GPs join call for vaccine passports

A Melbourne GP has joined other medical colleagues in a call for vaccine passports to help boost vaccination rates – and the freedoms of those who are fully vaccinated.
 
Dr Ahmed Sharif, who has worked at a clinic in Pakenham since 2005, is the lead author of a commentary article published this week in BMJ Global Health.
 
Titled ‘A pragmatic approach to COVID-19 vaccine passport’, the authors argue for a staged introduction of vaccine passports before they are used on a wide scale.
 
Dr Sharif said he decided to write the article jointly with four colleagues from the medical community, who include a fellow GP and a Monash University epidemiologist, as he believes the passports will offer people a greater incentive to get vaccinated.
 
‘We have noticed not only among the patients, but among the doctors, there is a sense of fatigue and tiredness about this lockdown,’ he told newsGP.
 
‘We still believe there is a big role for the lockdown to slow down the infection, but at the same time there should be a way out to reopen the economy and social life as well.’
 
At his own clinic, which is offering both AstraZeneca and Pfizer vaccines, Dr Sharif has noticed a shift in attitude since vaccination became mandatory for some industries. He says previously hesitant or resistant patients have now decided to be vaccinated – albeit sometimes reluctantly – as a result.
 
However, Dr Sharif believes vaccine passports would also offer another, broader incentive to the wider population. 
 
‘If you are double-dose vaccinated, you should be able to go to the MCG, you should be able to watch footy, you should be able to arrange a wedding party if all the [guests] are vaccinated,’ he said.
 
‘That would be a better incentive than dishing out $100 or offering a coupon for some beer.’
 
The article published in BMJ Global Health outlines numerous caveats to the proposal for the vaccine passport, including that it should be introduced in a ‘graduated’ way domestically before it is applied to international travel.
 
‘It is essential to devise appropriate stages of introducing such a certificate by addressing authenticity, ethical challenges, user-friendliness and individual country’s need,’ the authors write.
 
Eventually, they believe an internationally agreed World Health Organization framework should be put in place to facilitate quarantine-free travel – but the need to restart social and economic activity means a domestic solution should be worked out as a priority.
 
Any passport should be subject to an expiry date, set depending on data that emerges on vaccine efficacy and the need for follow-up doses, they write.
 
‘A vaccine passport can remain valid for a specific period with provision for further renewal as data on the vaccines’ long-term effectivity and the need for subsequent booster dose becomes available and while their ongoing efficacy against mutant variants is closely monitored,’ the article reads.
 
The authors also argue that any vaccine passports should be available in both digital and paper form and that they should ‘contain only relevant information needed to protect users’ privacy’.
 
Despite the provisos, Dr Sharif believes the experience of other countries shows such a system can have a positive impact on vaccine uptake.
 
He cites the example of Israel in particular, saying the introduction of a ‘Green Pass’ in that country prompted more people to come forward for vaccination.
 
In other regions, proposed vaccine passport systems have had a mixed reception. While the example of Israel is an apparent success, the UK last month dropped plans for a vaccine passport in England – but left the door open to the idea returning if cases surged.
 
With New South Wales now passed the 70% double-dosed vaccination mark for people aged 16 and older, attention is increasingly turning to the practicalities of allowing greater freedoms when restrictions are eased.
 
While the Federal Government has indicated it does not intend to implement vaccine passports, individual states are already at various stages of planning and the NSW Government has said vaccination status will be shown in its Service NSW app within a week.
 
Last week, the Therapeutic Goods Administration (TGA) also announced people who have received certain vaccine brands in other parts of the world that are unregistered in Australia could still be recognised as fully vaccinated.
 
Currently, people who have received two doses of a vaccine in Australia can access an immunisation certificate through their online Medicare account.
 
However, some fear missing out on freedoms through no fault of their own.
 
These include people who have been obliged to receive different types of vaccine for medical reasons and subsequently have not been recorded as fully vaccinated on the Australian Immunisation Register, as previously reported by newsGP.
 
Dr Sharif recognises there are many administrative considerations for the introduction of a vaccine passport. However, he and his co-authors believe they are worth tackling – at the same time as using other, complementary public health measures to keep outbreaks in check.
 
‘The freedom of movement conferred by a vaccine passport should be subject to expiry, amendments and cancellation, and be integrated with other measures such as physical distancing, mask-wearing and supported by ongoing scientific evidence,’ they write.
 
On a pragmatic level for general practice, Dr Sharif thinks the passports could help facilitate face-to-face consultations in areas with high community transmission, if required. And while he acknowledges the difficulties in policing the use of vaccine passports, he contends it would make a difference.
 
‘If there is a system, like random checking on the street, or QR codes in the various venues and restaurants, then there should be compliance – if not 100%, there largely should be,’ he said.
 
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