Vaccine passports to travel freely are still a dream—except in China

Policymakers and health officials have teased such documentation and the freedom of movement it could bestow as reasons to get a COVID-19 vaccine. But the practical challenges of rolling out a vaccine passport—Should it be analog or digital? Is it universally recognized? What about privacy concerns?—mean its tantalizing promise is proving difficult to realize. 

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In Europe, government officials are negotiating the details of a digital vaccine passport agreement but have hit snags on issues like how to ensure data privacy and the ethics of limiting travel among those who aren’t eligible for vaccines.

In the U.S., airline and business groups are pressuring the Biden administration to be a “leader” in developing a vaccine passport system. President Joe Biden signed an executive order instructing a committee to investigate how a vaccine passport system might work in January, but the White House has yet to announce any results or publicly endorse such a scheme. 

In China, meanwhile, a vaccine passport system is already taking shape. Dubbed “international travel health certificates,” the scheme launched nationwide on Monday as a free app.

China’s Foreign Minister Wang Yi buried the announcement deep in an hour and a half long press conference on the sidelines of China’s Two Sessions annual political summit on March 7. Hours later, China’s Ministry of Foreign Affairs released instructions on how to download the vaccine passport mini-program, built on China’s Tencent-owned WeChat messaging app.

But the Chinese government, with the help of Tencent, developed the system in a black box, without input from any international organizations or foreign countries.

Currently, China’s vaccine passports don’t have the power to permit international travel. And as other governments raise concerns about China’s data privacy practices and experts question the efficacy of China’s vaccines, it’s unclear if they ever will.

Going global

China’s international travel health certificates are QR codes displayed via a mini-program on WeChat’s app. When scanned, the certificates link to a record of the user’s vaccine and COVID-19 test history, collated by China’s National Health Commission.

Its design is similar to the track-and-trace systems Chinese authorities devised last year to monitor citizens’ risk for COVID-19.

Many track-and-trace systems designed by other countries either never got off the ground or failed altogether. A report issued on Wednesday by the U.K. Parliament found that the government’s national contact tracing scheme had “no clear impact” on reducing transmission despite its budget of $51 billion over two years.

China’s track-and-trace system, on the other hand, was a success because it was all but mandatory for anyone wanting to visit a restaurant or enter a housing complex. Plus, the two platforms that facilitated the system’s QR codes—WeChat and rival Alipay—were already ubiquitous in China, making adoption almost frictionless. But China’s track-and-trace apps were built entirely for domestic use and never needed outside validation. Vaccine passports, meanwhile, are mostly useless unless other countries decide to accept them.

On Wednesday, China’s foreign ministry spokesperson told reporters that “many countries and some international organizations” have expressed “readiness” to recognize China’s new vaccine passport, but currently no foreign authorities have signed on publicly.

One potential hang-up is not necessarily the system itself but the soundness of what a Chinese vaccine passport professes to prove: that its holder is protected against COVID-19.

“Given the lack of transparency [in Chinese vaccine development]…other countries may raise the concern of whether to recognize China’s immunity passport,” says Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations. 

Beijing has approved four vaccines for domestic use, two from state-owned vaccine maker Sinopharm and one each from the private firms CanSino and Sinovac. None of the manufacturers, however, have published data on their vaccines in peer-reviewed medical journals, a fact that has drawn criticism from foreign leaders like French President Emmanuel Macron.

And therein lies the enormous challenge of any vaccine passport system. It asks countries to recognize another nation’s vaccine as legitimate and effective, even if it hasn’t authorized the vaccine itself—a big ask considering the global patchwork of vaccine approvals.

Ben Cowling, an epidemiologist at Hong Kong University, says that it may be difficult for governments to make determinations on immunity given the varying efficacy rates of different vaccines. For example, the Pfizer-BioNTech vaccine that’s being distributed in the U.S. and 70 other countries is 95% effective in preventing COVID-19 infections, while China’s Sinovac vaccine is just over 50% effective.

“[Difference in efficacy rates] is a limitation specifically for vaccine passports because the idea is to prevent people from entering a country even if they have only a mild form of infection,” Cowling says, adding that the level of contagion in a visitor’s country of departure will be another risk factor.

China says it will negotiate acceptance of its vaccine passports on a country-by-country basis, and it may find plenty of willing participants among the roughly 40 countries that have struck deals to use China-made vaccines. But there may also be limits to how much its vaccine passport program can scale via one-off deals with other governments.

“[Vaccine passports have] to be coordinated at an international level, ideally, through multilateral means,” says Huang, noting that negotiating at a bilateral level is both costly and time consuming. But, thus far, multilateral discussions aren’t proving to be any easier, and the world’s leading health authority, the World Health Organization (WHO), seems reluctant to endorse such a system.

“I think there are real practical and ethical considerations that countries will have to address [before introducing vaccine passports],” Dr. Mike Ryan, executive director of the WHO’s Health Emergencies Program, said at a press conference on March 7, explaining that the WHO likely will not recommend the passports until vaccines are distributed widely and equitably. 

That could be a long way off. In January, the Economist Intelligence Unit estimated that 85 of the world’s poorest countries will not achieve widespread vaccination until 2023 or later. 

Off the ground

But China isn’t the only nation pushing ahead with an independent passport scheme. On Monday, Singapore flag carrier Singapore Airlines announced it would be the first airline in the world to validate vaccine records using the International Air Transport Association’s (IATA) Travel Pass: a mobile app that verifies COVID-19 health and vaccination records to facilitate international travel.

JoAnn Tan, divisional vice president of business transformation at Singapore Airlines, said in a statement that the pilot scheme—which Singapore Airlines is using on flights between Singapore and London from March 13 to March 28—could help create an “industry standard” for digital health certificates in international travel. 

“If the pilot is successful, we will explore enabling customers to store their COVID-19 tests or vaccination certificates in the SingaporeAir mobile app,” a spokesperson for Singapore Airlines tells Fortune.

Despite the WHO’s reluctance to rush into the development of vaccine passports, the IATA, a trade group representing 290 airlines, is urging the WHO to craft international standards for verifying proof of vaccine for its Travel Pass.

In a note to Fortune, IATA’s head of corporate communications Albert Tjoeng says that each day without the standards “means the challenge gets bigger” in creating a system that governments around the world will accept. “This process needs to be accelerated,” he says.

Tjoeng clarified that the Travel Pass is not a vaccine passport but rather a tool governments can use to verify vaccine records.

“IATA is not pushing for vaccine passports nor is the IATA Travel Pass a vaccine passport,” Tjoeng says. “We do not believe that vaccinations should be mandated for anyone to fly.”

In the next year, Cowling, the epidemiologist, says he hopes that vaccine coverage expands to the point that people won’t need to “worry about vaccine passports anymore,” because the world will have reached herd immunity. “The whole [vaccine passport] thing may only be a short-term measure anyway,” he says.

However complicated to implement, countries are likely to continue experimenting with vaccine passports because a successful system could jump-start tourism and hospitality, sectors of the economy that urgently need a lifeline.

In total, the IATA estimates that the pandemic’s reduction in air travel inflicted a $1.8 trillion blow to global GDP. Vaccine passports or global acceptance of a similar system may be the fastest way to begin recouping some of those losses.

“For governments to reopen international borders without quarantine and restart aviation they need to be confident that they are mitigating the risk of importing COVID-19 and have confidence in a passenger’s verified COVID-19 status, be it [through] testing or vaccination,” says Tjoeng. “Vaccines will have a role to play in the recovery of international travel.”

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