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The recent Indo-UK imbroglio has illustrated the inadequacy of a system that views a vaccine certificate or passport as an additional “licence to travel”, something that public health experts have been calling out for sometime now.

Vaccine passports have been called “unethical”, given the lop-sided distribution of vaccines around the world. Some doctors are also calling it “unscientific”, as the Covid-19 infection, in their view, provided greater immunity in an individual than the vaccine.

So to prevent someone who may have had the infection from travelling (for not being vaccinated) was not based on sound science, they point out.

Countries, nevertheless, are calling for vaccine certificates or passports from inbound travellers. Not just as proof of vaccination, but also as certification that vaccination was from the precise companies listed by their country.

Also read: Canada lifts ban on direct flights from India

Vaccine industry representatives point to a troubled road ahead for international travellers, as more vaccines get approved in different countries.

Not all may get a World Health Organization stamp of endorsement, soon enough. Bharat Biotech’s Covaxin, for instance, awaits a WHO green-light. And Russia’s Sputnik V vaccine faces its own issues with manufacturing. Both vaccines are deployed in India, and recipients are worried if their vaccinations would, in fact, be recognised in other countries.

Public health pitfalls

Pointing to the pitfalls in the vaccine passport approach, Martin Kulldorff, Professor of Medicine, Harvard Medical School, told BusinessLine, “Prior Covid disease provides stronger immunity than vaccines, so vaccine passports are unscientific.”

Besides, “since Covid affected the poor the hardest while the rich are more likely to be vaccinated, vaccine passports are also discriminatory and unethical,” he said, adding further, “While anyone can get infected, there is more than a thousand-fold difference in mortality risk between the old and the young. Vaccine passports for travel will entice young low-risk professionals to get the vaccine before older high-risk less affluent people, leading to more deaths. That is also unethical.”

Digital record

The WHO does not support the requirement of proof of Covid-19 vaccination for travel. Pointing out that vaccination certificates are not new, WHO explains, they are but health documents that record a vaccination event – traditionally as a paper card – with key details including the date, product and batch number of the vaccine administered.

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A digital Covid-19 certificate is a mechanism recording a person’s Covid-related health data, electronically. “And in some situations, depending on the risk assessment of countries, vaccination information may be used to reduce quarantine or testing upon arrival,” it added.

Mutual recognition

In the UK fiasco, the flaw in bracketing travellers based on vaccines taken, played out in public view as their initial list of approved vaccines did not mention Covishield from Serum Institute of India.

Covishield is the AstraZeneca-OxfordUniversity vaccine, and 5 million doses had been shipped earlier this year for use in the UK. Covishield is also recognised by the WHO.

This epicentre of the UK travel storm, has since shifted from vaccine to the vaccination certificate, as the reason behind the quarantine for travellers from India.

Also read: A lesson from polio vaccination to address hesitancy for COVID-19 vaccine

Experts point to the flaw in tarring an entire system with a super black brush, for some warts that may have shown up in the digital certification. Countries need to move towards mutually recognising vaccine certificates, they say, so vaccine recipients do not face an added anxiety.