Health

Legal and ethical issues in mandating a ‘vaccine passport’

With vaccinations taking place and spreading around the world, the debate over 'vaccine passports' is the next area of contention

Updated 5 years ago · Published on 01 Mar 2021 8:00AM

Legal and ethical issues in mandating a ‘vaccine passport’
Despite some optimism there is not yet any evidence the vaccine can protect against the various mutations of the virus. - Pixabay pic, March 1, 2021

by Rajen Manicka

I AM not going to wade into the issue of whether you should vaccinate or not. You need to have that dialogue with your trained medical professional and make that decision on the facts that are presented to you at the time when the decision needs to be made. 

The hotter issue that is being discussed globally and even here in Malaysia is the idea of mandating a “vaccine passport” with possible sanctions in terms of where you can’t go, including getting on an airline. 

A Silver Bullet? 

The hope that a vaccine is a silver bullet against Covid infection is at the heart of the drive to introduce “vaccine passports”. But there is not yet any evidence the vaccine stops infection or even transmission or can protect against the various Covid mutations. That is the opinion of scientists from the Royal Society  – an independent scientific academy. 

Also, we still do not know stuff like:

  • Which vaccines work better? The mRNA or the one from the inactivated virus?
  • How long do the effects of the vaccines last? After all the current flu shots – which are for a member of the coronavirus family – only lasts for the flu season and needs to be taken annually.
  • Will the vaccine protect against all the newer detected mutations? How about the future mutations? What if the newer mutations are more virulent? 

The 12 tests

Twelve legal and ethical tests must be met before any vaccine passport is introduced:

  • a vaccine must meet medical criteria that it provides immunity
  • proof it is effective against emerging variants
  • a passport would need to be standardized internationally
  • a passport would need to use credentials that proves someone had been vaccinated
  • a passport should have defined uses (such as whether it is needed in order to enter a shop)
  • a passport should be based on a platform that could be read by different operating systems and on different devices
  • a passport must ensure personal data is safe
  • a passport would have to be portable
  • it should be affordable for people and governments
  • it should meet legal standards
  • it should meet ethical standards
  • it should have conditions of use that are understood by the passport holder

Other Issues 

Clearly the advice now is not to vaccinate if you are intending to get pregnant, are pregnant or nursing a baby. This “vaccine passport” could unfairly discriminate against the young, pregnant and those who won’t have the Covid-19 jab for medical or personal reasons. What about those who have allergies or have auto-immune disease? How about those who have taken flu shots in the past and had unwanted responses? 

Even Anthony Fauci – who has served as the director of the US National Institute of Allergy and Infectious Diseases (NIAID) since 1984 – and is chief medical advisor to US President Joe Biden since 2021, has gone on record to say that we need to wear masks even after we have been vaccinated. 

Lead author of the report from the Royal Society, Melinda Mills from Oxford University said: “What would it be used for – getting a job or attending a football match or buying milk?”

There are real legal dangers of introducing a “no jab, no job” policy in a tight job market in the economies that are trying desperately to bounce back from the pandemic.

Herd Immunity

Herd immunity –  or community immunity –  is when a large part of the population is immune to a specific disease. If enough people are resistant to the cause of a disease, such as a virus or bacteria, it has nowhere to go. 

While not every single individual may be immune, the group as a whole has protection. This is because there are fewer high-risk people overall. The infection rates drop, and the disease peters out. 

Epidemiologists think that this number is somewhere between 60-80% of a population.  

Thus, the ultimate aim of the mass vaccination programme is to have about 70% of the population carrying the antibodies. So what about the 30% who will not be vaccinated? Will they be discriminated against as they do not have the vaccine and therefore, the “vaccine passport”. 

Alternatives 

There is an alternative in terms of testing – either the antigen or antibody. These tests clear you for 7-14 days when we can safely guarantee that you are “Covid-19 free”. What if someone showed you that they are “negative”. Would there be an equivalent to a “Covid-19 passport”? 

This is an important point as leading experts like Michael Mina of the Harvard School of Public Health now increasingly endorse “high frequency mass rapid testing” as a way out of the pandemic. 

Provide but don’t mandate 

It is commendable that the Malaysian government has gone out of its way to offer vaccines to all. There should be free choice based on the available evidence. There should be no mandates and force. There are just too many unknowns. It would be not fair to coerce the population with a “vaccine passport”. 

Furthermore, the opinion is that a majority of people would take it. So why make an issue by forcing it on all via a mandatory “vaccine passport”? – The Vibes, March 1, 2021

Dato’ Dr Rajen Manicka is a pharmacist with a doctorate in Holistic Medicine. He has been a columnist for various publications on and offline since the mid-1990s.

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