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There are many unanswered questions about an idea to return to normal travel.

USA TODAY

No shirt, no shoes, no vaccine – no service.

This is feared by future critics of “vaccine passports”, as Americans vaccinated against COVID-19 can safely live a more normal life, now including spending time in most closed rooms without a mask.

The idea that a “passport” can separate the vaccinated from the unvaccinated raises fears of a dystopian future, in which a person’s health decisions will limit where they can travel, where they can shop, what events they can attend and whether they will be asked to carry mask.

Many countries have taken a stand against this possibility.

Alaska, Arizona, Florida, Idaho, Montana, South Dakota, Texas and Wyoming have taken steps to limit the use of “vaccine passports.” Even more countries have signaled that they are not interested in launching such a program.

“Residents of our state should not be required by the government to share their private medical information,” Doug Ducey, the Republican governor of Arizona, said in a statement in April. “Vaccination depends on everyone, not the government.”

Idaho Gov. Brad Little, a Republican, went even further in his criticism: “Vaccine passports create different classes of citizens.”

But many public health experts are irritated by the controversy, given that Americans have long been expected to provide evidence of vaccination under certain circumstances.

“It’s not a new idea to document whether or not you’ve been vaccinated and to share that information at certain times,” said Rebecca Fielding-Miller, a professor at the Herbert Wertheim School of Public Health at the University of California, San Diego.

“This is something we are already doing,” she said.

Schools usually require students to be vaccinated, and proof of vaccination has long been a major part of international travel.

While critics fear that the technology could be used to restrict Americans’ daily freedoms, few health experts expect or want it.

What is a “vaccine passport”?

“Vaccine passport” has become a poorly defined buzzword for vaccine testing. Although there are many programs in development, none has yet been launched as a national or international standard.

“There is currently no passport for vaccines,” said Dr. Jay Wolfson, a public health expert at the University of South Florida in the United States TODAY on Thursday.

For now, paper CDC cards, which are easy to counterfeit and complicated to put in a wallet or purse, serve as the default verification method. Wolfson expects something to take their place soon, especially for international travel.

But because there is no federal vaccination database, the logistics of checking a person’s vaccination status are a challenge. Obtaining vaccination documentation outside the CDC card will require navigation in a package of systems and regulations that vary from country to country.

Additional complications: Prohibitions on vaccine passports in states may cover the issuance of documentation to provide evidence of vaccinations, as is the case in Florida.

Wolfson said state government bans indicate that vaccine screening programs are unlikely to be widely managed by states.

But businesses – especially cruise lines – are increasingly motivated to look for ways to keep their customers safe. Some will continue to look for technologies to check the vaccination status of customers, he said.

In the high-profile example from April, the parent company of Norwegian Cruise Line announced that it would require all passengers and crew on its ships to be “100% vaccinated” two weeks before boarding.

After cruise ships became zero for deadly COVID-19 outbreaks at the start of the pandemic, it makes sense for businesses to want “to be as squeaky as possible,” Wolfson said. “They don’t want that to happen again.”

And in the United States, companies have a good legal reputation for requiring clients to be vaccinated, said Wolfson, a law graduate from Stetson Law School.

What is wrong with the term “vaccine passport”?

The term has led to negative connotations, which has probably led some people to believe that they will be used to protect unvaccinated people outside common public spaces such as restaurants and retailers – but this is not the future that Rachel Pilch sees. Loeb.

Piltch-Loeb, an associate researcher at the NYU School of Global Public Health, said Thursday that most public health experts envision “vaccine passports” being used in situations similar to those in which vaccine testing is already quite common. .

International travel, schools, colleges, some jobs and some big events are likely to have an interest in maintaining high levels of vaccines and are key areas for testing vaccines, Pilch-Loeb said.

Retail, restaurants and other daily activities are less likely to require vaccine testing, she said.

Such companies usually do not want to act as a “vaccinator”, Pilch-Loeb said.

This came on Friday when retailer Joe and Walmart said they would allow vaccinated customers to shop without a mask, but would not require proof of vaccination.

In general, there is little appetite in the public health community for the future, where an attached passport, possibly controlled by a technology company, will regulate Americans’ ability to perform daily activities, such as going to the grocery store.

Many experts advocating for other public health measures, such as masks and social distancing throughout the pandemic, share concerns about the confidentiality of digital passports of medical information. It could become a “slippery slope,” Wolfson said.

What is the risk with “vaccine passports”?

Health experts say a solution is needed to check a person’s vaccination status against COVID-19, but there is enough room to debate the details.

It’s easy to compare the vaccine passport to the “no shirt, no shoes, no service” sign, but it’s actually “something new,” Wolfson said.

The disease is new, the politicization around it is new, he said.

Wolfson said technology companies are among the most likely players in the vaccine passport space and there are real questions about how much health data people would like to give to big technology.

But at the same time, the ability to check who has been vaccinated and who is not is a growing problem, given how effective vaccines are in preventing the spread of a virus that has so far killed nearly 600,000 Americans.

“There is a strong need for public health for … proof of vaccination,” said Brian Castrucci, president of the de Beaumont Foundation, a health advocacy organization.

Castrucci said the politically charged discussion on the topic was “premature and distracting.” He stressed that the focus now should be on vaccinating Americans, and worried that the debate was a sign that the vaccines themselves were becoming a political battleground.

“We continue to politicize the public health crisis,” Castrucci said. “Even the proposal for a vaccine passport … presses almost every guerrilla button on the right.”

This is a continuation of a trend observed in the mandates of the masks and the suspension of the state, he said. Liberals were more receptive to “collective action” – changing their behavior for the common good. Conservatives, meanwhile, have tended to return to threats to personal freedom.

“This happens when you politicize a public health crisis,” Castrucci said.

Collaborators: Maria Poleta and Stephanie Ines, Republic of Arizona; Associated Press;

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