Tech and health organisations come together to create a ‘digital COVID-19 vaccine passport’

Profile picture for user ddpreez By Derek du Preez January 15, 2021 Audio version
Summary:
Users will be able to present their COVID-19 vaccination records via digital wallet - but ethical questions will likely arise in response.

Image of a vaccine needle injecting the world
(Image by Arek Socha from Pixabay )

A consortium of technology and health organisations - including Oracle and Salesforce - have come together to work on developing a standard model for organisations administering COVID-19 vaccines to make the immunisation data available in an accessible, interoperable, digital format. 

Simply put, the Vaccination Credential Initiative (VCI) is working on creating digital immunisation passports, for those that have received one of the COVID-19 vaccines. That being said, the alliance has also said that those without a smartphone could receive paper printed versions with QR codes as an alternative. 

The COVID-19 pandemic has gripped the world, restricting movement, work, relationships and broader freedoms. With countries beginning to roll out available vaccines, it was inevitable that some governments and companies will be thinking about how to identify those that have received the vaccine and those who have not. 

Today we have heard how a large plumbing company in the UK has said that it will require its employees to provide evidence of vaccination in order to return to work. 

Those involved with the coalition include VARIN Alliance, Cerner, Change Healthcare, The Commons Project Foundation, Epic, Evernorth, Mayo Clinic, MITRE, Oracle, Safe Health and Salesforce. 

VCI states that the current vaccination record system does not readily support convenient access, control and sharing of verifiable vaccination data. It is looking to enable digital access to vaccination records - via digital wallets, such as Google or Apple Pay - using the interoperable SMART Health Cards specification, based on W3C Verifiable Credential and HL7 FHIR standards. 

The design goals for these standards include: 

  • Supporting an end-to-end workflow where users receive and present relevant healthcare data

  • Enabling workflow with open standards

  • Supporting strong cryptographic signatures

  • Supporting binding credentials to keys stored on a user's device

  • Enabling privacy preserving data presentations for specific use cases

Just this week we spoke with Salesforce's Chief Medical Officer about how organisations are using data during the COVID-19 pandemic, where she claimed that if that data is abused, then those organisations will face a "reckoning". 

The consideration and introduction of ‘vaccine passports' is likely to raise serious ethical questions, however. Elsewhere, the EU is set to debate the idea, with many state leaders wary. 

Paul Meyer, CEO of The Commons Project Foundation, said: 

The goal of the Vaccination Credential Initiative is to empower individuals with digital access to their vaccination records so they can use tools like CommonPass to safely return to travel, work, school, and life, while protecting their data privacy. 

Open standards and interoperability are at the heart of VCI's efforts and we look forward to supporting the World Health Organization and other global stakeholders in implementing and scaling open global standards for health data interoperability.

Mike Sicilia, executive vice president of Oracle's Global Business Units, said that electronic access to vaccination records will be "vital to resuming travel and more", whilst Bill Patterson, EVP and GM of CRM applications at Salesforce, said that the initiative will "help us all get back to public life".

Ethical considerations

A digital vaccine passport with secure access to health records will be compelling for many governments and organisations, as they look to find ways to return life to normal and kickstart economies. With clear evidence of having received a COVID-19 vaccine, people could in theory return to work, travel, socialise and go about their lives as ‘normal', without the risk of causing further spikes in infection. 

However, privacy organisations will likely speak out against the move and there are some serious ethical considerations to take into account. 

For example, there will likely be concerns that a digital vaccine passport - given that it will mostly be moved to enable the movement and potential tracking of people (venue check ins, etc) - erodes basic privacy rights. People have been more willing to share their data with organisations during the COVID-19 crisis, but whether that attitude will persist remains to be seen. 

Not only this, but organisations and countries need to consider what precedents they could be setting. Sharing health information readily via digital passports - something that would have been considered Orwellian just a short few months ago - needs to be carefully scrutinised. 

In addition, knowing, having evidence of and sharing your ‘COVID-19 status' could lead to further discrimination in society - creating a tiered system of who is ‘safe' and who isn't. This will be particularly troubling in societies where access to a free vaccine via universal healthcare is limited. 

One academic paper notes, for example, that people living with HIV are subjected to restrictions on entering, living and working in certain countries with laws that impinge on the rights of those from sexual and gender minorities. The long-term consequences of documenting (albeit digitally) your COVID-19 status need to be thought through. 

My take

Simply put, whilst vaccine passports offer a huge opportunity to enable freedoms that have been sorely missed during the COVID-19 crisis, there are also a number of ethical considerations that should be thought through in their implementation. This isn't something that should be rushed in order to ‘get back to normal'.