First 100: The Case for Vaccine Passports

We’re in a health emergency and they can stop the spread.

by

It’s April 1, 2021 and welcome to First 100. You can sign up to have First 100 delivered to your email by clicking here.

The Chief

America has a problem, and not just the one about eager social media staffers for consumer brands trying out really bad April Fools Day jokes. Just like most of the world, we can’t seem to shake the coronavirus without one last surge. The numbers here are pretty clear: cases plateaued in mid-March and have now ticked back upward for the past week. In every other moment in this crisis, once case counts move back up they continue to do so until a peak. And this wave starts from a “low point” that’s as high as the case count in the second surge last summer.

The surge is for now concentrated in the Northeast and Midwest—particularly Michigan—but close to 30 states are seeing an overall rise. (California, where I’m at and where we had the worst of the third surge this winter, isn’t one of them.) The B.1.1.7 variant, which originated in the United Kingdom, now accounts for a quarter of the nation’s cases and is becoming predominant in the surge locations. My penultimate edition of Unsanitized in mid-January noted that the reduction in cases would be a “false dawn,” and that the more transmissible, more deadly B.1.1.7 would take hold and create a resumption in a couple months. Here we are. 

The other thing that’s happened every time in this crisis is that a rise in cases has been followed by a rise in hospitalizations, and then a couple weeks later by a rise in deaths. Hospitalizations are just starting to tick up. The difference this time is that we’ve got 150 million shots in arms, and will be adding nearly 3 million more every day. As my Unsanitized in January said, this is a race between the vaccine and the mutation, and we still have a chance for the vaccine to win and minimize the mutation’s damage. But only if we get the vaccine passport situation right.

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About 38 percent of the U.S. adult population has received at least one dose of the vaccine. For people over the age of 65 that number rises to 73.5 percent. This is the population where about 80 percent of the deaths come from, and the vaccine has proven extremely effective in preventing sickness and death. In fact the vaccines are a miracle, even better than we dreamed. They appear to be more effective in adolescents between age 12 and 15 than they are in adults. And we have more than just studies, but hard data from the CDC showing that people with full courses of the vaccine don’t get infected and don’t transmit the virus.

I do think that, like in the UK, the superior vaccine rollout will prevent at least some of the tragedy of the final surge. But not enough people have been vaccinated yet, and while we may get to that point in the coming months, at this point some outbreaks and deaths are baked in. What do we do to prevent even more? There are lockdowns, of course, but we’ve never really done them to a serious degree in the U.S., and the politics are nearly impossible, as are the economics.

Moreover, we have a large and growing segment of the population that doesn’t need to be locked down, that can return to mostly normal activities without fear. I got my first shot on Monday, and while I’m not comfortable with sitting in a restaurant or movie theater right now I will be within a month or so. It doesn’t make economic sense to prevent that, and there’s a real mental health toll to keeping people separated, especially if they don’t need to be.

So that brings us to the vaccine passport. The idea is that there would be a record that would allow admittance to businesses where lots of people congregate. If everyone in a theater or bar is vaccinated, based on the latest science they won’t be transmitting the virus to each other, and therefore not to the rest of the people they encounter once they leave. Right now it seems that there’s no appetite from the White House to create a federal mandate or database of people’s vaccination records, and to the extent that this may happen it will come from the private sector and the states. New York unveiled a vaccine passport last week that runs on the blockchain.

From the left I’ve heard objections like this from The New Republic’s Jacob Silverman, arguing that there are privacy and equity issues. The equity question is a month or so behind the actual vaccine rollout, and its effort to ensure that at-risk populations can get a shot. The numbers are improving rapidly off a very slow start. This is called an administrative “burden,” when it’s really not much different than a “no shirt, no shoes, no service” policy that’s rather typical.

On privacy concerns, I don’t see why the passport needs to be tech-enabled at all. Everyone vaccinated gets a card with a record of their shots. Just laminate that and we’re good to go. Yes, they can be forged, but the reality is that very few people, relatively speaking, will go through that trouble. If it takes that much effort to sit down in a McDonald’s, you’ll probably go to the drive-thru.

I think the Biden team should centralize this, actually, and maybe create a watermark for the laminated copy. Or states could require anonymized data and destruction within a set time period. But there actually is a bigger issue here than user data, believe it or not. It's mortality.

If Silverman has a better idea to prevent mass death my DMs are open, but we happen to be in a public health emergency. The variant’s power is that serious. This is a short-term measure to make it safer to live until we hit a critical mass of immunization. It allows businesses to reopen and workers to return safely to cater to a large population of the vaccinated. It’s completely legal and less intrusive than a vaccine mandate, which would also be legal.

The other option right now is a mass lockdown, which is actually far more inequitable for essential workers that are disproportionately people of color, and the overwhelming majority of seniors who now have the ability to go about their lives.

That is a conception of freedom that makes more sense than the conservative objection, which is that vaccine passports are the road to serfdom. The conservative concept of freedom is the same as that of a 6 year-old. That somewhat apocryphal quote applies here: “My right to swing my fist ends where your nose begins.” When your liberty to do what you want starts to affect me, it ceases to become liberty for the greatest number involved. Nobody has the right to make countless people sick, just like nobody has the right to punch people.

A global passport is going to be a heavier lift; if we did rapid testing for cross border entry it could probably work. And of course we should vaccinate everyone on Earth, and take down any intellectual property claims that preempt that. We need to do this to stop mutations from spreading that may become vaccine resistant. But as a short term measure to stop disease and restore some normality? Bring on the passports.

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