What is a vaccine passport?

Many travelers are familiar with the yellow card, or Carte Jaune, which is an official vaccination record created by the World Health Organization. This document, named for the yellow paper it's traditionally printed on, is a public health tool that has been used for international travel since the 1930s and is typically carried with a passport. It shows customs authorities that a traveler has been vaccinated against certain diseases, such as yellow fever, typhoid or cholera.

Although vaccination cards like yellow cards are still being used and remain a popular way to document immunizations, many governments are considering creating modern, digital vaccine passports that are harder to forge. With the public health threat posed by the COVID-19 pandemic, multiple countries are exploring whether vaccine passports and health passes could serve as proof of COVID-19 vaccination to restore confidence in international travel and help people resume their normal activities.

Israel was the first country to issue a modern vaccine passport with the launch of Green Pass in February 2021. As of May 2021, Israel, China, Bahrain and Japan are the only countries that have issued vaccine passports to vaccinated people for international travel and other uses. Australia and multiple countries in the European Union, such as Denmark and Greece, have committed to developing programs, while other countries are still weighing their options. In the United States, the Biden administration and leaders at the Centers for Disease Control and Prevention (CDC) have stated the federal government will not support or issue vaccine passports for Americans.

Vaccine passports are taking advantage of the increasing prevalence of new, secure digital credentialing technology. Beyond vaccine passports for international travel, it’s also being applied in other settings. For example, organizations that gather people in groups are looking for digital alternatives to both paper vaccination cards and test results. In some cases, this means identifying whether individuals have been tested or vaccinated in a voluntary and privacy-preserving manner.

A digital health pass – not to be confused with a vaccine passport – is a voluntary, convenient option for individuals to share their health status, such as if they have been vaccinated or tested negative for COVID-19. Rather than having to remember to carry around multiple documents, people with digital health passes can share a scannable QR code on their smartphone or print a paper copy of their credential that confirms their status, while personal information remains securely encrypted in a digital wallet on the individual’s phone.

With COVID-19 vaccine rollouts underway around the world, digital health passes are one of many tools governments, private companies, nonprofits and industry groups are considering to help people return to their favorite activities. For example, in March 2021, New York State launched Excelsior Pass, a free, secure and voluntary digital health pass to support the safe reopening of New York.

Even after the COVID-19 pandemic subsides, digital credentialing technology will remain a useful tool for individuals to show they have received any necessary vaccinations or other aspects of their health status. Digital credentials could also become a useful way for schools to manage student vaccination records or for employers to oversee any medical clearances or vaccinations required for job sites.

Although many people will enjoy the convenience of using a digital health pass on their smartphone, some people may not have a compatible mobile device or prefer not to use one. Additionally, phones can be forgotten at home or batteries can deplete at inopportune times. Designers of digital health credentialing technology recognize these limitations, and many have added additional features like printable certificates that help people access their credentials, if needed, from a desktop computer or other device.

As lockdowns and other restrictions become less common, returning to pre-pandemic activities will require coordination from different organizations. Private sector businesses that want to welcome people back to their venues need straightforward ways to verify people’s health status voluntarily according to local regulations and their own policies. Healthcare organizations need simple ways to issue digital health credentials that other organizations can trust.

Digital health passes can simplify the process for issuers of COVID-19 and other health credentials, such as pharmacies, labs and providers, and the verifiers who are checking the credentials, like an airline gate agent. Instead of having to follow a one-size-fits-all process, digital health passes give organizations a chance to customize their processes according to their specific rules.

For example, an outdoor stadium might decide to admit fans who have received a negative COVID-19 test within 72 hours or proof of vaccination. An international flight to Europe might require travelers to show proof of receiving a COVID-19 vaccine. Digital health passes can accommodate the requirements of both organizations.

Similarly, healthcare organizations can issue credentials to individual holders. The security and privacy built into digital health passes help make it simpler for issuers to provide credentials that are trustworthy without a lot of extra work on their part.

Digital health passes are designed so that personal health information is encrypted using a digital wallet that can be accessed on a smartphone. The user has control over their information and how that information is shared.

That control is maintained through secured digital credentials. Pharmacies, labs and providers can issue secured health credentials (QR code), such as a COVID-19 test result or vaccination record, for individuals to add to their digital health wallet. Using a QR code minimizes exposure of your underlying health information to third parties without your knowledge or consent during verification. Those are securely stored in the user’s digital health wallet. Credentials simply provide a voluntary way to share health credentials in a secure manner with an employer, airline or amusement park.

How can these credentials be trusted? Some passes use a technology called blockchain, which uses a decentralized identity architecture. For example, it allows individuals to become active participants by giving them control over their data and the ability to choose how it will be used. Blockchain makes it so there’s no need to have a central database of sensitive health information. It helps organizations check the authenticity and validity of COVID-19 health credentials while the holder maintains control of their underlying personal health information.

A digital health wallet is a secured digital alternative to COVID-19 paper vaccination or test results and provides a convenient option for an individual to manage and share their vaccination status or a negative test result for the COVID-19 coronavirus.

Here's an example of how a digital health wallet could work:

Step 1: You get a COVID-19 test at your local pharmacy. The pharmacy issues a verifiable credential based on your negative test result and sends it to you.

Step 2: You receive the credential and add it to the digital wallet on your smartphone.

Step 3: Now let’s say you want to board a flight or attend a sporting event where you will have the option to use IBM Digital Health Pass. If you choose to do so, the airline personnel or event staff verifies your credential by scanning the QR code in your digital health wallet before you enter. It’s that simple.

When more people return to sharing offices, warehouses and other indoor co-working spaces, employers will need to confirm people are following health guidelines. Upon arrival, the employee might need to present the QR code in their digital health wallet app to be scanned to gain entry to the building. This isn’t too different from using an employee ID to gain access to a jobsite.

Cruiselines, airlines and hotels might use a digital health pass to verify individuals’ health status before they travel. An airline might have different screening requirements than a cruiseline, but travelers can voluntarily choose what data to share and with whom.

COVID-19 taskforces are prioritizing health and safety so fans can return to enjoying their favorite teams and bands in person. In addition to checking tickets for a concert or a sports game, ticket takers, ushers or security screeners could ask to see a health pass as well before admitting people into a venue.