LULU GARCIA-NAVARRO, HOST:
The U.S. is getting there. More than 100 million Americans have received at least one dose of a coronavirus vaccine. Twenty-five percent of adults are fully vaccinated. And yes, that means a return to some sense of normalcy is on the horizon. But this is a tricky stage in the pandemic, as we can tell from the ongoing surge of COVID-19 cases in the Upper Midwest. So businesses and governments are trying to figure out if they can or should distinguish between two groups of people - the have had the shots and the have-nots. Lawrence Gostin is a global health law professor at Georgetown University and has written about so-called digital health passes. And he joins us now. Welcome to the program.
LAWRENCE GOSTIN: Thanks very much, Lulu. Thanks for having me.
GARCIA-NAVARRO: You wrote about this this past week in the Journal of the American Medical Association - the idea of a digital pass showing your vaccination status and presumably allowing entry into different businesses or spaces. This has stirred up some controversy, though. But the idea of needing to verify vaccinations has been around for a while in public schools, for example.
GOSTIN: Oh, it sure has. I think we're likely - very likely to see it, and some colleges and universities have already announced that they're going to be doing this in the fall for COVID-19 vaccine. So it's not as unusual and uncommon as people may believe.
GARCIA-NAVARRO: The federal government under President Biden, though, has ruled out rolling one out.
GOSTIN: Yeah. Traditionally, in the United States, public health powers reside in the states, not in the federal government. So, you know, even if President Biden wanted to introduce a federal vaccine passport, it would really be stretching the limits of his power even if he did want to. It's also true that, beyond government, probably most so-called, you know, vaccine passports will be introduced by the private sector - for example, those that really need to get back up and running and have to assure that they're a safe place to work and to shop and to visit.
GARCIA-NAVARRO: I mean, I've already seen, for example, in some industries, like babysitting, home care, they're offering people with sort of vaccine badges. But how would people get a digital health pass? I mean, what would it even look like?
GOSTIN: Yeah, I mean, if we did do it, it should have the state involved because every state in the country has an immunization information system. It's like a registry. It's like a vaccine registry. And already, private companies like IBM are developing applications on your phones that would enable this. In fact, New York state is going to introduce a pilot program, but it's going to be on a voluntary basis.
GARCIA-NAVARRO: We're also not sure how long immunity lasts. I mean, would vaccine passes have to expire? Could people fake vaccine certification?
GOSTIN: Yeah, the challenges are very real. Authentication is hard, and we want to make sure that everybody uses this application fairly and doesn't, you know, forge it or somehow try to get around the requirement. And so we do need to find ways to authenticate it. But as we get more data - more real-life data about immunity, yes, we're going to need, perhaps, to have an expiration date. People may very well need boosters. The other thing that we have to understand is that there will probably be some cases where even a vaccinated person might be able to transmit it, and we need more data about that. So so-called vaccine passports can't provide a guarantee, but they can certainly provide a cushion of safety.
GARCIA-NAVARRO: Let's talk about the ethics because I can imagine that "vaccine passports," quote, unquote, could work as an incentive. I mean, we're seeing that in Israel where they have something similar to this that allows you access to into certain spaces. And that might mean that people who were hesitant would want to get the vaccine. But it could also worsen inequality.
GOSTIN: Yeah, it could. I mean, there are some governors in the United States who just are absolutely against it. For example, Governor Abbott in Texas and Governor DeSantis in Florida have issued executive orders essentially banning the use of digital health passes. I don't accept their ethical argument, you know, because there's this view that if you show your vaccine status, somehow that's an infringement of your liberty. And in my view, it's absolutely true that any of us has an absolute right to make decisions that affect our own health, safety and welfare. But we don't have a right to expose other people to potentially dangerous, maybe even lethal infectious diseases.
But there are very important equity questions. It would be grossly unethical, in my view, to give privileges to the already privileged and to leave the poor and racial minorities behind. So we have to fix equity before we can do these digital passports, and what that means is that everybody who wants a vaccine can get a vaccine. And only then should we introduce these kinds of systems.
GARCIA-NAVARRO: That's Lawrence Gostin, a global health law professor at Georgetown University, walking us through the very complicated and ongoing discussions around what to do if you get the vaccine. Thank you very much.
GOSTIN: Thank you, Lulu. Appreciate it. Transcript provided by NPR, Copyright NPR.