Vaccine passports, or digital certificates of vaccination, can be required in any activity where admission rights are a business choice. But they can be used more widely in society. Vaccination cards are already typically required for children who are sent to childcare, school, and summer camps. Joan Costa-Font looks at vaccine passports’ potential for discrimination, their ability to change behaviour, and the implications of limiting the right to undertake certain activities only to people who have been vaccinated.
Taking a vaccine is a not just a self-protection behaviour against a virus, but insofar as it reduces contagion and creates herd immunity, it is a pro-social behaviour. It reduces the chances of infecting others and minimises the risk of another wave of the pandemic, which would cause misery to so many. Taking the vaccine can be called a ‘win-win’ situation: engaging in one’s protection protects others. Hence it merits some form of promotion. The question of which vaccine is secondary and mostly irrelevant.
Yet, there are many out there who are still unsure whether to take the vaccine (the so-called ‘vaccine hesitant’), or who, more generally, happen to distrust medical decision-makers for all sorts of reasons. In a setting where effectively communicating knowledge is challenging, persuasion comes from the accumulation of previous knowledge, and building trust takes a long time, individuals are likely to pursue their own form of self-interest and go without taking the jab. In fact, today there is a petition in the UK parliament for the government not to roll out vaccine passports.
Yet, non-vaccination might be nonintentional, a form of procrastination (‘pushing critical decisions to the future’) or simply an additional expression of the universal preference for inaction which is known as ‘status quo bias’. People in the latter category might be sensitive to interventions to promote vaccine uptake. This includes the elimination of constraints to vaccination, namely frictions and transaction costs. However, when non-vaccination is intentional, a question that merits discussion is that of the legitimacy of making several benefits conditional on vaccination.
For this to be possible, one needs to be able to identify who has received the vaccine, something typically known as vaccine passports, which are proposed to be implemented in the EU from March 24. Below we discuss the conditions under which making certain benefits conditional on vaccine passports is acceptable, and what the advantages and potential consequences are.
When are vaccine passports discriminatory?
What we call a vaccine passport is just a digital certificate of vaccination, which some airlines or countries might require of travellers, but they can be used more widely in society, in any activity where the admission right is a business choice. However, how discriminatory are vaccine passports?
There are important technical issues at play, which the Royal Society has established. This includes, among other things: meeting benchmarks for COVID-19 immunity and dealing with differences in vaccines; some international standardisation; data security and portability; affordability; and meeting legal and ethical standards.
For vaccine passports to be fair, everyone should have had the chance of being vaccinated, at no major cost, or else passports become potentially discriminatory. First, some individuals will have to be excluded as they cannot be vaccinated due to allergies or pregnancy. Second, its immediate implementation would keep individuals in many lower income countries from travelling, as they might not get the jab until 2022. Not only people of power have used their influence to skip the queue, but in most countries older individuals would take priority against younger individuals—who have been prosocial and stayed at home, and now see that those who they have been protecting will be prioritised to travel. The exception of such argument is that people working for the health sector will also be prioritised, which provides for some compensation for their extra stress during the pandemic. However, in any event, discrimination would be only temporary whilst the vaccination rollout allows everyone to have the chance to take the jab.
What should vaccine passports piggyback on?
In addition to the discrimination of people who are willing but unable to take the vaccine, the use of passports should be limited to non-essential services. Hence, even when it comes to travelling, it should not be conditioned on travelling to work. And passports should not provide any special rights, else it can crowd out one of the most essential reasons people vaccinate: being pro-social towards others by helping contain the spread of the virus.
Who are the vaccine-resistant?
There have always been contrarian people in all societies, and their existence might be healthy, helping enrich our views of the world. Similarly, there are those who are so affected by a status quo bias that they oppose any form of change. In countries where herd immunity is likely to be reached even though some people might still not take the jab, such as the UK, conditioning certain benefits on vaccination might not be an efficient policy. However, data on vaccine attitudes suggests that many countries are far from reaching herd immunity in part due to the unwillingness of the population to vaccinate. Paradoxically, the population groups that are most at risk are those less willing to take the vaccine.
How do they change behaviour?
Vaccine passports can be used as an incentive to change behaviour. They not only provide some direct benefits, but they signal what society expects from individuals. They exemplify a social norm that individuals are expected to comply with. They are no different from other forms of conditioning used in a number of settings. Vaccination cards are typically required for children who are sent to childcare, school, and summer camp. These ensure that children do not put others at risk. Similarly, in some low income settings, cash transfers are conditional on beneficiaries vaccinating their children and, more generally, going through health check-ups.
Vaccination for yellow fever is required for travellers entering some countries already, so COVID-19 vaccines would simply be an addition to such requirements. Vaccination cards can be seen as a form of reward, and play the same role as blood donation cards in the UK. They signal compliance with a civil duty towards a community, very much like voting in an election when the costs of doing so are not large.
Assuming everyone has had the chance to take the jab, should we condition activities such as travelling and using leisure centres on taking the vaccine? Should it be used when individuals are hesitant, and marginal changes to what individuals can gain from taking the vaccine make a difference in the decision to vaccinate? Our behaviour is motivated by the consequences we might suffer—reinforcements and punishments. Examples of negative reinforcement include the “beep, beep, beep” until you fasten your seatbelt. Similarly, vaccine passports for certain activities act as a form of nuisance individuals must go through, like when one is fined and is reminded to pay.
Finally, it’s worth mentioning that recent YouGov data shows that 65% of the British people say they would support vaccine passports (‘a document that would theoretically allow vaccinated people to return to workplaces and bars, and even travel again, before those who haven’t had their shots’).
♣♣♣
Notes:
- This blog post expresses the views of its author(s), not the position of LSE Business Review or the London School of Economics.
- Featured image by Lukas on Unsplash
- When you leave a comment, you’re agreeing to our Comment Policy
Print Friendly
Convincing people to take a vaccine for altruistic reasons is one thing but to remove entitlement, already enjoyed by people that don’t or can’t take the vaccine, in order to manipulate or coerce them into having it is in any sense of the meaning quite dystopian and dangerous to say the least.
Some people are just simply afraid of taking a trial vaccine until evidential research on short term and long term health effects has been achieved. This is understandable and a normal human reaction.
Some people cannot, for health reasons, have the vaccine even if they want it. It’s preposterous to suggest these people and those who are hesitant through fear have certain normal life activities removed or restricted if they are not vaccinated. That is nothing less than plain irrational and unfounded punishment.
This is a vaccine that is still in a trial phase and not much if anything is known of its efficacy towards stopping transmission of the virus, reinfection, nor long term health effects on individuals.
We are seeing more adverse reactions from the vaccine as it is further rolled out and more time is needed to accumulate these cases and study the vaccines effects and make necessary adaptations to it
We are dealing with human lives here from 2 angles..
The impact of the virus itself and the impact from the vaccine. Neither of which we have a complete understanding of yet.
Laws of consent are there for a reason. Without them every human would become available as a test subject against their will which is totally Inhumane. These people are humans not laboratory animals.
What the hesitant people need is time to see and understand how this vaccine is going to work. Currently nobody knows for sure as it’s still early in its trial phase. Restricting normal life choices for not taking a trial vaccine is punishing them for being humans reacting in a normal human manner when fear of the unknown controls their decision. It creates division in societies, and inequality giving rise to creation of subhuman group mindset and and is completely unacceptable. Not to mention the psychological damage that subsequently occur.
As for those that cannot take the vaccine for medical or other founded reasons why should they have their liberties curtailed? Coercion and manipulation won’t be of any use to this group.
To incorporate all groups that is humane and fair a system that does not discriminate has to be found. One that is equal in cost and effort across all groups. Not one that punishes through cost or restrictions those unvaccinated.
In order to curb the spread of the virus free quick viral tests must be made available to the public. This will encourage people to partake and get economies going again. Paying for tests puts many people off and encourages them to find ways to avoid it, also most people cannot afford them.
People who are vaccinated still need to be tested as it still unknown whether they can still infect others.
Removing liberties and freedom of choice is not the way to get people onboard. That only perpetuates societal division, psychological trauma and fuels conspiracy theories.
Cheapest purest propaganda, nothing more! It is horrible how the pseudo-science of economy pays homage to the religion of vaccination.
Regards from Switzerland
I completely agree with E.Rice. Also it’s going to be discriminatory from the offset, from what I’ve read the fastest and easiest way they’ve figured to start the process is through the NHS app on smart phones. It will be a long time till they come up with and release some sort of working card or certificate. The problem with that is they started the vaccinations with the elderly and worked their way down, my elderly relatives don’t even own a smart phone, my grandad got confused and upset when I tried to take him for lunch the other week and they wouldn’t let him past the door till he “scanned” the QR code. All he wanted was a pint, a sense of normality. It also states on the website the NHS app doesn’t work on older model smart phones, so again discriminating against those who may not be able to afford the newer models. What’s the point in being vaccinated if you can’t prove it?
I am unable to get the vaccine, I have an autoimmune disorder and chronic angioedema. I have had COVID-19, studies show that immunity from infection is the same as immunity from vaccine. Neither is 100% and both can start waning after roughly 6 months depending on the individual. Herd immunity is the goal. I am not taking the risk for a trial vaccine when I do not know the outcome, especially with my body. Vaccine passports like this are a bad idea. I understand the reference to yellow fever, but you’d have made more sense if you’d compared it to having a passport for the flu jab.
What a poorly written piece. A real shame to see this on the LSE page. Freedom of speech is of course welcome but this piece is clearly biased. The comments offer a more intellectual discussion. The existence of contrarians “might be healthy”? I find it interesting the writer has taken it upon themselves to comment on a group of people who simply may offer a contrary opinion on one subject in such away. It’s seems so blizzard, contrarian or not, to analyse people is such a divided way. This article is almost an advert for why there needs to be challenge. This article had been write by an ” academic expert”. Possible reasons for not taking vaccine incl. procrastination or to maintain the status quo bias. Simply following what we are told to do could be argued to be the status quo bias. Are these really worth mentioning? Then surely reasons to take the vaccine should be discussed in greater depth..including some basic mention of compliant personalities and many people rightly or wrongly using it as a lesser of two evils (to treat their fear and anxiety). Such a complex and interesting topic for discussion. I would have expected better.