With Covid-19 causing extraordinarily intrusive and costly lockdowns, “passports” or vaccine certificates are increasingly seen as the key to getting out of them.
Decision makers and gatekeepers, from border guards to maître d’s, will have a means of knowing who can safely relate to others.
To that end, the New Zealand government aims to have one in place by the end of the year. But vaccine passports have also sparked riots and protests abroad, and there are still unanswered questions about their use domestically.
A central concern is that they will cause or exacerbate inequality because access to a passport depends on access to vaccines, and access to vaccines has been uneven.
At the international level, citizens of some countries are more likely to have access to vaccines, and therefore to vaccine passports, than citizens of other countries. And within countries, some individuals and groups are more likely to have access to vaccines than others.
Furthermore, these inequalities follow familiar and ethically troubling dividing lines: New Zealand has struggled to raise vaccination rates for Maori to match those of European New Zealanders, although Maori are at higher risk.
And vaccine passports could exacerbate existing inequalities, as those who have them return to work and other activities, while those who do not have them are trapped.
Inequality and discrimination
But there are reasons to think that these legitimate concerns do not automatically mean that vaccine passports are unethical.
First, the need to contain Covid-19 justifies the significant restrictions on important freedoms in the confinements. But as long as vaccines work, that justification doesn’t apply to someone who has been vaccinated. The justification for restricting freedoms is gone (or at least, given the possibility of breakthrough cases, has been considerably weakened), so for those vaccinated the restriction should also go.
Second, distinguishing between people on the basis of their Covid-19 immunity may be discrimination, but it is not obvious that it is unjustified discrimination.
Whether someone is vaccinated or not is a legitimate ground for discrimination.
The unvaccinated (for whatever reason) pose a greater risk to others than the vaccinated. They are also more likely to suffer severe symptoms if they contract Covid-19.
Third, one reason for tolerating inequality is that it sometimes improves the position of the disadvantaged. We could tolerate high incomes for doctors, for example, if the promise of higher incomes led people to study medicine and we believed that a good supply of doctors benefited the most disadvantaged members of our community.
Vaccine passports can work in the same way. They help jump-start the economy, so the government can support those who are still stuck. They are also an incentive to vaccinate, and high vaccination rates are good for everyone, perhaps especially the unvaccinated.
An offer you can’t refuse
But the use of vaccine passports as incentives raises some real problems. How they are used is critical. Under some proposals, vaccination passports are (like conventional passports) essentially another international travel document.
However, more and more countries (including potentially New Zealand) are proposing its use to control access to a wide range of household activities, such as returning to work in person, dining out, or attending concerts and sporting events.
In this context, it is clear that some incentives can be coercive: they can be an offer that you cannot refuse.
Some people are desperate to travel abroad, perhaps for good family reasons. But most of us can still decide if the IATA Travel Pass incentive is enough to motivate us to travel.
However, many people simply will not be in a position to decline the incentive of a national vaccine passport. Returning to work and a life prior to Covid-19 will not be a discretionary matter. For them, national vaccination passports are likely to be coercive.
At least for now, the government insists that vaccination will not be mandatory. But effectively it will be for those who have no choice but to get a vaccination passport to work or have access to non-discretionary domestic activities.
And that coercion will not apply equally. There will be much greater pressure on those who are already socially disadvantaged and less able to make a real decision.
Coercion is sometimes justified, and perhaps the threat posed by Covid-19 justifies it.
However, we must be careful to accept types of coercion that are discriminatory and inequitable.
Governments must be clear
So what should we do about vaccine passports and vaccine incentives?
We may restrict them to more discretionary activities, such as international travel, concerts, and restaurants. That would be an offer anyone could turn down, especially those already disadvantaged.
But this use of passports could be an insufficient incentive: too many people could refuse to get one. That is a problem if we believe that trying to increase vaccination rates is justified.
That’s why we believe governments have a choice: They must address concerns about vaccine passports by avoiding coercive, discriminatory and inequitable uses.
Alternatively, they must acknowledge their position that Covid-19 justifies coercion and make vaccination mandatory.
The second option would be less discriminatory and seems less likely to threaten trust and cooperation than the surreptitious and unequal compulsion provided by the wide range of requirements for national vaccine passports.