Vaccine passports have arrived in cities with varying degrees of strictness

a hand holds an iphone displaying a QR code reading text in German. It is a vaccination certificate
a hand holds an iphone displaying a QR code reading text in German. It is a vaccination certificate

Even before viable Covid-19 vaccines hit the market, vaccine passports promised to ease movement across borders and slow transmission risk.

Now, the passports are here. Roughly a dozen jurisdictions around the world have implemented policies so far over recent months, despite concerns about privacy and discrimination. Cities, countries, and international organizations are deploying numerous different digital and analog systems to track vaccination records and Covid19 tests. Some of the first passport systems were for meant international travel, but recently as vaccination rates in Western countries have gone up, national and local governments are introducing domestic passports that allow people to participate in public life for everything from restaurants and theaters to public transit.

As the delta variant threatens to roll back some of the progress being made against the pandemic, these pass systems are emerging as a key tool for government officials to control the transmission of the coronavirus.

Do vaccine passports work?

Vaccine passports have been presented as a way for people to move about safely during the pandemic without reverting to mass lockdowns. By allowing only those who have been vaccinated (or test negative for Covid-19) in high-risk public settings, health officials believe transmission rates will fall and protect those still not eligible for vaccinations, such as young children. A second goal is encouraging those who haven’t yet gotten the jab to do so in order to participate in public life. There’s some evidence this is working: vaccination rates spiked in Italy and France after announcements of their new vaccination rules.

Governments have sought to balance all this against privacy concerns. Highly centralized systems like the UK’s National Health System (NHS) health pass are the most reliable way to confirm vaccination information is accurate, but also vulnerable to hacking or misuse. So the NHS password-protected system ensures no other health records aside from a vaccination record or test result are stored with the account.

On the other end of the spectrum, the US has a patchwork of decentralized approaches. San Francisco expects establishments to check vaccination cards issued by the US Centers for Disease Control and Prevention (CDC). New York’s Excelsior system generates a secure digital copy of Covid-19 vaccination cards (with some potential security vulnerabilities since the app businesses use to scan QR codes could record logs of users’ visits, according to one test). Since the federal government has said there are no plans to issue a national vaccine mandate, it has left such action up to states (some of which have already banned vaccine passports).

Here is an overview of vaccination passes in cities and countries around the world.

France

France’s pass sanitaire is one of the most stringent domestic passport systems in Europe, with requirements applying to nearly all aspects of public life, and with steep penalties for noncompliance. The rules took effect on Aug. 9.

  • Pass confirms user is vaccinated, has had a negative covid test within 48 hours, or hasn’t had a positive test in more than 11 days

  • There is no single “pass sanitaire”, but individuals must show some proof document. The mobile app TousAntiCovid allows people to upload and store this information

  • Mandatory for entry in all cafes, restaurants, and bars (even for outdoor seating), theaters, and libraries, and even intercity trains

  • Those who don’t present a pass can be refused service. Presenting a false pass can result in a €135 ($158 USD) fine

  • Currently, only adults 18 and up are required to show passes, though children 12-17 may need them starting Sep. 30

Israel

Israel’s Green Pass, introduced in Feb. 2021, was one of the first passport models to roll out, after Israel had vaccinated about half of its citizen population. It was lifted in June when infection rates dropped, then reinstated it in July when the Delta variant caused a rise in cases. The Green Pass is broad in the venues it applies to, and has a short window for an acceptable Covid-19 test, making it moderately strict compared to other countries.

  • Confirms user is fully vaccinated, has tested negative within 24 hours, or has recovered from Covid-19

  • Available as a digital app

  • Applies to cultural events, gyms, restaurants, dining halls, conferences, tourist attractions, and houses of worship

  • Only applies within Israeli territories

Italy

Italy’s Green Pass (link in Italian) was announced on July 22. The national Ministry of Health issues certifications automatically based on centralized health data, not information uploaded by an individual. The strong controls make it one of the more robust passport national models.

  • Confirms user is fully vaccinated, has tested negative, or has recovered from Covid-19

  • Available as a digital or printable pass

  • Required for entry into cultural and tourist sites, indoor restaurants, spas, gyms, convention centers

  • Mandatory for people age 12 and up, can be enforced with “random checks” by police

  • Non-compliance can be punishable with a fine for individuals, temporary closure for businesses

UK

The UK’s National Health Service has introduced the NHS Covid Pass. It’s less strict relative to other European countries, leaving the decision up to individual businesses about whether they want to participate.

  • Confirms user is fully vaccinated, has negative PCR or rapid test within 48 hours, or no positive PCR test within past 6 months

  • Available as a digital QR code via an app or paper certificate

  • Available in England, but not yet Scotland, Wales, or Northern Ireland

  • Not yet mandatory, but encouraged for use in “high risk settings” such as concerts or night clubs.

New York City

New York announced its Key to NYC Pass in early August, the first US city to require proof of vaccination for entry into public spaces. It’s notable for having vaccination as the only acceptable standard for entry into a venue—not just a negative test or proof of having had Covid-19. In this way, it is more strict than the European and Israeli models.

  • Confirms user has had at least one dose of a coronavirus vaccine—negative tests are not accepted

  • Two main apps being used; a citywide NYC Covid Safe App, and the Excelsior Pass, available throughout the state of New York

  • Required for both workers and patrons for entry into indoor restaurants, bars, gyms, indoor movies, concerts

  • Mandatory, but a rollout period begins Aug. 16th. Enforcement will begin Sept. 13.

San Francisco

San Francisco announced on Aug. 12 some of the strictest vaccination requirements in the US. It goes a step beyond New York’s in requiring full vaccination, not just the first shot of a two-shot series.

  • People must be fully vaccinated to enter indoor bars, restaurants, gyms, and other spaces

  • As of now there is no single “pass” program, but individuals must show vaccination cards

  • Vaccine mandate applies to indoor venues like bars, clubs, and gyms, as well as large indoor events

  • Mandatory beginning Aug. 20

New Orleans

On the same day that San Francisco announced its vaccine mandate, New Orleans mayor LaToya Cantrell held a press conference announcing that it would adopt similar measures. Unlike San Francisco, however, New Orleans venues will accept negative Covid-19 tests for those who are not vaccinated.

  • People must show proof of having received at least one vaccine shot, or have a negative Covid-18 test from within 72 hours

  • Acceptable forms of proof included Centers for Disease Control vaccination card, photo of card, or a digital copy uploaded to the LA Wallet App

  • Mandatory for indoor dining at bars and restaurants, gyms, stadiums, large outdoor events

  • Goes into effect Aug. 16

How are these passports being received?

While compliance with vaccine pass policies appears to be high, they have provoked confusion and controversy in some places. France saw weeks of mass protests of more than 200,000 people in cities across the country. President Emmanuel Macron pled with critics to consider the common freedoms enjoyed when everyone is protected. In England, pubs that have chosen to comply with the health pass rules have been targets of in-person and online protests, and have been placed on boycott lists.

There has been less resistance in Italian cities, where most public life in the summer takes place outdoors anyway. Green Pass requirements do not apply to outdoor eating, and in surveys most people appear willing to present their pass in most settings (66% of Italians support the pass, according to polling by an Italian newspaper.)

Elsewhere, however, businesses have struggled to administer imperfect systems with little government support. Pub owners in the UK have worried about staff reviewing and enforcing Covid-19 passes. New York’s “NYC Covid Safe” app has been called “nothing more than a glorified photo storage app.” Tourists traveling abroad for the first time find themselves between incompatible systems (the European Union’s digital Covid certificate for international travel doesn’t work as a domestic pass in the bloc).

It’s too early to tell how vaccine passes will affect transmission rates even as they quickly become routine in some cities, similar to the use of QR-code restaurant menus over the last year. But for now, a patchwork of passports and mandates is one of the best tools health officials say they have to curb the pandemic.

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