Why Americans will be demanding proof of vaccination

Felix Salmon, author of Capital




Illustration: Aïda Amer/Axios


You've received a coronavirus vaccination — but can you prove it? The answer to that question will help determine how the global economy functions for the next few years.

Why it matters: The federal government will probably neither mandate nor encourage digital immunity passports or other proofs of vaccination. But privately-operated digital certificates are already being developed — and U.S. law means that anybody who gets vaccinated here should be able to obtain the proof they need.

The big picture: Your employer has a clear interest in knowing whether you've been vaccinated, as do the immigration staff in any foreign country you want to visit. Many workers, from nursing-home aides to opera singers, have a clear desire and even need to be vaccinated before doing their jobs. Which means they'll need some kind of proof of vaccination.

• What they're saying: "Those who get vaccinated deserve more freedom," wrote the FT's John Gapper last month. Private companies "should be allowed, even encouraged, to protect customers and employees from harm."
• There's also an "urgent need to restore confidence in travel and mobility," says Paul Meyer, CEO of the Commons Project, a group attempting to build a global platform for proof-of-vaccination apps.
• The other side: The federal government "should discourage the use of vaccination cards or apps for virtually any purpose other than guiding individual medical care," argued Duke University professor Nita Farahany in the Washington Post. "Vaccine cards (and immunization apps) could turn into powerful weapons of exclusion and discrimination," she wrote.

The catch: The official documentation that Americans receive upon being vaccinated is little more than a flimsy, easily-forged paper card. As Gavi, the global vaccination alliance, notes, that in turn creates "concerns that documentation could be fraudulently reproduced".

• It's a real concern: A recent flight from Russia to China was canceled after more than 190 of the passengers attempted to board with “completely identical” serology tests.

Between the lines: Trustworthy and reliable digital proof of vaccination is not only possible, Meyer tells Axios, it's also quite easy and will almost certainly happen.

• That's because the government doesn't need to be involved.
• Individual Americans have the right, under HIPAA, to access digital copies of their health information. Once they've done that, they can upload that information to any app or service that requests it.
• "People shouldn’t be happy walking out of getting their jab with just a piece of paper," says Meyer — they should be sure to demand digital access to their vaccination records as well. Rather than relying on the government to centralize vaccination records, he says, "the human being is the only central organizing point in the healthcare system."

The bottom line: Paper "yellow cards" were generally accepted as proof of vaccination against yellow fever. Proof of COVID-19 vaccination, by contrast, is going to be digital — and it's going to be on individual Americans to get it.

Go deeper: Axios' Joann Muller describes how an immunity-passport system is likely to work; Sam Baker explores the fraught question of vaccine mandates; and Ina Fried runs down the list of U.S. technology companies supporting the vaccination effort.

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