, Denmark has announced that a vax passport will be required to visit a hairdresser. This could lead to an 'underground economy', where people prevented from visiting premises such as hairdressers and other personal services will visit unauthorised, and less safe, premises to access the services they need (e.g. provided by friends, acquaintances, etc).
International implications of a vax passport:
- As mentioned above, the UK government can't stop other countries imposing vax passports on people seeking to enter their territories. Nevertheless, the prospects of international vax passports raises various absurdities and concerns.
- Take, for instance, the proximity of France to the UK: France will struggle to vaccinate as much as half of its adult population this year. With a regular flow of people between the two countries (except during lockdown), there’s little point in trying to rely on a vax passport, because a lot of people entering the UK from France won't even have the Covid vaccination, let alone a vax passport – unless we’re prepared to restrict people travelling from France indefinitely, which is hardly a realistic proposition.
- A vax passport could inflame Irish border tensions. Ireland might inoculate over half its adult population by summer 2021 – it certainly won’t vaccinate all adults by then, nor will it vaccinate half its total population. Refusing facilities in Northern Ireland, or the rest of the UK, to Irish citizens would hinder the aim of a ‘seamless border’ on the island of Ireland and in the Irish Sea, and bring contentious 'border issues' to the fore.
- On an international basis, as previously noted, we might have the irony of countries such as France and Germany, where anti-vax opinion is widespread, requiring visitors from elsewhere to have a vax passport.
- Vax passports on an international scale would require widespread vaccination. And there is pressure from some quarters for universal, or approaching universal, vaccination against Covid 19. (4) But this again raises questions of ethics concerning inoculation of children (see above) and of whether vaccinating the global population (whether adults or all age groups) would be an efficient use of resources when mortality rates from Covid 19 are tiny except in some cohorts of the population (mostly in categories that can easily be identified).
- The European Union set out a programme to introduce a vax passport throughout the EU in 2019, i.e. before Covid 19 became a concern; at that point the UK was still in the EU. (5) Therefore the vax passport is not merely a response to Covid; on the contrary, it looks as if Covid 19 has given various states an opportunity to persuade their populations to accept something that governments had already planned pre-Covid.
It’s understandable that vulnerable sections of the population might choose vaccination against Covid 19. They will probably require further vaccination year after year. However, a vaccine passport scheme, which would require mass vaccination, seems disproportionate, given the low risk of mortality which Covid 19 poses to much of the population, a risk likely to diminish further as treatment improves. It seems rational for vulnerable people to consider vaccination; it seems less rational for vaccines to be encouraged among healthy people who don't need them and for this to extend to vax passports. Neither, as argued earlier, do large-scale vax passport schemes sound workable. Moreover, such schemes carry the threat of mandatory vaccination by the back door.
A healthy population is more likely to result from people having scope to lead healthy lives (using gyms and other fitness facilities, getting adequate exercise and vitamin D outdoors, etc). A less healthy population, on the other hand, is likely to ensue from people needing vax passports to visit gyms, etc (as with Israel’s ill-judged scheme) and thus being deterred. It hardly benefits people’s health, moreover, if they’re bombarded with other restrictions, locked down, subjected to scaremongering propaganda, and losing their jobs and prosperity. A vax passport is a sign of a wider, misguided approach to managing health, one that rests on generating fear; it is sometimes termed a ‘freedom pass’, which is the ultimate of contradictions. We need instead to be more positive.
(1) The journal Nature has indicated the difficulties of determining effects of vaccinations on transmission (S. Mallapaty, Can COVID vaccines stop transmission? Scientists race to find answers’, Nature, 19 February 2021). Proving such effects sounds a somewhat over-ambitious aim, given the inevitable limitations of such research.
(2) 'New technology could help make vaccine passport our ticket to freedom', Sunday Telegraph, 28 February 2021, pp. 4-5. Despite its title, this article points out many problems with vaccine passports.
(3) The gov.uk website has 'Information for UK Recipients' for the Covid 19 vaccines: Pfizer-BioNTech, AstraZeneca and Moderna.
(4) For instance, Robert Yates of Chatham House, interviewed on BBC News 24, 13 March 2021, and his article: ‘The Health Priority for Italy’s G20 Presidency’ etc, 1 March 2021, www.ait.it
(5) European Commission, ‘Roadmap on vaccination’, update: Q3 2019, available via the EU website.