Vaccine "passports" are making headlines and eliciting emergency measures by governors in a handful of states.
So what are these credentials, exactly, and what are they used for?
What is a vaccine passport?
It's a credential that can be used to show that a person has been vaccinated. The same technology can be used to show a person's coronavirus test results. It's a way to demonstrate a person's health status, generally through a smartphone app or a QR code that has been printed.
"It's really not a passport to necessarily cross borders. It's a certification. It's providing information about what your status is in some area," Dr. Zeke Emanuel, professor of medical ethics at the University of Pennsylvania and former member of President Biden's Transition COVID-19 Advisory Board, told NPR.
Sharon Pinkerton, senior vice president of policy at Airlines for America, an airline trade group, puts it this way: "It's really just digitizing a little piece of paper that has your vaccine information on it."
The basic idea is that you would have a QR code, likely stored in a digital wallet, that indicates your vaccination status. State health departments, pharmacies and health systems have this information; your status would be verified along with your identity and downloaded in some way, generating the QR code. The QR code would then be scanned by another app for entry.
Why are vaccine passports controversial?
Some people have concerns about how their health status will be stored and used. There are also concerns around equity: making sure that people of all ages and backgrounds have access to vaccination and to these credentials. And some people don't want to get vaccinated against the coronavirus, and they may bristle at the idea that their unvaccinated status could potentially block their access to certain places.
Like masks and vaccines, vaccine passports have become politicized.
Florida Gov. Ron DeSantis issued an executive order last week prohibiting businesses from requiring customers to provide any certification of COVID-19 vaccination to gain entry or service.
The order says that "so-called COVID-19 vaccine passports reduce individual freedom and will harm patient privacy," and that requiring the passes for "everyday life" activities like going to a sporting event, restaurant or movie theater "would create two classes of citizens based on vaccinations."
Texas Gov. Greg Abbott issued an executive order this week that prohibits state agencies from creating a vaccine passport requirement, or otherwise conditioning services on an individual's COVID-19 vaccination status. Organizations receiving public funds are prohibited from requiring consumers to provide documentation of vaccine status in order to receive service or gain entry.
Is the U.S. government going to require Americans to carry a vaccine passport?
The White House emphatically says no.
"The government is not now, nor will we be supporting a system that requires Americans to carry a credential," White House press secretary Jen Psaki said this week. "There will be no federal vaccinations database and no federal mandate requiring everyone to obtain a single vaccination credential."
The government's interest is to ensure that Americans' privacy and rights are protected and that such systems are not used against people unfairly, Psaki said.
"There is a movement, as you know, in the private sector to identify ways that they can return to events where there are large swaths of people safely in soccer stadiums or theaters. And that's something that — that's where the idea originated, and we expect that's where it will be concluded," she added.
Psaki said the federal government will soon provide guidance, like an FAQ, that addresses questions people have about privacy, security and discrimination.
What problem does a vaccine passport solve?
These credentials can be solutions to a few different problems, depending on the setting.
One is that they can help in allowing society to safely return to normal activities.
Emanuel, the bioethicist, says the passes can be a way of lifting the substantial restrictions that are currently in place due to COVID-19.
"In public health, there's a principle that you should use the least restrictive method necessary," he explains. "This [credential] allows us to say: 'Those people who've gotten vaccinated, you don't have to adhere to certain restrictions because you are now immune. You're not likely to pass or transmit the virus.' "
New York State says its Excelsior Pass is "a tool to support reopening New York's economy and accelerating the return to pre-pandemic activities" and "a free, fast and secure way to accept proof of COVID-19 vaccination or negative test results to aid compliance with State reopening guidelines." The pass is optional for use by people and businesses, and it can show vaccination status or the status of PCR or antigen testing.
For businesses like airlines that need to screen for a country's health requirements, digital passes are a huge time-saver.
"Digitizing paper essentially allows airlines to process passengers more quickly," says Pinkerton at Airlines For America. "What a digitized testing or health or vaccine credential would allow is us to make that determination automatically without an agent having to touch a piece of paper, look at it, determine it's accurate and meets the requirements. So this is really, in sum, an automation and a facilitation for passengers in order to speed up their journey through the airport."
Where might they be used?
They will almost certainly be used for international travel, where many countries already have testing requirements for arriving passengers. But they could also be used at sporting events, movie theaters, music venues, workplaces and for domestic travel.
Why are they called passports if they're not just for international travel?
It's a problem. Actual passports are generally required for international travel. These credentials, in contrast, are often optional and could be used much closer to home. Even for international travel, airlines say the new credentials are more akin to TSA Precheck or CLEAR – they're an optional means of faster check-in.
Folks working to develop the new COVID-19 status credentials generally say that "passport" is a misnomer, and say that a better term is "digital credential" or "health credential."
Where are these passes already in use?
New York State has already launched its Excelsior Pass, which is voluntary and can be used by a range of businesses.
For travel, some of these passes are already in use to satisfy coronavirus testing requirements. CommonPass, made by a nonprofit called The Commons Project, is being used on all Lufthansa flights from Germany into the U.S. JetBlue is trying out the CommonPass on flights between Boston and Aruba. United has tested it for flights between Newark and London Heathrow.
American Airlines is using an app called VeriFLY on international flights to the U.S., and on flights from the U.S. to at least eight countries.
Is there a precedent for requiring vaccine credentials?
Yes. Schools and universities commonly require proof of vaccination for students.
And for travel, such requirements are routine. Many countries have long required arriving travelers to have received specific inoculations.
There are other precedents where a certain kind of credential is optional, but can make for speedier entry, like TSA Precheck, Global Entry, or CLEAR.
Are these passes actually going to be required many places?
Due to politicization and other features of American life, the adoption of these passes may be scant in places like restaurants, theaters and music venues.
Georges Benjamin, the executive director of the American Public Health Association, told STAT that the passes represent a "slippery slope."
"It's impractical," Benjamin said. "This is a nation that does not allow a national identity card. Getting compliance is going to be hard, and I think it leads to politicization. I would like to avoid that."
Audrey Fix Schaefer at the National Independent Venue Association, an organization of independent music venues, expressed relief that there won't be a national requirement for such passes.
"We're grateful to learn that there will not be a national mandated verification program; independent venues will be making their own individual policy decisions taking into account guidelines and recommendations from the CDC. That said, while vaccine verification is the hot topic, we have questions and concerns surrounding the effectiveness of only implementing verification at live events and not other business where people gather, the cost implications for small businesses, and equitable access and ethical issues surrounding such programs."