Immunity Passports – Are They the Key to Restarting Travel With COVID-19?

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Experts are thinking about strategies for restarting travel once COVID-19 cases begin to slow. More countries are looking for an easy way to check if someone has had the vaccine. Some options, like requiring a 14-day quarantine upon arrival, may make it difficult for many people to be able to start traveling again — but what other options exist?

A few countries have started considering issuing “immunity passports” or some kind of health certificate indicating a person has immunity to COVID-19 — whether they have received a vaccine or recovered from COVID-19. But how reliable would these immunity passports be, and how would you even get one?

We’ll explore what exactly these immunity passports are, how countries might use them to cross their borders, and if they might the key to getting travel back soon.

What Is an Immunity Passport?

An “immunity passport” assumes that once you’ve been infected with the virus that causes COVID-19 and makes a full recovery, you will have immunity that will protect you from getting the disease again. This could also show that you’ve been successfully vaccinated for COVID-19.

Theoretically, this means that you would not be able to pass the virus to anyone else and you would be free to move around in public without worry.

Unfortunately, what we don’t know for certain with COVID-19 is whether people do have immunity once they’ve recovered. The good news that the vaccination efficacy rates have proved to be as high as 95%, but we still don’t know how long immunity might last.

Hot Tip: For a detailed look at how antibody testing works, check out this article from the Massachusetts Institute of Technology (MIT).

What’s the Difference Between a Coronavirus Test and an Antibody Test?

A coronavirus test, or a diagnostic test, looks for signs of active virus. It’s simpler and faster than an antibody test but only tells you if you have the virus in your body at the moment when you’re tested.

An antibody test shows that you had the virus at some point in the past. It could be gone, or you could still be contagious.

How Might an Immunity Passport Help With COVID-19?

At the center of the idea of immunity passports is the testing for antibodies OR showing proof of vaccination. To be able to receive an immunity passport, you would either need to know if your body has the antibodies specific to SARS-CoV-2 (the strain of the virus that causes COVID-19) present because you previously fought off the coronavirus or that you have received a vaccination.

The U.S. Centers for Disease Control and Prevention (CDC) is providing a vaccination card that tells you key facts about your inoculation, including the date you received the vaccine and the type you received. Either this card, or some electronic version of this card, could help with this.

People who have an immunity passport could safely return to work and travel because they would not get sick again. As enough tests become available and enough people get clearance, business and activity could slowly return to normal.

Bottom Line: If enough people are shown to have the vaccine or immunity, these passports could help lift “shelter in place” orders and would make it possible for borders to reopen.

Obviously, there are some big considerations here. To start, something like this hasn’t been done before, since we haven’t had a pandemic of this scale or this level of shutdown in our lifetimes. Attempting to issue some kind of certificate to millions of Americans would be unprecedented. We would first need these vaccines and tests to be widely available.

Who Would Need an Immunity Passport?

Between 25% to 50% of people who become infected with COVID-19 may never develop symptoms, and some may become only mildly ill. Others may have known they were sick, but could not get tested. This means that it is important for every individual to be tested for antibodies to COVID-19 or receive the vaccination.

This leads to some ethical issues. Would you need either the right connections or enough money to spend on the testing/certificate? Due to the limited access, it will be some time before the general public gets vaccinated. Vaccination priority is determined by individual states, but the CDC recommends that the order first should go to healthcare workers, essential workers, elderly individuals, and then those with pre-existing conditions. Are there medical reasons that might prevent someone from even being able to get a vaccine?

Fiji Airways Airbus A350 Economy Class Cabin from Rear
Image Credit: Greg Stone

This could essentially create 2 different classes of people: those who are permitted to re-enter society (to work, take public transit, travel, go to church, etc.), and those who aren’t.

Testing for Immunity Passports

To be tested for immunity, you’ll have to give some blood, through something like a finger prick. Doctors will use your blood to test for 2 kinds of antibodies linked to COVID-19. Antibodies usually stay in your blood long after the infection goes away, but we don’t know how long that is for COVID-19 specifically.

On May 9, 2020, the Food and Drug Administration (FDA) approved the emergency use of the first antibody test to Abbott Laboratories. The tests can indicate whether a person has had COVID-19 (either asymptomatic or recovered).

Since then, many companies have been approved to distribute antibody tests and they have been made widely available (either for free or at minimal cost) at local clinics and through your healthcare provider.

Hot Tip: The vast majority of tests currently on the market are at-home test kits that are not approved by the FDA. 

How Would You Use an Immunity Passport?

It is unclear to what extent countries may recognize immunity passports granted in other countries. So while we don’t know exactly how an immunity passport will be used, we do have some ideas of how this might look thanks to a few countries that are planning to introduce them.

Already, the European Union (EU) is discussing plans on travel, which include proof of vaccination for Schengen visa application and visa-free entry if you are traveling from outside of the EU, including U.S. travelers.

In addition, in November 2020, the IATA announced plans to implement something like an immunity passport. This so-called “digital health pass” would help facilitate the management and verification of testing and vaccination requirements between various governments, airlines, laboratories, and travelers by creating a global registry of requirements and allowing for standardization of testing results. The official launch is scheduled for Q1 of 2021 and airlines such as Qatar Airways, Etihad Airways, and Emirates are already signing up.

IATA Travel Passport Workflow
Image Credit: IATA

An internationally-accepted digital certificate developed by The Commons Project is currently being used by all 3 major U.S. airline alliances to check for vaccination status.

United States

In the U.S., the Vaccination Credential Initiative, which includes companies such as Microsoft, Oracle, and Mayo Clinic, are working to create a system that can weed out the real vaccination certifications from the fake ones.

Immunity cards could “have some merit under certain circumstances,” Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said on CNN in early April 2020. “It’s one of those things that we talk about when we want to make sure that we know who the vulnerable people are and not,” he said.

These cards have been mentioned in especially hard-hit places, such as New York City and Los Angeles.

The CDC announced that it has begun using antibody tests to see what proportion of the population has already been infected.

Chile

Chile is so far the only country to launch an official immunity passport plan. This plan is primarily directed at those who are employed, in hopes that individuals that have recovered from the COVID-19 virus will be exempt from quarantines and other restrictions and can get back to work.

Other applicants may be tested for the presence of antibodies to determine eligibility. Details about a mass rollout have been very limited, but officials have promised a mass testing plan and say cards will be issued to people with a “very high probability” of being non-contagious.

United Kingdom

The idea of issuing some form of certificates to people who have been sick with the COVID-19 virus has also been popular in the U.K. as authorities look for ways out of socially and economically devastating lockdowns.

The country has stockpiled over 17.5 million home antibody testing kits and has raised the prospect of sending out tests en masse, although this has come under major scrutiny from scientists who have raised concerns that the test may not be accurate enough to be useful.

Nevertheless, the National Health Service has begun rolling out a new app that could make immunity passports a reality.

Airline Requirements

Some airlines, such as Delta, are floating the idea of immunity passports for passengers to be cleared for takeoff.

American Airlines and British Airways recently announced the use of the digital health passport app VeriFLY (iOS, Android) to streamline COVID-19 test results. Using the app, travelers can select a destination, upload negative test results, and receive a QR code to show upon check-in at the airport. Once COVID-19 vaccines are more widely available, the hope is that this app will be expanded to include evidence of immunity as well.

United has launched its Travel Ready Center where passengers can upload their vaccine and testing documents, as well as see what destination requirements are needed.

In November 2020, Qantas CEO, Alan Joyce, said the move would be “a necessity” when vaccines are available. Australia has famously shut its borders to prevent the spread of COVID-19.

Delta Air Lines’ CEO Ed Bastian has also made statements that he will embrace the potential document. Speaking on the airline’s first-quarter earnings call in April 2020, he said the carrier was open to the idea if it helped passengers feel more comfortable onboard aircraft again.

Hot Tip: A federal policy began January 26, 2021, requiring arriving international passengers, regardless of their vaccination status, to get a test for current COVID-19 infection within 3 days prior to their flight’s departure, with written documentation of their test results or proof of recovery from COVID-19.

What Are the Leading Authorities’ Opinions?

Individuals in possession of an immunity passport could be exempt from physical restrictions and could return to work, school, and daily life.

However, immunity passports pose considerable scientific, practical, equitable, and legal challenges.

In Favor of Immunity Passports

Overall, there are definite positives to the idea of immunity passports, but no real data of how exactly they would work.

Immunity Assumptions

Based on what scientists know about immunology, there is reason to assume that recovering from COVID-19 will provide some amount of immunity. Scientists have long known from other diseases, such as hepatitis and the common cold, that your body can protect you from contracting a disease that you’ve already had by producing antibodies.

Health Passports Already Exist

We already see a similar concept at work with the yellow fever immunization cards given to people traveling or living in Africa who have been vaccinated against the disease.

Similarly, while waivers do exist, U.S. university students at some states across the U.S. are required to have meningococcal and Hepatitis B vaccinations.

Other countries have similar rules in place for compulsory immunizations. For example, if you want to reside in Singapore long-term, the country mandates vaccinations for diphtheria and measles by law for children 12 and under and no exemptions or waivers are available.

However, having documentation proving immunity would be more difficult than having proof that someone has been vaccinated.

Robust Contact Tracing Is Possible

In China, QR codes have been used to loosen restrictions in Wuhan, where the pandemic originated. People assessed to be healthy have been given a green QR code, indicating they can travel within the province.

COVID 19 Immunity Passport App
Image Credit: Ivan Marc via Shutterstock

Countries like Iceland are also requiring residents and visitors to download cell phone tracking apps to assist with contact tracing.

Enables Return to (Somewhat) Normal

And lastly, but maybe the most compelling reason, is that immunity passports allow the economy to open back up for those that have immunity.

Opposed to Immunity Passports

While the arguments in favor of immunity passports get the world’s economy moving much quicker, unfortunately, they are more based on opinion. By contrast, the leading authorities seem to be unanimously opposed to immunity passports — at least for the immediate future.

World Health Organization’s Opinion

“At the present time, do not introduce requirements of proof of vaccination or immunity for international travel as a condition of entry as there are still critical unknowns regarding the efficacy of vaccination in reducing transmission and limited availability of vaccines,” per the WHO panel. Overall, The WHO believes that there aren’t enough vaccines available to use an immunity passport as it creates “unnecessary barriers to travel”.

Immunity Unknown

How long COVID-19 immunity lasts is unknown. The World Health Organization (WHO) said that “there is no evidence yet that people who have had COVID-19 will not get a second infection.”

If it is similar to other coronaviruses like SARS and Middle East respiratory syndrome (MERS), then this study suggests the average length of immunity for SARS is 2 years.

For those who recover from COVID-19, research shows immunity to the virus can last for at least 8 months, and may last much longer. For those who receive the COVID-19 vaccine, that immunity can last up to a few years — but since this is still a new vaccine, much is unknown about the long-term results.

Antibody Testing Unreliable

As discussed above, there’s also the issue of the quality of the testing kits to consider. False positives (or negatives) can have a drastic impact on someone’s life.

The WHO also warns that “people who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission.”

Experts have also raised concerns that immunity passports could encourage people at lower risk or people desperate for work to try to deliberately infect themselves.

The CDC says in new guidance that decisions to return to work shouldn’t be based on these antibody tests. This is because “the serologic tests…might be wrong up to half the time.”

Ethical Concerns

There have been recent reports that immunity passports may violate U.S. law because they would “violate U.S. disability protections.” The Americans with Disabilities Act is broad but could be interpreted to protect against workers being discriminated against based on whether they have or don’t have immunity.

And there’s concern that the policing of immunity passports would harm people of color in cities like New York City that have seen a higher percentage of African Americans and Latinos affected by the virus. The American Civil Liberties Union (ACLU) is opposed to the idea because it could “exacerbate racial and economic disparities, and lead to a new health surveillance infrastructure that endangers privacy rights.”

In some instances, it might not be an option for someone to receive a vaccine. Specifically, the CDC notes that there have been concerns about pregnant women or women trying to become pregnant or those with certain underlying health conditions as little, if any, testing has been done for these groups.

Finally, it might encourage fraud, resulting in a black market for fake immunity passports.

Final Thoughts

So, are immunity passports the key to restarting travel?

The idea of immunity passports sounds very appealing — and like a light at the end of the tunnel. When antibody testing is reliable and readily available, there may be a way to successfully roll out immunity passports in the future. In addition, once the vaccine becomes widely-available, this could be another way to show immunity.

Once this happens, immunity passports would provide a level of security that many people want to feel before they starting traveling again.

What are your thoughts on immunity passports? Do you think they are a good idea?


All information and content provided by Upgraded Points is intended as general information and for educational purposes only, and should not be interpreted as medical advice or legal advice. For more information, see our Medical & Legal Disclaimers.


Frequently asked questions

What are immunity passports?

An immunity passport shows that the holder is immune to a contagious disease due to the presence of antibodies — in this case, for COVID-19. Since 25% to 50% of people do not show symptoms, it is very possible to have antibodies without even knowing that you were sick.

How can immunity passports restart travel?

In theory, if a person has antibodies for a disease, it means they will not get the disease again. If this is the case, those people with antibodies could travel without fear of infecting others. Unfortunately, we don’t know enough about COVID-19 to know if people can become reinfected or even how long antibodies might last. Currently, not enough is known about the COVID-19 virus to feel confident that immunity passports would be successful.

Are airlines requiring immunity passports to travel?

While many airlines and countries are requiring proof of a negative COVID-19 test in order to travel, there is not currently a process for providing evidence of immunity to COVID-19.

The IATA announced plans to implement something like an immunity passport. This could be used by travelers as an official way to show standardized test results. The official launch is scheduled for Q1 of 2021.

How is an antibody test different from a COVID-19 test?

A rapid test or a PCR COVID-19 test looks for signs of active virus. In comparison, an antibody test shows that you had the virus at some point in the past, although antibodies could fade over time.

If you are looking to travel, most countries are requiring evidence of a negative COVID-19 PCR test, meaning they are checking to see if you currently have COVID-19.

Christy Rodriguez

About Christy Rodriguez

Christy was born in St. Louis, Missouri, but lived in Texas the majority of her life. Now, work has her living in the Bay Area with her husband and yellow lab. Her first international travel experience was for a summer study abroad program in Italy. After that, she knew that she was destined to travel as much as possible. Luckily, her husband worked at Southwest Airlines, so they were introduced to the exciting world of “non-rev” travel.

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2 comments

  1. Brian C Hill June 7, 2020

    This whole paragraph actually defeats its own point:

    “And there’s concern that the policing of immunity passports would harm people of color in cities like New York City that have seen a higher percentage of African Americans and Latinos affected by the virus. The American Civil Liberties Union (ACLU) is opposed to the idea because it could “exacerbate racial and economic disparities, and lead to a new health surveillance infrastructure that endangers privacy rights.””

    Groups that have been hard-hit will have more ostensibly-immune members, not fewer of them. The idea of immunity passports could actually give those groups a leg-up over other groups with less collective immunity.

    Where is the harm to those groups from ‘passports’ in that?

    Also, the WSJ was wrong about reactivation. At very least, your story missed newer info. In not one case of an ostensible ‘second infection’ could viral matter from the infected person be successfully cultured. It turns out that all of the shed material found in the ‘second infection’ were old deactivated virions (e.g. ‘dead’ as most people think of it). The tests were merely not properly tuned. South Koreas cases were no exception to that:

    https://news.sky.com/story/coronavirus-scientists-conclude-people-cannot-be-infected-twice-11981721

    The endless fear-mongering is truly ridiculous. Let’s try to find the positive information before we are so eager to report the negative information.

    Reply

    • Hi Brian, to address some of your concerns, the quote you mentioned from the ACLU was specifically related to the financial hardships that those minorities would face, not the fact that more members from those groups might already be more immune. It is noting that the steps to obtain a passport might create two groups of people – one that could afford a passport, and another that could not. This is actually addressed earlier in the article when we state “Would you need either the right connections or enough money to spend on the testing/certificate?”

      With regards to reactivation of the virus – there are even more recent articles that are still very much debating what these second positive tests mean. For example, here. We specifically state “So whether the virus is reactivated, the virus mutates, or an individual’s initial immunity goes away, we still have a lot more to understand about COVID-19.”

      We definitely aren’t trying to “fear-monger”, but include cited sources from credible sources that explain how immunity passports might (or might not) work in real life. Thanks for reading!

      Reply

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