Thursday, December 2, 2021

On Vaccine Passports

This week, NBC reported that “Gov. Charlie Baker said Massachusetts may "soon" deploy a digital COVID-19 vaccine passport similar to those in use in other states, he stressed that he remains opposed to requiring that businesses screen customers for proof of vaccination.


"I've never supported or agreed to any sort of statewide vaccine mandate program," Baker said Tuesday. "We just want to make sure that people have the ability, if they've been vaccinated and want to have proof that they've been vaccinated, that they can easily download it onto their phone and use it whenever they need to."

Vaccination has proven to be extremely effective at preventing serious illness and death from COVID-19. The data show that the mRNA vaccines in particular are among the safest and most effective vaccines in history, but that protection is limited. New variants like Delta and Omicron are able to cause illness in vaccinated people, especially those who have not received vaccines in the last 6-9 months. COVID-19 can also be transmitted through vaccinated people, though not as virulently as through the unvaccinated.


The data also show that prior infection and recovery from COVID-19 is at least as effective as vaccination, although far more risky.


Businesses, especially health-related ones, like hospitals, physical and massage therapists, etc., or schools, and performance or conference venues that bring large numbers of people together in a central indoor location, have a right to protect themselves and their customers with measures like a requirement of vaccination. States overstep their bounds and hurt us when they substitute their judgement for the decision making of countless people making their own individualized risk/benefit assessments, whether it be through a vaccine mandate, or through a mandate not to allow vaccine requirements.


It is up to each individual and business owner to decide if vaccination and vaccination requirements are right for their goals and values.


A vaccine passport system that allows people to certify their vaccination status to those who choose to require it, so long as it is voluntary, should not be considered a violation of anyone’s rights. But, that does not mean it is a good idea.


The most obvious problem is that people who have recovered from a COVID-19 infection are at least as “vaccinated” as those who have had two mRNA vaccinations. A widespread vaccine passport system that makes second-class citizens of people recovered from infections is irrational and socially corrosive.


The second most obvious problem is that both vaccination and prior infection have a “shelf-life” that decays over time. This is both because the immunity itself wanes, and because new variants have emerged that break through the partial immunity conferred by both vaccination and prior infection.


A ham-fisted vaccine passport system that depends only on vaccine status, and doesn't fully account for both the immunity conferred by prior infection, and for waning immunity over time in the face of new variants, is likely to do more harm than good. It will both provide a false sense of security that lets new variants run rampant through waning immunity, and unfairly exclude people with recovered infections from full social participation.


The lesson of masks should have taught us something. Masks work very well at preventing the spread of COVID-19 (and other respiratory viruses), but mask mandates do not. The reason for this is that mask mandates create an incentive to comply in the least effective way possible, with flimsy pieces of cloth improperly worn, rather than a properly worn surgical mask. We can expect a vaccine passport to suffer the same problem. If someone with a single J&J vaccine in February is cleared by the passport system, and an unvaccinated person who recovered from a Delta infection in October is not, then it is worthless.