In an important op-ed in the Washington Post yesterday, columnist Leana S. Wen argues that the term “vaccine passport,” increasingly used to describe COVID-19 vaccination records, could be severely damaging not just to the current vaccination campaign, but for many years to come.
I’ve heard similar concerns from public health and health communications experts over the past four months, but Wen doesn’t dig in to one of their biggest reasons for concern. Calling vaccination records a “vaccine passport” doesn’t just turn off your average Joe: it provides ammunition for the same extremist conspiracy theories upending our entire society.
Wen’s core point is that the term is both inaccurate and divisive, for essentially the same reason. A passport is generally understood as a government-issued document with significant powers to control a person’s movements. While a system like Israel’s Green Pass has some real parallels with passports, systems rolling out in the U.S. are being used mainly by private entities like restaurants and Major League Baseball to improve the safety of their facilities.
Yet in recent weeks, as public controversy over the apps has spiked, “vaccine passport”’ appears to have become the default terminology for the media. That’s likely in part because of the technological angle. The transition of vaccine records to apps and digital wallets sure sounds like some radically new thing, and coming up with a new name makes for snappy headlines and better search engine rankings.
But the truth is there’s not all that much new about COVID-19 vaccination records just because they’re on your smartphone. For example, MMR and other vaccines are broadly required to attend public school in the U.S., but we’ve never referred to proof of those shots as a ‘vaccine passport’ allowing kids to get into schools.
These are all fair and true points. But Wen doesn’t dive into the context for her concerns – and that context, particularly in the U.S., makes the “vaccine passport” terminology especially dangerous.
Because “passport” doesn’t just imply government authority. By evoking a national border, it implies a specifically militarized and bureaucratic vision of governmental authority that plays directly into the troubled worldview that has fed conspiracy theories like Qanon, “The Great Reset,” and that old classic, The Lizard People. In these narratives, a common denominator is the idea that at any moment, government ‘thugs’ will come out of the woodwork and, essentially, throw everyone into cages.
These are all ultimately rooted in a skepticism of government power that is in itself healthy enough, but has been twisted and amplified by disinformation entrepreneurs into towering edifices of delusion. The same impulse has already fostered the idea that COVID itself is an elaborate ruse to implant Americans with tracking microchips. This is false, of course. (To borrow the most concise rebuttal I’ve heard, wouldn’t it have been simpler to just put the chip in everybody’s Big Mac?)
To be clear, governments do often abuse their surveillance powers, and there is ample reason to be cautious about digitizing health records in general. Much of the blame for the latter, though, lies more with Big Tech than government: The ineptitude of companies like Facebook when it comes to protecting (usually much less sensitive) user data has likely poisoned the waters for more beneficial and secure digital-info efforts of all types for decades to come.
That means, yes, any digital version of vaccination records must be built with a level of security not present in most apps. That appears to be happening, including with IBM’s work on the New York vaccination records app (see below).
But pushing for good security doesn’t require inflaming conspiracy theorists by using a term that isn’t even accurate.
David Z. Morris
david.morris@fortune.com
@davidzmorris
DIGITAL HEALTH
New York's vaccine app works, mostly. New York has launched the first state-backed electronic vaccination record system, and the Washington Post has tested it out. Columnist Geoffrey Fowler finds the system fairly convenient and easy to use, and he was even able to easily help a friend in their eighties set it up, though the app is still glitchy in actual use. Most importantly, Fowler believes privacy protections in the IBM-created app are robust. One serious shortcoming, though, is the apparent ease of essentially copying a friend’s records to use as your own. (Washington Post)
(Unfortunately, just a day after the op-ed discussed above, Fowler describes the app as a ‘vaccine passport’ throughout his piece.)
INDICATIONS
First live lung transplant in COVID-19 patient. A Japanese patient with serious pneumonia triggered by COVID-19 received a partial lung transplant using tissue from her (still living) son and husband. Lung transplants have become a rare but recurring treatment for patients with serious post-COVID lung damage, with an estimated 20 to 40 such procedures already completed around the world. But the procedure in Japan, conducted at Kyoto University Hospital on Monday, is the first to use tissue from live donors rather than brain-dead donors. One downside: This radical approach is only viable for people under 65 without other organ damage. (NikkeiAsia)
AstraZeneca vaccine gets a warning. The European Medicines Agency, Europe’s drug regulator, has confirmed a possible link between the AstraZeneca COVID-19 vaccine and rare cases of unusual blood clotting. The agency said Wednesday that clotting should be listed as a “very rare” side effect of the vaccine. Both AstraZeneca and health agencies are continuing to investigate the possible mechanisms to explain the extremely rare clotting events. The EMA, while acknowledging the possible link, emphasized that the benefits of the vaccine still far outweigh risks. (FiercePharma)
THE BIG PICTURE
No vaccine surge for Michigan. Biden administration officials on Wednesday said they would not send a “surge” of COVID-19 vaccine supply to Michigan, which is in the midst of a terrifying wave of cases. One expert interviewed by STAT News described sending more vaccine to the hardest-hit areas as a “no-brainer policy,” but CDC Director Rochelle Walensky and White House COVID czar Andy Slavitt have both argued that it is too early in the vaccination drive to shift allocations, currently based on population, in response to infection surges. The White House does say it’s working with Michigan closely on other mitigation strategies. (STAT News)
REQUIRED READING
A quarter of Americans are now fully vaccinated. See how your state is doing - Erika Fry and Nicholas Rapp
Europe is as divided as ever on the AstraZeneca vaccine rollout - Bloomberg
COVID is triggering mental and neurological disorders in some survivors - Bloomberg
