KUALA LUMPUR: As it would take time for nations to reach herd immunity, mechanisms to help re-open the economy and international borders such as health passports have been met with increased enthusiasm and strong support from economic sectors.
However, issues related to immunological uncertainties, social-ethical concerns related to its implementation as well as operational challenges in global standardisations have to be addressed in order for vaccine passports to be effective.
Firstly, vaccination passports are not the same as immunity passports. There are still chances for some vaccinated individuals to not be successfully immunised. As for those who gained immunity, we don’t know yet how long it would last.
Unless there is a way to track, measure and link this to health passports, it carries uncertainties (that may increase over time) regarding the passport holder’s actual immunological status. In these two cases, health passports provide a false sense of confidence, risking the passport carrier as well as others.
Furthermore, even if passport carriers successfully retain immunity, they may still transmit the virus to others. Although there appears to be growing evidence that vaccination reduces infectivity, the ability to completely stop transmission (through sterilising immunity) is still inconclusive. In this case, passport carriers may still pose a spreading risk, especially to non-vaccinated groups, questioning the ability to achieve herd immunity altogether.
On top of this, health passport carriers may still be vulnerable to infections and severe symptoms from emerging Covid-19 strains, further complicating the validity of health passports.
As it stands right now, a vaccination passport is merely a receipt, or a proof of vaccination. It’s hard to formulate effective health policies without better visibility on the mentioned uncertainties.
In light of these unknowns, it’s best to consider more data over a longer period of time from local and global observations before making decisions on vaccine passport. The Health director-general also have alluded to the need for such longer-term observations before implementing this as an “immunity passport”.
Secondly, there are social, legal and ethical dimensions to be considered for vaccine passport implementation.
Depending on how the proposed health passport would be used and enforced in reality-be it for domestic purposes or international travels-this could present itself as a discriminatory system for people who are medically-unfit to receive vaccines and people with other potential medical conditions that have not been sufficiently elucidated through clinical trials.
It could also discriminate against people who are currently not recommended as vaccine recipients due to lack of clinical and real-world data such as children and pregnant or breastfeeding women.
Any discriminatory impact may only be justified for those who opt-out without valid reasons and only in the case where there is clear risk to the many. Though this may still be arguable from lens of human rights, Malaysians don’t actually have a choice to opt-out from the epidemiological perspective, notwithstanding uncertainties in virus transmissibility especially in relation to herd immunity.
Taking into account those below 18 years of age which makes up 29 per cent of the population along with other groups mentioned earlier, we have to vaccinate (and successfully immunise) all adults in order to cover 70 per cent of the population, which could be the lowest threshold for herd immunity.
Thus, prioritising health security for the many appears to supersede the socio-ethical concerns, which could be shaping current public policies. As mentioned by researchers Iñigo de Miguel and Jon Rueda, differentiation (even if it appears discriminatory) of immune and non-immune people will be needed for public health reasons.
The issue gets more complicated if health passports are linked to personal data and digital ID, raising privacy concerns on top the mentioned personal liberty issues.
Reportedly, according to Health Minister Datuk Seri Dr Adham Baba, the health passport could be in a digital form displayed in the MySejahtera app as proof of vaccination, or a physical form that could be accepted by other nations.
Perhaps authorities should consider a ‘self-sovereign’ ID whereby personal data is both owned and controlled by the individual. According to Accenture, a trusted and secure form of digital ID can be enabled through technologies such as blockchain and biometrics.
Given that health passports could be used for international travels, there could be a future scenario where it would be linked to a standardised form of global digital ID such as the one developed by ID2020 Alliance.
Computer Weekly reported how a company has developed its own digital health pass that has been certified to meet the 41 technical requirements under ID2020 Alliance which claims to address privacy, security and ethical issues.
If so, adopting these technical requirements as part of Malaysia’s own National Digital ID could provide a more seamless transition to participate in a foreseeable globally-implemented health passport.
Of course, such decisions must be made in balanced and careful consideration of national interests, security and sovereignty.
This touches on the third part of the equation related to operational issues of global standardisations. At the moment, this mostly concerns international travel.
The Edge reported that according to Tunku Datuk Seri Iskandar Tunku Abdullah, former president of the Malaysian Association of Tour and Travel Agents and former chairman of the Pacific Asia Travel Association, there has yet to be standardisation of the various health passport versions from other countries and that an acceptable version would be endorsed by the World Health Organization (WHO) and the World Tourism Organization (UNWTO).
Airline industry support of such opinion can be observed through a travel pass being developed by the International Air Transport Association (IATA), which was reported to be in support of WHO efforts to build global standards of digital vaccine records.
However, despite industry’s apparent reference the WHO, interim position paper by WHO related to this matter dated February 5 states that “national authorities and conveyance operators should not introduce requirements of proof of Covid-19 vaccination for international travel as a condition for departure or entry, given that there are still critical unknowns regarding the efficacy of vaccination in reducing transmission” and “WHO also recommends that people who are vaccinated should not be exempt from complying with other travel risk-reduction measures.”
Thus, it would appear health concerns are still at odds with the deserving enthusiasm from certain economic sectors to quickly push for health passports.
Relatedly, and circling back to ethical issues, a global health passport may discriminate poorer nations with lower access to vaccines. Proponents of a global digital health pass, digital ID and global health authorities should put equal (if not more) focus in ensuring equitable access of vaccines to low- and middle-income countries.
These concerns are consistent with a February 14 report published by the SET-C (Science in Emergencies Tasking: COVID-19) group at the UK’s Royal Society, where it recommends addressing a set of “demanding criteria” prior to introducing a passport system. Oxford University reported and summarised the 12 criteria in the report, which include issues covered in this article and should be considered by the authorities.
We have to ensure that our desire for normalcy does not come at the expense of public health, with serious considerations of ethical, legal, technical and social issues. Rushing this may lead to failing both public health needs as well as economic sectors that desperately depend on its successful adoption and implementation.
Ameen Kamal is the Head of Science & Technology at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.
** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.
Ameen Kamal
Tue Mar 02 2021
The issue gets more complicated if health passports are linked to personal data and digital ID, raising privacy concerns on top the mentioned personal liberty issues. APpic
Who is Prabowo Subianto, incoming president of Indonesia?
A wealthy ex-general with ties to Indonesia's popular outgoing president and its dictatorial past, looks set to be its next leader.
Iran's supreme leader says Hamas leader's death will not halt 'Axis of Resistance'
The "Axis of Resistance", built up with years of Iranian support, includes Hamas, the Lebanese Hezbollah group, the Houthi movement in Yemen, and various Shi'ite groups in Iraq and Syria.
Putin says Russia willing to seek compromises between Iran and Israel
Russia is ready to help seek compromises between arch-foes Israel and Iran, President Vladimir Putin said on Friday, saying these would be difficult but possible.
What proposals will Russia push at the BRICS summit?
The proposal is also to establish a BRICS reinsurance company to allow uninterrupted shipment of goods and key commodities between members.
Indonesia's free meals plan in the spotlight as Prabowo readies for office
Prabowo calls the programme one of the main drivers of economic growth, eventually set to add an estimated 2.5 million jobs.
Astro AWANI's revamped English news website, AWANI International, launches on Oct 21
Astro AWANI's revamped English platform delivers in-depth global news and expert analysis to keep you informed on key developments.
Israeli strikes kill 33 people in Jabalia refugee camp in Gaza, medics say
Residents of Jabalia said Israeli tanks had reached the heart of the camp after pushing through suburbs and residential districts.
Liam Payne's ex-partner calls for media restraint after 'painful' death
Cheryl Tweedy used her statement to urge the media to remember they had a seven-year-old son, Bear, who could read the reports.
Analysts: Indonesia's strong MoF leadership team to boost investor confidence
Sri Mulyani Indrawati as head of Indonesia's Ministry of Finance is expected to instil confidence among investors.
Biden offers both a carrot and a stick to Israel as his term nears an end
Israel has frequently resisted US advice and has caused political difficulties for the Biden administration.
Putin says BRICS will generate most of global economic growth
Russian President Vladimir Putin will host a summit of the group in the city of Kazan on Oct. 22-24.
ISIS Malaysia's perspective of Budget 2025
An excellent rakyat-centric budget under the overarching principle of a caring and humane economy.
Budget 2025: Record increase in STR, SARA aid initiatives
The government will provide a significant boost to the Sumbangan Tunai Rahmah (STR) and Sumbangan Asas Rahmah (SARA) initiatives next year.
Budget 2025: EPF contributions to be made mandatory for foreign workers – PM Anwar
The government plans to make it compulsory for all non-citizen workers to contribute to the Employees Provident Fund (EPF).
What policies to expect from Indonesia's new President Prabowo
Prabowo will be open to foreign investment, his aide has said, such as by offering investors management of airports and sea ports.
Budget 2025: Govt allocates RM470 mil to empower women's participation in PMKS
The Women's Leadership Apprenticeship Program will be intensified as an effort to produce more female corporate personalities.
Israel sends more troops into north Gaza, deepens raid
Residents of Jabalia in northern Gaza said Israeli tanks had reached the heart of the camp, using heavy air and ground fire.
Indonesia ramps up security ahead of Prabowo's inauguration
Prabowo Subianto will be sworn in as Indonesia's president on Sunday with Vice President-elect, Gibran Rakabuming Raka, also taking office.
Immediate allocation of RM150 mil for local authorities, DID to tackle flash floods
Datuk Seri Anwar Ibrahim said this allocation is intended to address the recent flash floods that hit the capital and several major towns.
Budget 2025: Sabah, Sarawak to continue receiving among highest allocations - PM
Sabah and Sarawak continues to be prioritised under Budget 2025, with allocations of RM6.7 billion and RM5.9 billion respectively.