Travel has always at it’s most fundamental level been about freedom. Over the years there have been necessary limitations on that freedom, for security needs or the purposes of public health for example, and by and large they have been reasonable and acceptable, but this newly proposed ‘vaccine passport’ for Covid19 is a step too far. It places unparalleled restrictions on our freedom to travel with no clear clinical justification, is immoral, unethical and even illegal in many countries, and should never be imposed on any traveller anywhere.
The covid19 pandemic has seen some of the worst restrictions placed on individual freedoms since the second world war, from unjustified lockdowns to the shutting down of entire industries, including the hospitality and travel sectors, and now as the world starts to come through the end of the pandemic travellers face even more punitive restrictions on their freedom in the form of ‘vaccine passports’. Restrictions like this would once been thought of as unthinkable in the western world after the horrors of WWII and they should horrify anyone with any understanding of authoritarianism and who values the freedom we once had to travel the world.
I am a classical libertarian at heart, which means that I value individualism and freedom above almost all else, and whilst I recognise that sometimes some restrictions are obviously necessary in society I am extremely suspicious of and naturally opposed to anything that seeks to curtail that freedom without good reason. That is why I am wholly opposed, instinctively and intellectually to the proposed ‘vaccine passports’.
I should qualify first of all that this is nothing to do with the vaccine itself. As a nurse who routinely advises on travel health and vaccines in my own travel clinic, and wholeheartedly recommends them when they are appropriate, I take the same stance with this vaccine too. I should also take a moment to dispel a few myths and misinformation about the vaccine because frankly scaremongering and emotional zealotry has replaced fact and common sense all too often in this debate, and that has been a significant problem.
There are three primary vaccines that have all been approved for use in the UK, declared safe and have met the strict standards set out by the Medicines and Healthcare Regulatory Agency, the Pfizer vaccine, the Oxford Astrazenica vaccine and the Moderna vaccine. All work in similar ways but are safe and they are effective.
Now, like any vaccine there may be side effects, this is true of all medication. Like all vaccines there will be a number of people who have no side effects at all and the vast majority will have a sliding scale of side effects ranging from barely noticeable up to feeling mildly ill. These are in the absolute majority of cases nothing to worry about. There will also be a much smaller percentage of people who may get rare, more serious side effects. Again, this is true of any medication and is not something that is unique to the covid19 vaccination. Acute exanthematous pustulosis or toxic epidermal necrolysis are technically side effects of paracetamol, but people generally consider paracetamol to be safe and don’t think twice about taking one for a headache do they? (Both of those occur in less than 0.01% of patients by the way and are rare to the point of barely being a consideration). Any mainstream media reports of fatalities and side effects should be taken with an extreme amount of salt, remember that there is a vast difference between causation and correlation.
I strongly recommend vaccines in most cases, but I also understand that it is and always should be a personal, individual choice, and that choice should never be compromised, coerced or forced.
So in very general terms I do recommend getting the vaccine, but like the risk assessment of all vaccines this is always contingent on an individual risk assessment and personal medical history, because the choice of getting the vaccine is yours and yours alone based on your own conversations between yourself and a qualified medical professional who knows you best. As a nurse I can advise you, give you the facts, but never coerce, force or pressure you into a decision either way. That is the basis of informed consent and underpins everything we do. One of the most pernicious and horrific things I have seen in this whole farce is the malicious, disgusting and dangerous public attitudes toward anyone who has any genuine questions and concerns over what is still a very new vaccine. People have the right to be worried, they have the right to have questions and concerns and should be able to ask those questions without fear of being berated. There are many out there who may be pregnant for example and concerned about the fact that not enough is yet known about the long term effects for the vaccine to be routinely advised, there may be people with a history of significant reactions to vaccines, you just don’t know people’s individual circumstances or reasons, and you have no right to. These people have the right to make their own decisions based on the facts and the evidence, they are not antivaxxers, they are not evil, they are not killing your grandma or putting people at risk. That mentality needs to end because it is disgusting, pernicious and wrong.
The ‘vaccine passport’.
Despite frequent exertions to the contrary, the Health Secretary Matt Hancock explicitly ruling them out and even the UK vaccines Minister Nadhim Zawadi stating that there are absolutely, definitely, without any shadow of a doubt zero plans at all for any form of passport, because ‘it isn’t how we do things in Great Britain’ according to our very own, supposedly Libertarian Prime Minister, the truth is that a vaccine passport is being considered in Whitehall.
This means at the very least we will be forced to carry some form of ID or information showing our vaccination status to be able to at the very least travel, but more likely to do anything else too.
Of course the language used is very evasive and non committal, it is sometimes referred to as a passport, or a certification, but it is happening. It has already happened in New York and soon the rest of the so called land of the free, other countries are following suit and the EU is pushing for it too (I’m less surprised there, they have form). And it is very, very wrong.
Apart from the fact that there are obvious logistical and practical concerns about the effectiveness of any new passport, the very idea is immoral and illegal in many countries.
Don’t we already have vaccination passports?
One of the most common arguments for this system is that we already have vaccination passports and requirements for travellers, so why is this new vaccine passport any different? What that is referring to is the ICVP, or the International Certificate of Vaccination or Prophylaxis, and whilst that is true, the two things are not comparable at all.
First of all is the disease itself, and the risk of covid19 is not comparable to the risk of those diseases where those vaccines that are considered mandatory by an order of magnitude. Yellow Fever for example is a mosquito borne disease where up to 1 in 4 will develop serious symptoms and of those people, up to half of those cases will prove fatal. Case fatality rates of Yellow Fever are in the range of 15 to 50% and the disease is very prone to having epidemic outbreaks, compared to the current CFR of 0.8 – 9.64% and dropping for covid19. Meningitis is a very serious disease that in most cases doesn’t require a proof of vaccination on entry to a country, unless you are attending the Hajj or Umrah pilgrimages in Saudi Arabia due to the significantly raised risk during that time. These are mandatory vaccinations in a sense, but are used in very specific circumstances in very specific countries, they are not applied across the board as a blanket measure and only apply to specifically high public health risks. Covid19 does not now fit that definition.
At best, in my opinion, it should be added to the list of ‘recommended’ travel vaccines and people should be allowed to make their own risk assessments and their own choices.
Secondly the ICVP is mandated under specific International Health Regulations under the World Health Assembly and provide an international set of laws and guidelines that provide a public health response to various PHEICs (Public Health Emergencies of International Concern). More importantly they are applied very specifically in very limited, surgical ways that effectively curtail and manage any public health risks whilst still allowing international travel, traffic and trade. This is part of the reason that international travel bans have never been a recommended part of emergency pandemic response protocols.
We already have a set of internationally recognised standards for public health risks and mandatory vaccination status for travel in very specific circumstances, if this current pandemic reached the standard required to be managed by that, it easily could be. It does not. We do not need a whole new ‘passport’ system.
The proposed ‘vaccine passport’ is not even close to being the same thing as this. So far every country who is planning this are essentially applying their own standards to it, potentially applying it to not only travel but everyday life as well, and it will not be international health organisations that oversees its implementation or use. It will not be the WHO (who by the way do not recommend vaccine passports or immunity passports either) or a border official checking you meet international requirements to enter a very specific place at a specific time, it will be the owner of an airline taking the unilateral decision to ban those who don’t have the vaccine, it will be no neck John the doorman, with no qualifications or basic intelligence, banning you from entering the hotel unless you show your papers. And it won’t be an internationally recognised certificate of vaccination either, like the ICVP, it will be any number of tech companies designing a variety of apps that will decide what is acceptable and how you have to present your vaccination status, with zero guarantee so far that it will be recognised from one country to the next.
These are economic decisions, designed as a response to get ‘back to normal’ and kickstart travel and the economy again. They are decisions based on fear and ignorance and designed to illegally and immorally coerce and bully. They are political decisions based on the extreme precautionary principle. What they are not are decisions based on science or clinical data.
The ethical and legal issues.
The ethical issues around the blanket enforcement of a vaccine passport are quite clear. Travel and freedom of movement are basic human rights, and when those rights are curtailed in any way, which they can be for good and very specific reasons, there must be clear and unarguable reasons for that. This vaccine passport, based on the supposed threat of Covid19, simply does not reach that standard.
The impact of any passport will quite simply be discriminatory, both directly and indirectly and that is illegal under the Equalities Act 2010 in the UK and Article 21 of the Charter of Fundamental Rights in the EU. Many other western countries have similar legislation. It really is as simple as that.
Our public health policy is based on the medical paradigm of informed consent, and rightly so. UNESCO’s Universal Declaration on Bioethics and Human Rights states very clearly that any medical intervention is only to be carried out with the prior, free and informed consent of the person concerned.
As I stated earlier there will be a large number of people who physically cannot get the vaccine for a wide variety of reasons, from religious concerns to medical issues and everything in between. There will even be for some time yet a number of willing younger people who want the vaccine but are unable to get it because of their low risk status. For some European countries and in the US for example, it may well be coming to the end of 2021 or even 2022 before everyone who wants a jab can be vaccinated. Is that fair? Should they be denied the right to live their lives? Discriminating against those people by denying them access to travel, denying access to services or punishing them in other ways by treating them differently than those who can get or have had the vaccine is illegal. Punishing those who do not or can not get the vaccine and rewarding those that do, especially when bribery and threatening language is used to force people to get it, or use it as a way to ‘get back to normal’ out of a system of disproportionately harmful lockdown measures they imposed on the country in the first place is just abhorrent. It is coercion plain and simple, and that is morally, ethically and legally wrong, and as I said earlier goes against every principle of informed consent that any medical practice is underpinned by.
Then there are also those who will be indirectly discriminated against by this. There are those from lower economic backgrounds, black and ethnic minority backgrounds and younger age groups who are traditionally less likely to take part in vaccination rollouts, again for a wide variety of reasons, and frankly it doesn’t matter if you think that is right or not, they have that right, and that freedom of choice.
Even the EU Parliamentary Assembly, on their own report on the ethical, legal and practical considerations for the Covid19 vaccination rollout in January 2021, stated very clearly in its resolution 7.3 that the vaccine should never be mandatory, that all citizens should be made very aware of that fact and they should never under any circumstances be politically, socially or otherwise pressured to get it or discriminated against if they choose not to get it.
That is pretty black and white isn’t it? The vaccine is not mandatory and no one should be pressured into getting it or discriminated against for not getting it. You cannot put it any simpler than that, and yet this is exactly what the vaccine passport does! It does not meet the standard for mandatory travel vaccination consideration, and yet governments all over the world are threatening to punitively take away not only our rights to travel but our basic freedoms to live and work if we do not get it.
The mainstream media is full of headlines stating this is a way to ‘help us travel safely again‘ and as a way to jumpstart international travel (which by the way had no clinical reason to be stopped in the first place). Tech companies specialising in biometric data are jumping at the bit to make a lot of money off this and are obviously ramping up the ‘return to normal’ rhetoric for their own ends.
Fear. Control. Threats. Coercion.
Seriously, can no one else see a problem with this?
The practical issues.
Now quite apart from the fact that the proposed vaccine passports are unethical in concept and illegal in practice, why is no one asking fundamental questions about the practical logistics of running such a scheme? As I stated before this is not an addition to the already existing ICVP programme overseen by the WHA, this is a whole new set of systems being looked at by a variety of different countries with different ideas and different tech companies all trying to undercut each other to get the lucrative contracts. And we all know that the UK and EU governments stellar record with farming out contracts during the pandemic don’t we?
Still think this is a good idea?
I mean at the end of the day we still do not know the long term effectiveness of the vaccine. Will we need to get a new jab every single year just like we do the influenza jab and then get an updated passport for that? How often will booster jabs be needed? How much will that cost? Who will pay for it? More importantly, who will make money from it? Hell, influenza has the potential to be a significant risk every flu season, are we going to be expected to add our flu jab status to the vaccine passport too?
What about the requirements for each individual country? What if any given country doesn’t recognise the specific brand of vaccine you have taken? What if the French decide to throw another political strop about Astrazeneca? Will only those with the Pfizer jab be allowed in? Will the ‘digital green passport’ be accepted in Mexico? Or Thailand? Or Australia?
What if you have only had one jab but cannot get an appointment for your second dose before your need to travel? Will that be allowed? What if a country decides to enact policies that don’t recognise any passport at all and lets anyone travel, or the next country decides to only recognise one specific type of app? What if every country has their own specific app? Will world travellers need a hundred different apps and every type of jab imaginable? Will we need IATA’s ‘travel pass’ to fly on their airlines, but a completely separate one to enter the country when we land? What if we have one flight with an IATA airline but then another connecting flight outside of that system?
We also seriously need to question the role of private business in international health regulations like this. If, as the EUs own resolution 2337 on democracies facing the covid19 pandemic states ‘any proposed vaccine passport should only ever be used for their designated purpose of monitoring vaccine efficacy, potential side-effects and adverse events’, then why exactly are private businesses and corporations being allowed to stipulate their own discriminatory rules based on them? Will private airlines, hotels, bars or any other travel or leisure industry business open themselves up to future legal action? And if they are going to be forced to use this system to ‘reopen’ without punitive action, then will that help or will it more likely hinder their business?
What about privacy issues around those developing apps having access to private medical records, which at this current developmental stage is being proposed as an alternative to little pieces of card. Apart from the tiny issue of medical confidentiality, which despite recent rhetoric is actually very important, what guarantees do we have that our data will be kept that way? Why should every Tom, Dick and Harry be able to access or view our personal medical data which at the moment are still protected under legal privacy and confidentiality laws?
And perhaps most importantly how long will this be a requirement? The risk of covid19 is falling rapidly, to the point it is barely more of a risk than influenza and it hasn’t been considered a High Consequence Infectious Disease since last March, and that is being compounded as vaccine rollouts continue to get better and better (some places are performing better than others admittedly). The risk of international travel is already relatively low. Will these passports only last until the risk has fallen low enough? Who decides that standard? Are we expected to believe that the risk should fall to absolute zero which just will not happen? Or will this be a permanent requirement? In which case a whole new set of worrying questions need to be asked.
What is the point?
And that level of risk leads to perhaps the real question that no one is asking. What exactly is the point here?
Now just to shut the extremists up, covid19 is a very real disease, it is a very serious disease that can have very serious consequences and has placed a huge strain on the worlds health systems over the last year. That is a fact and is not in doubt. What covid19 is not however is the world ending plague that the media and the world’s governments have portrayed it to be.
When it first appeared in 2019 it hit the worlds population hard, as new diseases tend to do, so hard in fact that governments around the world ignored existing emergency pandemic response protocol and clinical advice designed for this exact scenario (yes, governments all over the world have been preparing for this for decades) and did the exact opposite based on fear, the precautionary principle and public opinion, which led to travel bans, lockdowns and mask mandates. No government wanted to be seen to be doing nothing.
With any new disease large numbers of initial cases and deaths in the population it effects are unfortunately inevitable until more is learned about the disease and actions are taken against it. But as we have learned over the course of the year the risk is now not as high as initially feared.
Despite initial fears, Covid19 was declassified as a High Consequence Infectious Disease over a year ago now. Of all current active cases, the risk of developing severe symptoms is just 0.4%. For those under 50 and with no specific health risks the risk is even lower than that, with even the risk to those over 75 (and over the average age of death in the UK) with severe comorbidities the highest, yet still less than 1%. The number of cases has fallen significantly, perhaps in part to the overreporting of data due to rushed PCR tests being administered incorrectly at too high a cycle rate, but the levels of hospitalisations and deaths have dropped significantly too. Asymptomatic spread, once used to scaremonger the population to believe that everyone who didn’t have symptoms were spreading the disease by default, is now believed to be negligible compared to initial estimates. The number of cases and deaths that were initially feared, based on now highly laughable and debunked models from the ever wrong Ferguson et al (and yet still not as high as those prepared for in the planning for an emergency response for a super coronavirus pandemic) never happened. Hospitals were never overwhelmed.
A serious disease yes, but an honest conversation about the genuine risk was never allowed to happen because of the fear and the precautionary principle.
The vaccine rollout programme in the UK has been extremely successful, and it has been fair to good in many other countries too, with huge percentages of the adult population already vaccinated in the UK. Findings from the University College London suggest that this is reinforcing the natural antibodies and T Cells that the population in the UK has naturally built up and has lowered the risk of the virus spreading through communities significantly.
So given all of this, by the time any of the practical issues raised around the introduction of the vaccine passports are solved, they will be largely irrelevant to the risk of covid19 and be completely redundant, so what exactly is the point of introducing them at all? Especially now, when we are coming to the end of this?
Why are we not only continuing with extreme and disproportionate measures, but contemplating adding even more draconian measures in on top? Where is the justification for it? The truth is there is no justification. No clinical justification at any rate.
It is time we started to open up travel again.
It is time the world opened up again and travel resumed as normal. Travellers are hungry to see the world they love and the travel industry is eager to have them back. There is still room for some mild caution of course, and it is perhaps right that smaller countries who do not have the healthcare infrastructure to cope with another outbreak take a little more time to slowly ease back to normality, that is reasonable and proportionate, but in general terms there is no reason that most developed countries cannot open up fully with no restrictions, no mandatory quarantines or lockdowns, no mask mandates or any other wholly unnecessary punitive (and against all science, before anyone starts) impositions. And certainly no damn covid19 vaccine passports.
Although to be fair as a nurse I am ecstatic that people are finally paying attention to basic hand hygiene, I have been screaming from the rooftops for years! We can keep that change!
Vaccines are a wonderful thing, and the covid19 vaccine is a great step that will absolutely help in the fight against the disease, but forcing or coercing people is not the way to ensure a strong uptake. Continued punitive and disproportionate measures that curtail travel for no real clinical reason are no longer justifiable in any way, shape or form, and a ‘vaccine passport’ that will be a permanent solution is not the answer. Pandemic response best practice has always been to protect the vulnerable and learn to live with the disease as life goes on. We have done it with every PHEIC before, from sarscov1 to MERS and many more, and we do it every single year with influenza, norovirus and many others. It is time we did that with sarscov2 and Covid19 as well.
The proposed vaccine passport is wrong on every level, it is unethical, immoral, impractical, unworkable and illegal, and it should be opposed with every fibre of our being in a free and democratic society.
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