Today, Explained - Vaccine passport, please

Episode Date: April 12, 2021

Recode’s Rebecca Heilweil explains how proving you got the shot became controversial. Transcript at vox.com/todayexplained. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Visit connectsontario.ca. Almost 200 million doses of COVID-19 vaccinations have been administered in the United States. Something like 75 million people have been fully vaccinated. Almost a billion people have received a shot globally. And with so many people itching to get back to normal, it's inevitable that we start talking about proving you have the vaccine. Some call this proof a vaccine passport, but our guest today will explain why that's a bit of a loaded term. Yeah, so one of the big challenges with this discussion is that a whole bunch of things are now being bucketed into this term vaccine passport. Our guest today is Rebecca Highwell from Recode. So broadly, it essentially just means a record of the fact that you have received an inoculation or a vaccine.

Recently, it's come to refer to the idea that this record might be on your smartphone, it might be on a pass that you carry in the pandemic, and it would basically include a record from maybe a health provider that's given you that vaccine, or a government, or a state health authority that confirms that you have had this vaccine and you've been inoculated for COVID-19. But one thing I'd really, really push against is actually calling them vaccine passports. One of the challenges has been that that term implies that it means you can actually go places and it's going to give you all these privileges, which is part of it. But I think a lot of the things that are being rolled out right now are

simply digital records of the fact that you've been vaccinated and aren't, you know, so different from a paper version of the same thing or the record of the fact that you've received a vaccine that exists with your health care provider. Okay, so this isn't going to get me into Canada necessarily. What will this do? Why would you need a so-called vaccine passport or a digital record? So there are a separate slew of initiatives that are trying to take those records to enable life to sort of return to normal again. So we've seen this airport security company, Clear, try to roll out using these vaccine records for venues and, you know, returning to sports games and things like that. Meet Jane. She's eager to cheer on her favorite team at the stadium, get back to her favorite restaurant, and even get back to the office. Health Pass is the solution for your business to allow safer access while providing Jane the

confidence to get moving. You know, it's possible some small businesses might want to look at it, or even cruise lines might want to use a vaccine record in order to make sure that you're vaccinated before getting on board for two weeks with a bunch of other people. So the idea is that this is going to help us get back to normal, whatever that looks like, but it's not necessarily for traveling abroad just yet. So maybe get you into a concert one day? Yeah, potentially, though it's worth keeping in mind. Remember concerts, Rebecca? get you into a concert one day? Yeah, potentially, though it's worth keeping in mind. Remember concerts, Rebecca? Yeah, I think back in those days fondly. The thing to keep in mind also is

a lot of the apps that are actually rolling out to do something like that also have other functionalities built into them that allow you to just test negative for COVID and do the exact same thing. So it gets really complicated because there are so many apps, there are so many different initiatives, and they're all doing slightly different things, but everyone's calling them vaccine passports. What is required for a true vaccine passport? What does it look like? So the first thing that you need is a record that you've been vaccinated. One of the challenges with this is that we've been getting these little paper cards

with the CDC insignia. They're famous now, but they're not set up to be double-checked. It's not like if you're hosting an Ariana Grande concert, you can just call up the CDC and say, hey, someone showed me this card. Is that right? That's not how the system is set up. So we have to use all these different records that might exist with your healthcare

provider or whoever gave you the vaccine to make sure that you have in fact been vaccinated. So you need that record and then you need some sort of level of trust between whoever's looking at that record, like a concert and the provider of that record. So there's sort of a two-step process here. And those CDC cards, to be clear here, not a vaccine passport. So what's weird is some places have been using them as a proof of vaccination, but a lot of people don't see them as completely trustworthy because of the problems that I just mentioned. They've also been forged. They look like they'd be really easy to forge. Yeah, I've reported on how easy they are to forge in the past. According to cybersecurity firm Checkpoint, this listing on the dark web offering a fake vaccine certificate for

$150, claiming not everybody will like to take the COVID-19 vaccine and we provide proof of having been vaccinated. You know, that's why we've had all of these initiatives to build a digital system that would do somewhat of a similar thing. Who is pushing for a better system right now? Who is pushing for some sort of legitimate vaccine proof of purchase? So what's interesting is that the

federal government has said basically they're not going to be involved in offering a standard credential of vaccination and they're not going to be forcing people to prove that they've been vaccinated. The Biden administration has basically opted out on this. So now we have different states that have moved ahead by and trying to offer this themselves. So we've seen New York State roll out something called the Excelsior Pass, which Andrew Cuomo is really sort of pushing ahead. Excelsior, huh? Yeah. Sounds fancy.

New York State pride. Yep, the city is coming back all right. And the crowds in Midtown are building fast. Now the state is hoping its new excelsior app can help speed things up even more you know hawaii is talking about having a vaccine passport program this summer for travelers and there's been some discussion in north carolina as well but what's also interesting is that the people who have been rolling out apps the quickest are actually these sort of collectives of nonprofits, healthcare companies, and sort of health record companies, tech companies trying to come up with standards

for this. So it's actually the private sector that's leading on this. And that's created this problem where you have a million different initiatives trying to do the exact same thing, and there's no standardization across them, which makes the prospect of having a universal vaccine passport system seem really unlikely in the U.S. So just like everything else over the course of this pandemic, we're looking at a likely patchwork of verification of vaccination? Yeah, it's very patchwork.

Why is the federal government not into this? The Biden administration has said that they're worried that instituting some kind of federal or government-based vaccine credential system would make people less trusting of the vaccine process and less likely to actually get the vaccine. As these tools are being considered by the private and non-profit sectors, our interest is very simple, from the federal government, which is Americans' privacy and rights should be protected so that these systems are not used against people unfairly. And they've said, you know, we think Americans will not trust a government-backed system here.

It's better to leave it up to the private sector. And to some extent that has played out in some of the outrage that we've seen about the idea of a vaccine passport. Outrage, you say? Tell me about the outrage. Yeah, there's a lot of legitimate concerns about vaccine passports, which we should get to. But there have also been a lot of sort of culture war-like concerns that have been brought up as well, not necessarily in good faith. But we've seen the Republican governors of Florida and Texas have recently banned vaccine passports to various extents. We are not supporting doing any vaccine passports in the state of Florida.

Government should not require any Texan to show proof of vaccination and reveal private health information just to go about their daily lives. You want to go to a movie theater? Should you have to show that? No. You want to go to a game? No. You want to go to a theme park? No. We've also seen legislation proposed by one Republican in Congress that would ban the federal government from issuing or requiring vaccine passports, which, again, the federal government is not trying to do.

And it plays into this whole thing of, like, fear of government surveillance, you're limiting my freedom, arguments about get a government overreach and things like that. Other countries, we have seen state-backed, government-backed initiatives that basically involve a vaccine passport system. But vaccine passports of an idea have been picked up by conservatives as sort of a way to sort of start a fight and create a giant argument. So it sounds like there's a culture war over a federally mandated vaccine passport, but is there a culture war over like private, not-for-profit, or even for-profit entities taking up this cause? I think the broader culture war has kind of sort of trickled down to include anyone who wants to ask for

vaccine records or proof of COVID-19 vaccination. So people aren't just upset about a government role in this. They're upset that, you know, a venue might ask for proof of vaccination. But again, it's all predicated on this idea of vaccine passport, which refers to several different initiatives that are all doing different things and might be as simple as just giving you a printout or like a phone record of the fact that you received a vaccination, which is a record that your healthcare provider already has, right? So it could be as simple as that, and that's being called a vaccine passport. The CDC card is being called a vaccine passport,

and it's all factoring into this argument where no one's quite being clear about terms and really referring to one specific thing. But beyond politics, you mentioned there are some legitimate concerns about these kinds of vaccine certifications. What are those? Well, one of the questions is supply, right? And this is a criticism that the World Health Organization has brought up in regard to international travel. And they have said, you know, as long as there are lots of people in the world who cannot get the COVID-19 vaccine yet, instituting a system in which some people can travel freely between countries because they've gotten vaccinated and other people can't, creates really significant questions about equity and questions about, you know, incentivizing people from wealthier, more privileged countries taking up more vaccine doses so they can go vacation while other people who are maybe more at risk still haven't gotten

the vaccine. You know, there are questions about privacy, this going digital, and what does it mean to have this record on a phone or in a database? But that's not often the criticism that's being brought into the mainstream in the U.S. that we're talking about. But it's important to acknowledge those questions as well because they are important. I hear that. Also worth noting, there are already vaccine certifications out there in the United States and all over the world, right? Yeah, I mean, people have to show proof of vaccination to do a whole lot of things. You know, if you ever went to summer camp or you probably had your parents show or get some forms from a doctor's office proving that you had some kind of a list of vaccines

that you're required to get or school or whatever. So credentials for vaccination certainly aren't new. What's new is the pandemic and what's new is COVID-19 and the question of whether we want that kind of system to be applied here, how it should be applied and whether this is something we want. They might be controversial in 2021, but vaccine passports have been around in some shape or form since vaccine number one. That's in a minute on Today Explained. Support for Today Explained comes from Ramp. Thank you. they give finance teams unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp. You can go to ramp.com slash explained, ramp.com slash explained,

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with iGaming Ontario. Okay, so in the year of the ox, 2021, vaccine passports are stirring up all sorts of controversy around the world and in Florida and in Texas. Also, maybe don't call them vaccine passports, but whatever you call them, it's important to remember they're not new. They've been around just about as long as vaccines have. We reach out to historian Jordan Taylor for a reminder. The first thing we need to do is talk about smallpox. The smallpox vaccine is really the first vaccine introduced into the Western world. And by the late 19th century, the design of the smallpox vaccine was pretty straightforward. And we've talked about this a little bit on the show before, but remind people what a smallpox vaccination looked like. Yeah, so someone would scrape you across the arm with a lancet or something like that that was abrasive.

And smallpox vaccines would leave a scar. You would get a sore, and that would leave behind a really distinctive looking scar. According to people in the 19th century, you could really tell a vaccine scar from smallpox apart from other scars. It was really distinctive looking. Some people said that it looked like a peach pit. If you have an older relative or an older friend, you can probably ask them to see theirs because most people who were born in the first part of the 20th century probably have a smallpox vaccine scar. And I can only assume giving people scars would pull poorly in the present day, but were these smallpox scars in a

way the first vaccine certifications? Yeah, absolutely. For people in the late 19th and early 20th centuries, the fact that these vaccines left a scar was kind of a godsend. It meant that it was really pretty easy to tell who had been vaccinated and who hadn't been vaccinated. Anytime you were traveling, anytime you were entering an institution like a school, or even moving into a new employment situation, you might be asked to prove your vaccination status by showing your scar. And so in a lot of ways, it did function almost exactly like the vaccine passports that are being debated and proposed today. And like today, there was some controversy. Yeah. Some people didn't want to get vaccinated because it was uncomfortable. Some people didn't want to get vaccinated because it was uncomfortable.

Some people didn't like the scar. Some people just were uncomfortable with the whole idea of being vaccinated. Remember, this was, you know, the first vaccine and it was pretty new. And the idea of putting a strain of a virus into your body on purpose seemed pretty counterintuitive to a lot of people. And so as there is today, there was a small but pretty vocal and well-organized group of what we might call anti-vaxxers who thought that vaccines weren't healthy and weren't a good idea. There was a newspaper in New York in 1901, I think, that had this story about people who were manufacturing these fake vaccine scars with plaster and selling them. There were also reports about physicians and other people who were forging vaccine certificates saying that you had been vaccinated when you hadn't, because there was a big market for people who wanted to evade these restrictions.

But lots of people still ended up getting the shot. How? Yeah, it was enforced in all kinds of ways. So there was no national policy. Every kind of state or local government or institution had its own sort of rules. Some places experiencing deadly outbreaks of smallpox would mandate compulsory vaccination. In other words, forcing everyone in a neighborhood or community where an outbreak was happening to get vaccinated and prove that they had been vaccinated. Occasionally, there are a few examples where this actually got violent. There are at least a couple examples of reports of Boston police forcibly vaccinating people on the streets who wouldn't comply. Overall, though, that was pretty unusual. And it's certainly not a precedent that I think

anyone wants to follow today. And we actually recently ran an episode from our friends over at the Experiment podcast in which they talked about one of these original anti-vaxxers and how his case, I think it was Jacobson, ended up at the Supreme Court, right? Yeah. So there was a Swedish immigrant. A guy named Henning Jacobson. Who lived in Cambridge, Massachusetts in 1902, who refused to be vaccinated, even though his city had required that everyone be vaccinated. They argued that vaccination was dangerous, that compulsion was unnecessary, that this was a violation of every individual's right to make choices about their own bodies. In his case, as you said, it worked its way all the way up to the Supreme

Court, where a majority, I think it was a seven to two ruling, they ruled that, and this is a quote from the decision, they ruled that a community has a right to protect itself against an epidemic of disease, which threatens the safety of its members. So the government has this Supreme Court precedent when it comes to mandating vaccines, but it doesn't feel like we're getting anywhere close to that right now. Was there something different about the smallpox pandemic? Yeah, there are a lot of differences. Probably the most important thing to point out is that

smallpox and COVID are very different diseases. As horrible as COVID is, smallpox was just absolutely horrifying. It had a 30% mortality rate. In other words, if you contracted smallpox, there was a 30% chance that you were going to die. It was deadly enough that even extreme measures seem to be pretty well justified. Unlike today, where there is a lot of misinformation circulating about COVID being nothing more than the flu or something like that, no one doubted the severity and the deadliness of smallpox. But maybe the two most important differences between the reaction to the smallpox epidemics of the 19th and the 20th century and today is the politics and the way that people thought about personal liberty. Anti-vaxxers in the 19th and the early 20th century didn't have the vehicle of a major political party to spread their message like they do today. The anti-vaccination campaign wasn't entangled with the partisan politics of its moment.

Compared to today, the anti-vaxxers, Americans were living through what we now call the progressive era, which evolved in part out of an increasingly expansive understanding of what liberty meant, what freedom meant. Today, we often think of liberty as being sort of the absence of restraint or interference by the government, right? But there's also another way of thinking about it. What the philosopher Isaiah Berlin calls positive liberty, being able to live your life, being able to flourish and to determine your own destiny. And as we've seen over the past year, I'm sure all of us have experienced this. It's really hard to flourish in quarantine. So I think there's an important case to be made that vaccine passports aren't just restrictions on personal liberty they're a way of ensuring that we all have the liberty to determine the

direction of our own lives and to live without fear of being infected by our neighbors. Jordan Taylor teaches history at Smith College in Northampton, Massachusetts. I'm Sean Ramos-Firm. This is Today Explained.