The idea of creating immunity passports or vaccination passports has already created some controversy. It turns out they are already here. And the controversy continues.

We have already seen multiple versions of the immunity passport idea. When vaccines are available, the travelling public may need to have a way to show that they are immune from the virus. This could mean that they have had a Covid-19 vaccine. Alternatively, they could have tested negative once or more times. Or they could have had the virus, sometime in the last few months.

Some controversy arose when Qantas CEO, Mr Alan Joyce suggested that vaccines will eventually be a requirement for his airline. Other organisations like IATA suggest that testing should continue being an alternative. They could be part of a system like immunity or vaccine passports, as other airlines have suggested. Qantas CEO sticks to vaccines-only. The matter has drawn a lot of criticism, but it is worth pointing out that Joyce reflects the Australian point of view.

Australia has a fairly strict quarantine rule for arriving visitors and returning Australian nationals. While controversial in itself, this approach has now reduced Covid-19 cases enough for Australia to wish to continue it. In other words, Australia is doing better than other countries, so they see no reason to change. Joyce feels the public broadly supports the measures, as well as his stance on vaccines.

The problem, for Australia-based airlines, is that their government has stated that they are in no rush to roll-out any vaccine. They’d rather see how it goes in other countries first. This means that the measures they have in place will likely stay until half-way into 2021. Australia isn’t thinking of immunity or vaccine passports at the moment. But others are.

The First Two Countries That Use Immunity Passports

Hungary has had a recent history of rather tight border controls, even before the pandemic. The arrival of Covid-19 saw them closing their borders on all sides. To be fair, everyone else in the EU did the same thing. But beginning in September, Hungarian authorities added an exception to this. While they didn’t decide to call it an immunity passport, that is more or less what it amounts to.

You can travel to Hungary if you can show that you HAD the disease within the last six months. So you have to provide a positive, and a subsequent negative test. This applies to ground travel and air passengers as well. So far there are no suggestions that other EU countries are considering such immunity passports. However there’s at least one non-EU country, that is.

Iceland depends on air travel way more than Hungary or most other countries in Europe. From the 10th of December, Iceland will accept incoming people who are immune, without any quarantine or other requirements. Again, the necessary proof for an immunity passport will be in the form of a positive PCR test. They will also accept specific antibody tests, only from approved European labs.

Iceland already permits people who have recovered from Covid-19 to ignore mask wearing rules. This requires a letter from a doctor. However few people take up this offer, to avoid having the conversation.

Immunity After The Disease

Epidemiologists in the US and Iceland have now done studies showing that 90% of those who had mild or moderate cases of the virus, still have the necessary antibodies to kill it, many months later. This is the basis for Iceland’s planned immunity passport scheme. However, the World Health Organisation (WHO) has yet to reverse its position on the matter. Early on in the pandemic, they declared that it still possible for people to get the disease, after recovering.

The worry, for many, is that someone might deliberately try to get the disease, to get an immunity passport and travel. This worry probably explains why Hungary hasn’t advertised its policy on allowing people who have recovered from Covid-19. People in the country hardly know about it, and even the experts the CNN quizzed in Iceland and the US, were unaware of it.

Deliberately Immune?

Iceland’s chief epidemiologist Thorolfur Gudnason researched the immunity levels of past patients. He admits that someone getting the disease deliberately is theoretically possible, but unlikely. And points out that this is not a fair reason to exclude immunity passports:

“…I think it’s also unfair to people who have had the infection. Why should they not be allowed to travel freely? I think it’s a question of justice, basically. If you have the medical condition that you are not spreading or having the virus, you’re not a risk to the environment, then you should be sort of recognized for that.“

Ethicists disagree on such immunity passports. Some agree with Dr Gudnason, adding that very few people would do something like this. Getting the disease is not only risky, even for young people, it also risks long-term issues, after recovery. Others counter that such a measure would reward reckless people who weren’t taking the necessary measures. And perhaps this argument would seem all-encompassing, and harsh on those who got the disease despite being careful. Think hospital doctors and nurses, or others who contact a lot of people, like underground/subway drivers and employees.

The matter of immunity passports will probably get more attention as vaccines gain approvals and their usage spreads. We have already seen IATA’s support on the matter. Also, some airlines have introduced third-party apps allowing passengers to process their private information securely. Passengers can then board flights without the airlines getting direct access to this information.

Immunity passports, or whatever they might end up being called, could become 2021’s hottest conversation topic.