Should Australia introduce a vaccine passport?
As millions of Australians continue to face lockdowns and other COVID-19 restrictions, there is one burning question on people’s minds: when will things go back to normal?
- A vaccine passport will only work if a substantial portion of the population is vaccinated.
- A system-wide approach is needed to successfully roll out the program.
- Vaccine passports – and the subsequent ending of lockdowns – are critical for the tourism industry and other businesses to survive.
Australian Prime Minister Scott Morrison announced an update to the Federal Government's four-phase plan to return Australia to pre-pandemic life following a National Cabinet meeting on 30 July.
While the announcement did not specifically mention a vaccine passport, the backbone of the plan is widespread vaccination. Based on the targets agreed on in principle by National Cabinet, 70 per cent of eligible Australians must be fully vaccinated in order to progress out of Phase 1 (the suppression phase) and into Phase 2 (the transition phase), while 80 per cent is needed to progress to Phase 3.
The plan also proposed a gradual roll back of restrictions in each phase, such as lockdowns and border controls for vaccinated residents.
As federal, state and territory leaders deliberated on the details of the four-phase plan, the European Union (EU) launched a COVID-19 Vaccine Passport/Certificate in July, which allows unrestricted, quarantine-free travel within the EU for those who have been fully vaccinated, tested negative or have recovered from COVID-19.
With eradication of COVID-19 now considered unlikely – even with a vaccine – low levels of ongoing community transmission are inevitable, and Australia needs a way to manage a safe return to pre-pandemic life and travel.
So, we put the questions to UQ experts and alumni: is a vaccine passport a fair and safe way forward? How would it work? Can the tourism industry and businesses survive without one? And can we expect one any time soon?
Image: Nattakorn/Adobe Stock
Image: Nattakorn/Adobe Stock
Would a vaccine passport work?
A digital COVID-19 vaccination certificate is already available for vaccinated Australians and can be accessed through the Express Plus Medicare app.
However, it currently offers no additional freedoms to vaccinated Australians.
UQ virologist Dr Kirsty Short said the low vaccination rates across the country meant a vaccine passport introduced anytime soon would be unfair, with only 40.1 per cent of Australians having had their first dose and 18.1 per cent fully vaccinated (as of 30 July 2021).
“We still have a significant portion of the population who want the vaccine, but simply cannot get it,” Dr Short said.
“If we reach the point where the vaccine was available to anybody who wanted it, then I think a vaccine passport – or at least different rules for vaccinated individuals – would be a very smart move.”
Associate Professor Paul Griffin – an infectious diseases physician and microbiologist within UQ’s Faculty of Medicine – said once vaccine rates improve, Australia needs to start recognising vaccination status to regain some of the freedoms taken away during the COVID-19 pandemic.
“I think some of the reluctance to implementing a vaccine passport is because people are concerned about having liberties removed or restricted. But I think we should look at restoring some freedoms to people who are vaccinated as something they’ve earned by being protected,” he said.
“We need to learn how to live with this virus. While our strategies in Australia to control the virus so far have been highly effective, they were always designed as temporary measures until we had access to safe and effective vaccines, which we now do.
“Some people simply can’t see enough benefits to getting vaccinated. If we can demonstrate some freedoms – like unrestricted domestic travel – that will go a long way to overcoming some vaccine hesitancy.”
UQ graduate and infectious diseases paediatrician Professor Robert Booy (Bachelor of Medicine and Bachelor of Surgery ’84, Doctor of Medicine ’00) said a passport would only work within context, meaning a substantial percentage of the population must be vaccinated.
“Something that is both achievable and which will work is 75 per cent minimum rate. Even if we don’t have herd immunity at that point, we’ll be very close to it, and any outbreak will be small and short," he said.
As vaccinations do not create 100 per cent immunity, other measures will still be important to ensure community safety, including things like pre- and post-flight testing.
“I propose that the airlines continue taking strong measures, including mask wearing, social distancing where possible, and frequent handwashing – all these things need to be done in the context of having a vaccine passport,” Professor Booy said.
“Another option is a lateral flow test, which, much like a pregnancy test, can be done in 10 to 15 minutes and can be moderately relied on, with around a 50 to 70 per cent sensitivity level.
“These are being used widely in the UK – they’re especially appropriate for places where there’s a lot of disease transmission.”
Looking to international travel, Associate Professor Griffin said Australia should consider a risk-based approach – focusing on a person’s justification for travel, their vaccination status, and where they’re going.
“If people are going somewhere that has little COVID-19, and they’re fully vaccinated, then perhaps they could have a shorter period of quarantine at home, rather than 14 days of hotel quarantine,” he said.
“To continue down the current path means we can’t allow international tourism, migration or study for the foreseeable future. I think we should be allowing more Australians to return, but also other important travel groups – like students.
“If they’re vaccinated, if more Australians are vaccinated, and other mitigation strategies are implemented in parallel, then some international travel should be able to resume safely.”
Image: James Thew/Adobe Stock
Image: James Thew/Adobe Stock
Is a vaccine enough to protect Australia from COVID-19?
A vaccine passport would eventually see Australia move away from strict measures like lockdowns and border closures required by the 'aggressive suppression' strategy (no community transmission) it has pursued.
Instead, we would likely see a disease-management response more comparable to how we manage other pathogens, like influenza and measles.
“Widespread vaccination – and so widespread immunity – will not stop small outbreaks of COVID-19, and that will happen because there’s some members of the population who aren’t vaccinated, can’t be vaccinated, or their vaccine response has waned,” Dr Short said.
“But what I could imagine is a situation like we have today with measles, where occasionally you’ll get alerts that someone with measles was at a certain location and to present yourself if you have symptoms and were in the vicinity.
“A measles outbreak doesn’t trigger a lockdown, as a lot of people are vaccinated against measles.
“If we reach a certain proportion of people vaccinated against SARS-CoV-2, I imagine a small outbreak would not cause a lockdown, but rather a similar process of contact tracing and health follow-ups as for a measles outbreak.
“Vaccination is the way out of these lockdowns and all the restrictions we have.”
While the risk of contracting COVID-19 is unlikely to disappear – even with vaccines – it’s important to remember that COVID-19 vaccines have demonstrated strong rates of disease reduction.
Two doses of the Pfizer vaccine create up to 90 per cent protection against severe disease in COVID-19, with two doses of AstraZeneca creating up to 89 per cent protection. However, Dr Short said individual efficacy rates were largely unimportant once the booster scheme is introduced.
So, while the potential of contracting COVID-19 remains for vaccinated individuals, the likelihood of severe disease is much lower.
How far away is a potential vaccine passport?
While the Prime Minister had planned for all Australians to be vaccinated by the end of the year, UQ graduate and Clinical Director of the Queensland Health COVID-19 Vaccination Taskforce and Vaccine Command Centre, Dr Bav Manoharan (Bachelor of Science ’07, Bachelor of Medicine and Bachelor of Surgery ’12), said the timeframe would rest on several key factors.
“These factors include vaccine supply and capacity within the system,” he said.
“For all Australians to be vaccinated, a system-wide approach will be needed to successfully roll out the program.”
“This is a collaborative effort that includes GPs, community controlled health organisations, community pharmacies, state-run clinics and commercial providers.
“Australia has a well-established national immunisation register which has the capability to record an individual’s vaccination data. This register is perfectly positioned to support a vaccine passport.
“So how far away is it? It’s difficult to say, but Australia is very well placed.”
Dr Short pointed to two major concerns with rolling out a vaccine passport: which vaccines will be included, and the lack of current data around how long immunity lasts.
“Every country has a different vaccine rollout,” Dr Short said.
“In the US, they’re allowing people back to college if they’ve had an FDA-approved vaccine. But those who have had a non-FDA-approved vaccine – say, Sinopharm – aren’t recognised as vaccinated.
“People are then required to be re-vaccinated with FDA-approved vaccines, and that becomes very complex.
“We also don’t currently know how long vaccine-induced immunity lasts, and we don’t know if it’s different between different individuals and different vaccines.
“We need that data to roll out this system rationally, and that’s why I’m saying we’re not ready for a vaccine passport now.”
Image: rangizzz/Adobe Stock
Image: rangizzz/Adobe Stock
A lifeline for tourism
UQ tourism expert Associate Professor Pierre Benckendorff said an international vaccine passport – and the subsequent ending of lockdowns – were critical for the tourism industry to survive.
“Beyond the health perspectives, there are good behavioural reasons to do it from a tourism point of view. It reassures international travellers that the risk of them contracting COVID-19 en-route is being managed and potentially reduced,” he said.
“The tourism industry has been hanging in there – a number of operators have gone out of business already, and the airlines are bleeding money.
“The constant threat of domestic borders being shut creates confusion in the marketplace, and some people are reluctant to travel interstate.
“When we are not in lockdown, we already have a lot of freedom to move around Australia and I would be surprised if governments tried to restrict this movement by introducing a domestic vaccine passport.
“But an international vaccine passport is very much on the cards. This would be a really good initiative in terms of reassuring the market and sending a signal about traveller safety.”
If a vaccine passport remains a distant possibility in the coming months – and a rolling cycle of lockdowns continue – Associate Professor Benckendorff said the Australian Government would need to offer additional support to the already struggling industry.
“The JobKeeper allowance was critical to the tourism industry because a lot of workers are casual staff. It was an important lifeline just to allow businesses to retain staff,” he said.
“The big risk now – particularly for small businesses – is that the support is no longer there. If you have that constant cycle of lockdowns, businesses are forced to let staff go, and that has an impact on unemployment, but also wears down businesses.”
Is a vaccine passport legal?
UQ constitutional law expert Professor Nicholas Aroney said the idea of ‘passports’ to enable citizens to travel within Australia was not a good precedent to set.
“People should ordinarily be free to move within the country without having to produce a passport or similar identification document,” he said.
“In Australia, we have a protection for freedom of movement between the states contained in section 92 of the Constitution, where any restrictions on movement have to be justified as proportionate to legitimate objectives.
“If we’re going to have a certificate or ‘passport’ of this kind, you need to be careful not to interfere with freedom of movement more than is necessary.”
“Restricting it to just a vaccine is more than is necessary, as there are less restrictive approaches that achieve the same objective – for example, if people have tested negative or have recovered from a COVID-19 infection.
“I am concerned about the tendency in Australia to refer to it as a ‘vaccine passport’; it should not be limited to those who are vaccinated and we should not normalise the idea that you need a ‘passport’ to move about the country.”
Image: Jacob Lund/Adobe Stock
Image: Jacob Lund/Adobe Stock
Still confused about vaccines?
If you’re confused by some of the mixed messaging coming from the Australian Government and our state governments, you’re not alone.
The Prime Minister announced in June that the AstraZeneca vaccine would be made available to under 40s who sought it from their GPs, despite the Australian Technical Advisory Group on Immunisation’s (ATAGI) recommendation in June that Pfizer is the preferred vaccine for anyone under the age of 60 due to concerns around a rare blood clotting disorder linked to AstraZeneca.
In a press conference days later, Queensland’s Chief Health Officer Dr Jeannette Young said she advised against anyone under the age of 40 receiving the AstraZeneca vaccine based on health advice.
More recently, the New South Wales Government and the Australian Technical Advisory Group on Immunisation are urging all adults in Sydney to take up the AstraZeneca vaccine to stem surging case numbers, with the shot once reserved for over-60s soon to be widely available to all adults.
Dr Short said the mixed messaging was very confusing and urged people to get informed from reliable sources and data.
Similarly, Dr Manoharan encourages people to talk to their GPs.
“You really need to be seeking your own health advice, talking to your GP, and see if it’s a good option for you based on your personal situation.”
Join the conversation
Would you support a vaccine passport system in Australia?
UQ researchers are at the forefront of the big issues facing the world. And now you can get all the latest research news delivered straight to your inbox.