Written by Julian Savulescu and Alberto Giubilini
The government has reportedly flirted with the introduction of vaccination passports that would afford greater freedoms to people who have been vaccinated for COVID-19. However, the UKs Minister for the Cabinet Office, Michael Gove, recently announced that vaccination passports are not currently under consideration in the UK. However, the issue may linger and businesses may introduce such requirements.
One of us (JS) defended immunity passports in the context of affording people with natural immunity greater freedom during lockdown, if immunity significantly reduces the risk of infecting others.
Vaccination passportsafter vaccines have been made availablecan be seen as a mild form of mandatory vaccination. Proof of vaccination could be a requirement to, for example, access certain places (e.g. restaurants, hospitals, public transport, etc, depending on how restrictive we want the mandate to be) or engaging in certain social activities (e.g. mixing with people from different households) or enable health care or other care workers to not self-isolate if in contact with a person with COVID (there were 35 000 NHS workers in isolation at the peak of the pandemic because of contact). It is worth noting that this kind of measure has already been in place globally for a long time in a more selective way, e.g. in the US where, in most states, children cannot be enrolled in schools unless they are up to date with certain vaccinations. These are also a form of vaccination passports, which simply do not use that term. Yellow Fever Vaccination Certificates are required to travel to certain parts of the world where Yellow Fever is endemic.
The ethical ground for restriction of liberty is a person represents a threat of harm to others. That is, the grounds for lockdown, quarantine, isolation or mandating vaccination is to reduce the risk one person poses to another. However, if a person is no longer a threat to others, the justification for coercion evaporates. If either natural immunity or a vaccine prevents virus transmission to others (and this remains to be determined), the grounds for restricting liberty disappear. This is one argument for an immunity or vaccination passport it proves you are not a threat to others.
Moreover, if we thought there were sufficient grounds for the drastic and long lasting restrictions of individual liberties entailed by lockdowns and isolation requirements, it is at least legitimate to ask whether there are also sufficient grounds for vaccination passports, given that the individual cost imposed getting vaccinated is likely to be much smaller than the cost entailed by those other measures (unless the risks of vaccines are significant).
However, the more effective a vaccine is, the greater the opportunity for individuals to protect themselves. A Libertarian could then argue that the risk of harming others is nullified. If you want to protect yourself, you can vaccinate yourself. If this is true, then a vaccine doesnt need to give us herd immunity. We can take individual responsibility.
Many objections can be raised against vaccination passports. For example, it is not clear to what extent vaccines will reduce transmission. However, this is something which can be addressed by science: we can work out whether natural or vaccine immunity prevents transmission by empirical work, such as employing challenge studies or other experimental designs. If it turns out that immunity is a short-lived phenomenon, then, assuming large enough availability and easy enough access to the vaccine, passports could simply be renewed with a new vaccination, in the same way as we periodically renew normal passports in order to be allowed to travel in certain countries.
Others would argue that this is the step towards an authoritarian regime which restricts liberty. However, liberty is already extraordinarily infringed by lockdown and it is hard to see how immunity passports could be worse in this respect. Indeed, it could also be argued that vaccination passports would actually increase peoples liberties: if the baseline is lockdown, having the option to leave increases options (of course, this assumes lockdowns are valid).
An analogy one of us (JS) has given in the media is with smoking in the workplace. This freedom can legitimately be restricted to ensure workplace safety and to prevent harm to others by passive smoking. Going to work unvaccinated, JS argued, is like smoking in the workplace.
But actually, there is a major disanalogy here. There is nothing you can reasonably do to protect yourself if you are non-smoker from passive smoking in the workplace. You have to breathe the air. But there is something that you can do to protect yourself from COVID-19: get vaccinated yourself.
Thus, the strongest argument against vaccination passports is that there is something people can choose to do to lower their own risk: get vaccinated. This is what makes the strongest case against vaccination passports stronger than the strongest case against immunity passports (which could be obtained after immunity is mounted through natural infection): the choice to reduce their personal risk by vaccination is more reasonable and safer than the choice to get voluntarily infected in order to acquire immunity.
So the argument that, for example, airlines like Qantas need to protect their staff and other passengers by requiring everyone to be vaccinated and to prove it through vaccination passports is flawed. Staff and passengers who are concerned about infection can choose to be vaccinated and protect themselves. It doesnt require others to be vaccinated, or so the libertarian would reply.
This stance of course assumes vaccines are highly effective. We are told that some of them might be more than 90% effective although these are only preliminary, not peer-reviewed data. Paradoxically, the less effective they are, the weaker the libertarian objection becomes because the less people can reliably protect themselves. When effectiveness is low, we need more people vaccinated to maximize the chances of achieving herd immunity
Importantly, there will be people who cant be vaccinated for medical reasons they require herd immunity. The libertarians response could be that they can protect themselves through social isolation. And given that this will be relatively rare, then the argument might be that it is a reasonable cost to pay rather, compared to infringing upon the liberty of a whole society by requiring vaccination passports to enjoy certain freedoms.
However, we need to consider not only how rare these cases are, but also the size of the costs involved. It seems reasonable to require the majority to pay a small cost (e.g. to be vaccinated, assuming the vaccine is very low risk) in order to prevent a very large cost (e.g. self-isolation) to a minority. After all, many policies are structured in this way. For example, wehave parking spots allocated to people with disabilities and which are typically less likely to be occupied, and placed in more convenient locations. The majority of people pay a small cost having to park further away or spending more time looking for a spot to park in order to prevent a large cost to people with disabilities who might have significant difficulties if they had to park further away.
The best response to the libertarian argument may be that it is important to protect those in whom vaccination is not effective, those whose immunity wanes and those who cant get vaccinated for medical reasons. If we really value liberty, the liberty of these persons to enjoy as normal a life as possible without unnecessary risks weighs in favour of introducing vaccination passports.
However, in the end, as with most practical ethics we must weigh competing reasons: liberty, well-being, for the worst off vs the wider population. Hopefully the vaccines will be effective, safe and in sufficient supply and sufficiently attractive to enough people to achieve herd immunity quickly then people can make their own decisions
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