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Right to roam: the ethical implications of vaccine passports

By Chloe Kent 19 Apr 2021 (Last Updated April 21st, 2021 14:58)

After over a year of bouncing in and out of lockdowns, the Covid-19 vaccine rollout is finally allowing the global economy to begin reopening. For many countries and territories, digital vaccine passports form a key part of their action plan – forms of certification to prove an individual’s Covid immunisation status, and thus grant them access to certain areas. How might these platforms work, and can they stand up to ethical criticism?

Right to roam: the ethical implications of vaccine passports
Is it morally acceptable to use Covid-19 vaccination status as a precursor to public life? Credit: Shutterstock

Israel’s ‘Green Pass’ digital vaccine passport is the most developed platform of its kind in the world. While shopping malls and museums have reopened for all, the Green Pass allows fully inoculated citizens exclusive access to public spaces like gyms, restaurants, music venues and cinemas. Available through either a smartphone app or a physical pass, holders are given a QR code that businesses can scan to verify their Covid status and permit them entry.

The EU is planning to launch a similar ‘digital green certificate’ this summer, specifically focused on international travel. It will give those who have been vaccinated, recently tested negative or recovered from the disease access to a scannable QR code. This will allow them to cross borders between member states without quarantining on the other side.

Travel health company Practio managing director Dr Jonas Nilsen says: “It’s likely that vaccine passports will work in a similar way to international certificates of vaccination, which are already in use in many countries around the world. Travellers can be denied entry to some countries if they do not have a valid certificate for vaccinations such as yellow fever.”

As countries around the world begin to prepare to reopen their economies, both ethical and technological questions hang in the balance. How can the privacy of digital vaccine passport users be protected? How will the technologies operate? Is it morally acceptable to use Covid-19 vaccination status as a precursor to public life?

BLOK BioScience: certifying Covid status through QR codes

One organisation working on developing a vaccine certification system is BLOK BioScience. The company has developed two apps, BLOK Pass and BLOK Verify, which work together to verify an individual’s Covid status before they enter a venue.

BLOK BioScience commercial director Ed Rayner says: “As the app is built using self-sovereign ID technology, the information is completely private and never leaves [the user’s] device.”

Self-sovereign identity (SSI) is an approach to digital identity that gives individuals control over their own digital identities. With an SSI platform, the power to control personal data resides with an individual rather than an administrative third party granting or tracking access to these credentials.

The BLOK Pass app allows users to record relevant Covid-related information, such as vaccination status, test results or symptoms information. This gives them a risk status via a red, amber or green QR code, which they can then use to enter a venue which is using the platform.

The BLOK Verify app can then be used by a facility to check the health status of individuals who want to enter to ensure they meet pre-selected criteria, such as full vaccination, a recent Covid test or being symptom-free. If they meet the criteria their QR code for that organisation goes green; if they get an amber reading they might be required to take an action such as a rapid test for entry, while a red QR code indicates that the person presents a high risk for spreading Covid-19 infection.

“No information ever leaves the individual’s device – it is simply the colour of the QR code that shows whether they meet the entry criteria,” says Rayner. “Organisations can configure the entry criteria to implement new government guidance, and can vary the rules depending on infection rates, the latest scientific understanding and the organisation’s risk management needs.”

Of course, the need for host facilities to also run the BLOK system highlights yet another complication of the evolving situation around digital vaccine passports – will a single system gain ubiquity in the market, or will users have to maintain a confusing tapestry of third-party apps to move freely? National governments might be able to influence the competitive landscape to reduce complexity for users within their own borders, but there is still a risk of confusion about which systems to use when travelling internationally, and interoperability will be a key consideration to avoid these issues.

iProov: access to a location through facial verification

Another organisation working to develop a vaccine passport platform, based on distinctly different technological principles, is identity-check software provider iProov.

iProov’s Covid-19 certification platform uses facial verification technology to confirm an individual’s Covid status. The solution, jointly developed with Mvine and backed by £75,000 of funding from Innovate UK, went into live testing in January. The company has previously won contracts to supply identification technology to banks, HMRC and US border security.

“There are two key characteristics about this architecture: one is that the certificate is in the cloud,” says iProov CEO Andrew Bud. “If you drop your phone in the toilet, your certificate doesn’t disappear. Secondly, the bearer can authenticate their ownership of the certificate through automatic face verification.

“One possible model is that a public health authority issues you with a QR code with your name and date of birth on it. You photograph that QR code and at the same time, you enrol your face. A new credential is then created within the iProov Mvine system, which contains nothing but your Covid status, plus your face.”

Bud maintains that, despite capturing the user’s face for verification, the platform is completely anonymous, as it does not contain any other personally identifying information such as the person’s name or date of birth.

“One of the things people may worry about is their face,” says Bud. “But their face has been filed anonymously, alongside a single fact, that the person has been vaccinated or recently done a Covid test. That’s all. No name, no address, no date of birth, nothing that will actually say who they are.”

Can vaccine passports be ethical and inclusive?

The UK Equality and Human Rights Commission (EHRC) has advised the British government that Covid status certificates could amount to unlawful discrimination, creating a two-tier society of the vaccinated and unvaccinated.

The watchdog has said employers should not be allowed to instate a ‘no jab, no job’ policy until all young people have been offered the vaccine. The impact digital vaccine passports could potentially have on young people has been a significant talking point in discussions around their potential rollout. Many pundits have argued that it would be unfair for such a scheme to come into place when significant swathes of the population have yet to even be offered a vaccine, with most countries rolling out Covid-19 vaccines on some sort of age-based priority system.

The EHRC also noted that digital vaccine passports risked discriminating against individuals from protected categories in society – including migrants, people from minority ethnic backgrounds and people from poorer socioeconomic groups – due to lower vaccine uptake in these groups.

Still, Rayner maintains that vaccine passports can in fact be ethical and inclusive, telling Medical Device Network that the BLOK BioScience system is the only Covid health pass in the world to be ID2020-certified for passing 41 technical and ethical requirements.

The company is also founding member of the global Good Health Pass Collaborative, which is working to ensure that vaccine passport solutions are ethical, privacy-focused and interoperable.

“We truly believe that vaccine passports can be ethical and inclusive but they have to be designed that way from the ground up. You can’t bolt on ethics,” says Rayner. “From the very beginning of the pandemic we have talked about the need for end-to-end systems that allow people who cannot get vaccinated or choose not to get vaccinated to have a simple way of accessing the same things as those who do get vaccinated, either by taking a rapid test or through other criteria such as self-declaration of symptoms. There also needs to be offline options, such as our guardianship model, where people who are perhaps less digitally-savvy can store their record on the mobile device of a trusted family member or carer.”

However, there are some who argue it is not the role of the software developer to decide whether or not digital vaccine passports are ethically acceptable.

Bud says: “We are technologists, and our job is to provide technology that gives society choices. It’s not our job to make those choices. That is a job for politicians, for civil and democratic society. It’s a social question of deciding how to apply these things equitably, not a technological one.