Reports that the Biden administration is working with private companies to develop “vaccine passports” — a way to prove to businesses that one has been vaccinated and can enter safely —set off a flurry of internet chatter this week about government overreach, HIPAA, and Big Brother.
At the same time, White House press secretary Jen Psaki told reporters the administration wouldn’t issue any kind of federal mandate vaccine passports.
“There are a couple key principles that we are working from,” Psaki explained on Monday.
“One is that there will be no centralized universal federal vaccinations database, and no federal mandate requiring everyone to obtain a single vaccination credential. Secondly, we want to encourage an open marketplace with a variety of private sector companies and nonprofit coalitions developing solutions. And third, we want to drive the market toward meeting public interest goals.”
These steps and comments made on a national level come amid news announced Friday that New York state launched its first digital Covid-19 passport, called Excelsior Pass.
The result? Confusion about what vaccine passports are, legal and privacy concerns, and lots and lots of discussion on Twitter about HIPAA (the Health Insurance Portability and Accountability Act).
Arthur Caplan, director of NYU Langone's Division of Medical Ethics, tells Inverse there are two kinds of vaccine passports:
- One used domestically
- Another used internationally
The latter, Caplan says “would be something you would use with a regular passport be able to go to another country would require proof of vaccination.”
What is a domestic vaccine passport?
The domestic kind of vaccine passport, which Caplan says is really a “vaccine authentication” operates off certain incentives. Business owners, for example, want to reopen but know that if we don’t do it safely, we might just end up in another lockdown. Hence, vaccine authentication.
New York already launched their version of this on Friday. Called an Excelsior Pass, a New Yorker visits the website to see if they qualify. Qualification isn’t limited to those who have been vaccinated, the website states:
You may retrieve a pass if you have not tested positive for Covid-19 in the last 10 days and:
- You have been fully vaccinated in the State of New York and it has been 14 days or longer since your final shot, or
- You had a PCR test administered in the State of New York in the last 3 days and the result was negative, or
- You had an antigen test administered in the State of New York in the last 6 hours and the result was negative.
If you meet the criteria, you can download an app and fill in your information et voilà! You have an Excelsior Pass.
Whether or not they create an app, expect to see other states follow suit, Caplan predicts. Right now, for most vaccinated people, the vaccination authentication is just the little card you get after vaccination.
“It’s not a very sound document; it’s not even laminated,” Caplan says. “But if I were you, I would take a picture of it and maybe photocopy it. Again, I think you're gonna need it.”
He adds that sports venues and cruises are already requiring proof of vaccination, as will most colleges come fall. “And I think we'll see that growing exponentially over the next few months,” he says.
And while Caplan says there’s some opposition to the idea, he doesn’t think it will matter. His advice? “Get vaccinated, get one of those cards.”
What is an international vaccine passport?
This is not a new concept. Many travelers have something called a yellow card stapled to their passport, showing proof of vaccination against yellow fever. Some countries, like Japan and Israel, have already extended this to include Covid-19 vaccinations. The European Union is developing something called a Digital Green Certificate, which would allow vaccinated citizens to move freely about countries in the EU.
Caplan says the U.S. government doesn’t offer that kind of passport — yet.
“Our government says it doesn't want to get into it,” Caplan says. “I will say within six months, they absolutely will be doing it.”
One of the driving forces behind any country developing these passports is tourism, he explains. After a year with virtually no international tourism, combined with lockdowns, cities around the world are suffering economically. International vaccine passports could go a long way to ensure that tourism can restart as safely as possible.
Do vaccine passports violate HIPPA?
Whenever there’s any discussion around disclosing medical information, inevitably the subject of the Health Insurance Portability and Accountability Act (HIPAA) comes up.
The 1996 law says that medical professionals can’t disclose records or other medical information about a patient without their permission. But in the case of vaccine passports, no one is asking your doctor to disclose anything. They’re asking you to disclose medical information about yourself.
For example, if a business asks for proof that you’ve been vaccinated, you don’t have to give it to them. They, in turn, don’t have to let you into their place of business (“No Shirt, No Shoes, No Covid-19 Vaccination, No Service” signs may be in our future.)
Further, the intent of HIPAA is to prevent discrimination against people who have medical conditions. You don’t want a potential employer to be able to call your doctor and ask about your health conditions and then be discriminated against because the employer thinks it means you can’t do something as a result. Covid-19 vaccinations are something a) we hope that most of the population will get and b) is for the safety of other patrons and employees.
The Inverse analysis — Caplan’s biggest concern about vaccination cards is fraudulent cards.
“There’s a lack of standardization because we don’t have a government-issued card,” he says. “I think we will see forgeries. We’ve got this goofy paper card thing.”
Ultimately, vaccine passports are an inevitable part of the future. But they are also optional. You just have to know that if you refuse to participate, you may miss out on the reopening of the world.