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COVID passes and vaccine passports may promise the ideal solution to avoiding further lockdowns in the UK or pose a threat to people's freedoms and right to privacy, experts argue in a debate published by The BMJ today.

Experts whose institutions have carried out research into the impact of using such tools to try and prevent the spread of the coronavirus have different opinions about whether or not they are a valid alternative to lockdown.

In the debate, the authors distinguish between a 'vaccine passport' which is a document or app showing evidence of vaccination status only; and a 'COVID pass' which is a document or app showing evidence that a person has either a lower risk COVID status based on their vaccination record, a recent negative lateral flow or PCR test, or a positive antibody test showing they had the infection before and have some level of immunity.

Researchers from the Tony Blair Institute for Global Change in London argue that COVID passes are a useful tool to enable people to prove that they are either fully vaccinated against the coronavirus, have immunity from a previous infection, or have recently tested negative for COVID-19.

If people are asked to prove their before entering a crowded or enclosed environment, this can potentially reduce the risk of COVID being spread.

Kirsty Innes and Daniel Sleat from the Institute highlight the government's Events Research Program pilot which had provided optimism that tools such as a COVID pass would help limit transmission at mass events.

In the first phase of that program, only 28 cases of COVID-19 had been detected in 7,764 participants who completed the full testing requirements.

The Institute carried out an analysis based on a June 2021 model of the virus's spread, created by researchers at Imperial College London for the UK's Scientific Advisory Group for Emergencies (SAGE).

This showed that if the government had opted to make COVID passes mandatory for crowded indoor and mass attendance settings in England after the lifting of final restrictions on 19 July, this could have reduced cases and deaths by as much as 30%.

They acknowledge that safeguards are needed before adopting widespread use of COVID passes such as ensuring that people who are unable to have a COVID vaccination are not "unduly excluded", if passes become legally required, legislation should limit their use to managing the current COVID pandemic, and protecting and maximize privacy.

They say: "In the context of rising cases or, worse, a new and more dangerous variant, a COVID pass is the best mechanism we have to target restrictions and avoid the need for another hard lockdown. Ultimately, faced with further spikes, we either force everyone to stay at home or we require only those with the virus to do so."

Imogen Parker, associate director at Ada Lovelace Institute, London, and policy fellow at Centre for Science and Policy, University of Cambridge, argues against COVID passes.

Like more traditional public health measures such as mask wearing or social distancing, passports can reduce risk, but cannot guarantee safety, she believes. Communicating vaccination or test status provides some information about risk, but it does not prove that people are free or safe from the virus.

Parker cites the experience in August of this year at the outdoor Boardmasters Festival in Cornwall which used vaccine passports with additional testing, but it still became a "super-spreader" event, incubating almost 5,000 cases.

The Ada Lovelace Institute's own research on the issue did not rule out passports as a valid tool to help transition from lockdowns but called for transparent scientific foundations such as models on their public health effects in comparison with other tools and technical design standards with clear, specific, and limited purposes.

Parker warns that unlike masks or distancing, passports introduce "profound risks" into society such as the risk through segregation of introducing barriers to economic and social participation as some people might not want to or be unable to be vaccinated.

In addition, normalizing third party policing of individuals' status could contribute to additional barriers for minority ethnic people, who already faced "over-policing", she argues, or people with insecure citizenship.

There was also a risk of creating "enduring surveillance technology", as she explains: "Technology justified for emergencies has a habit of becoming normalized."

Digital tools make data easy to share, which could benefit health research, but could also allow personal information to be shared with police or insurance companies for example, she adds.

"To create the technical, operational, legal, and policy infrastructure that would be required, policy makers should pause to calculate whether these are a justified health measure or whether investment in passports might prove to be a technological distraction … from the best mechanism available for us to reopen societies safely and equitably: global vaccination," she concludes.

More information: Are vaccine passports and covid passes a valid alternative to lockdown? BMJ (2021). DOI: 10.1136/bmj.n2571

Journal information: British Medical Journal (BMJ)