The Ethical Case for Vaccine Passports
Some conservatives are turning their backs on a program that harnesses the energy of the free market to create incentives for people to make good choices.
To put the pandemic behind us, America desperately needs at least 75 percent of adults to get vaccinated. But since millions of Americans say they don’t want to get the jab, we need to incentivize them to do so. “Vaccine passports”—which are just easily-accessible ways of verifying vaccination without viewing an individual’s personal health information—are an indispensable tool to do this.
Sadly, and predictably, the issue has been exploited for political gain by Republicans pandering to their far-right, truth-denying, science-denying religious and nationalist base—most notably Florida Governor Ron DeSantis, who has (probably unconstitutionally) banned even private businesses from using vaccine passports in the state.
I’ve been writing about the ethics of health regulations for 25 years, and it’s quite clear that conservatives’ purported objections to vaccine passports are specious at best. While there are legitimate issues of privacy and security, these are being addressed. And contrary to conspiracy theorist Marjorie Taylor Greene’s blindingly stupid protestation of “fascism, or communism, whatever you want to call it,” portable vaccine credentials are an ethical, American way to beat the virus. Instead of government mandates, vaccine passports incentivize people to make the right choices and harness the energy of the free market to solve a collective problem that we cannot address individually.
Speaking of which, I got mine yesterday from the state of New York: a simple QR code called an “Excelsior Pass.”
Having received both my shots, I may be personally immune to serious disease. But my daughter isn’t. And some people, due to their personal risk of side-effects from vaccines, may never be. And none of us will be if the virus mutates in a dangerous way. So, as is fairly well known by now, we collectively have to reach “herd immunity,” which is where so much of the population is immune that the virus has nowhere to go.
This is why DeSantis is completely wrong that getting a vaccination is a “personal decision.” A personal decision, in the sense he is using the term, is one that affects only one person. But this is a decision that affects everyone, because until we hit herd immunity, we’re still stuck in the pandemic.
By way of parallel, wearing a seat-belt may be a personal decision—though, of course, it is nonetheless required by law. But signaling before I make a left turn is not, because it affects everyone around me. Getting a vaccine is, in addition to its personal benefits, part of a collective effort to beat this virus.
Even more importantly, the longer it takes to get to herd immunity, the more likely the virus will mutate. It is entirely possible that a new mutation will be resistant to the vaccines, though thank God, existing variants are not. If that happens, we are back to square one: back to lockdown, back to not seeing our friends and relatives, back to economic devastation and death.
Vaccination affects everyone. If we have large numbers of unvaccinated people walking around, the virus could mutate and we would all suffer. Refusing a vaccine isn’t “live and let live.” It’s “live and let die.”
And we are in real danger of that happening. According to a Pew Research study, 45 percent of white evangelicals say they won’t get the vaccine due to a toxic mix of bad faith, bad politics, bad (pseudo-)science, and bad media. That’s 18 million people. Just that number, plus children who generally don’t become sick but who can get the virus, is enough to threaten herd immunity and give the vaccine months to mutate. It’s a ticking time bomb.
So, what do we do?
Well, the simplest option would be to require every American to get a vaccine whether they want one or not. But thankfully, that is not the society we live in. Though vaccination does affect everyone, it is still happening to your body, and you have the right to decide what happens to it—though it is curious that conservatives don’t respect that right when it comes to women not wanting to carry babies to term. Our constitutional and ethical values make this option unacceptable.
What we need, then, are ways to incentivize people to make the right decision. We do this all the time already. The government gives tax breaks for charitable donations, home ownership, growing sugar, selling GameStop stock, you name it. Insurance companies pay people to stay healthy. And, of course, every business in America offers incentives of some kind, from my coffee shop’s caffeine-addiction card to Delta SkyMiles.
Vaccine passports are just another incentive. We have a public interest in getting everyone vaccinated, and so to promote that public good, vaccine passports set up valuable incentives: they’re your ticket to football games, malls, and Toby Keith concerts. They enable you to get on airplanes and (hopefully) trains. They’re literally your “ticket to ride.” They’re the key to normal.
There are other benefits as well. If I’m in an all-vaccinated space, I can feel safe knowing that I’m not endangering anyone else. (Data from Israel suggests that vaccinated people cannot infect unvaccinated ones, but we don’t yet know for sure.) And I know that I’m very, very, very unlikely to pick up the virus and, while not getting sick myself, potentially transmit it to my unvaccinated daughter.
All of this has already been put to the test in Israel, which is leading the world in per-capita vaccinations, and which has already rolled out a successful “green pass” program, and reopened large swaths of the economy.
Israel's green passes have created a system of positive reinforcement and community norms that promotes vaccination. All your friends are doing it, so you do, too; it’s part of how the human mind works.
That’s especially true in the vaccination context, in which many people are not faux-libertarian, anti-vax crusaders but simply vax-reluctant. When they see that their friends and communities have all gotten the jab, that reluctance lessens.
Vaccine passports aren’t the harbingers of a dystopian super-state, or the “great reset” conspiracy mongers talk about. They’re a very American compromise between individual freedom and collective responsibility for defeating a global pandemic. And since they’re incentives rather than mandates, they’re conservative as well.
What’s un-American is DeSantis prohibiting businesses from requiring them. Weren’t Republicans supposed to be the party of free enterprise? Why won’t DeSantis allow businesses to make this decision for themselves, based on what they think their customers want?
Now, there are several legitimate concerns regarding vaccine passports, mostly around privacy and security. We live in a surveillance state, with private companies sharing our personal data without our knowledge and bad actors eager to make use of it. It’s important to make sure that state-run and private vaccine passports take my privacy more seriously than Facebook does.
Fortunately, these concerns have been taken seriously and are being addressed. In addition to HIPAA’s restrictions on protected health information, a Biden administration task force, including industry leaders, is developing a set of standards for state-run and private vaccine credential programs. (The administration is not developing its own passport, citing concerns about the federal government amassing the information.)
It would also be appropriate for vaccine passports to be issued to those who are physically unable to obtain a vaccine due to health conditions. While this does present some risk, the number of people with such conditions is small enough to make it insignificant.
Of course, maybe none of this reasoning matters. Maybe DeSantis, Greene, and others like them are simply throwing red meat to their angry and drooling base, and even they don’t know what they believe.
But we owe it to ourselves to do better. Incentivizing people to get vaccinated is the American way, it’s the right thing to do, and it’s an essential part of ending this misery before the next winter comes.