Home Health ‘Vaccine passports’ are on the way, but developing them won’t be easy

‘Vaccine passports’ are on the way, but developing them won’t be easy


The administration’s initiative has been driven mainly by arms of the Department of Health and Human Services, including an office devoted to health information technology, said five officials who spoke anonymously to discuss the effort.

The White House this month took on a more significant role coordinating government agencies involved in the work, led by coronavirus coordinator Jeff Zients, intending to announce updates in the coming days, said one official. The White House declined to answer questions about the passport initiative instead of pointing to Zients and other officials’ public statements this month.

“Our role is to help ensure that any solutions in this area should be simple, free, open-source, accessible to people both digitally and on paper, and designed from the start to protect people’s privacy,” Zients said at a March 12 briefing.

The initiative emerged as an early test of the Biden administration, with officials coordinating across dozens of agencies and various experts, including military officials helping administer vaccines and health officials engaging in international vaccine efforts.


The passports are expected to be free and available through smartphone applications, which could display a scannable code similar to an airline boarding pass. Developers have said that Americans without smartphone access should be able to print out their passports. Other countries are racing ahead with their passport plans, with the European Union pledging to release digital certificates allowing summer travel.

U.S. officials say they are grappling with an array of challenges, including data privacy and healthcare equity. They want to make sure all Americans will be able to get credentials that prove they have been vaccinated and want to set up systems that are not easily hacked or passports that cannot be counterfeited, given that forgeries are already starting to appear.

One of the most significant hurdles facing federal officials: the sheer number of passport initiatives underway, with the Biden administration this month identifying at least 17, according to slides obtained by The Washington Post. Those initiatives — such as a World Health Organization-led global effort and a digital pass devised by IBM that is being tested in New York state — are rapidly moving forward, even as the White House deliberates about how best to track the shots and avoid the perception of a government mandate to be vaccinated.

One of the teams working on vaccine passports is the Vaccination Credential Initiative, a coalition endeavoring to standardize how data in vaccination records are tracked. “The busboy, the janitor, the waiter that works at a restaurant, want to be surrounded by employees that are going back to work safely — and wants to have the patrons ideally be safe as well,” said Brian Anderson, a physician at Mitre. This nonprofit company runs federally funded research centers, which are helping lead the initiative.

“Creating an environment for those vulnerable populations to get back to work safely — and to know that the people coming back to their business are ‘safe,’ and vaccinated — would be a great scenario.” Anderson’s team is aiming to release its free software standards in April, hoping developers will use them to help build digital vaccine records that allow people to show they have been inoculated.

The Vaccination Credential Initiative includes the Mayo Clinic, Microsoft, and more than 225 other organizations, many of which have pledged to use the code when administering shots. Biden administration officials privately acknowledge the high stakes of the effort. Proof of vaccination “may be a critical driver for restoring baseline population health and promoting safe return to social, commercial, and leisure activities,” according to the March 2 slides prepared by the Office of the National Coordinator for Health Information Technology and obtained by The Post.

But officials at the session — attended by more than 150 staff from the health, defense, homeland security, other departments, and even far-flung agencies such as NASA — warned of the “confusing array” of efforts underway to create credentials. “A chaotic and ineffective vaccine credential approach could hamper our pandemic response by undercutting health safety measures, slowing economic recovery, and undermining public trust and confidence,” one slide reads.

Micky Tripathi, whom Biden tapped as the national coordinator for health IT, recently said federal officials are concerned with various health-tech challenges, including protecting the credentials against fraud, ensuring data security, and ensuring that low-income populations aren’t squeezed out.

“How do we make sure that whatever is available is accessible to everyone so no one is left behind or feeling like they can’t participate in the return of their day-to-day activities?” Tripathi asked at a virtual meeting hosted by the Health IT Leadership Roundtable on March 11.

Tripathi told the group he didn’t like the term “vaccine passports,” adding that “passports are issued by governments. … I think of them as vaccine credentials or certificates.” Tripathi did not respond to a request for comment.

The Centers for Disease Control and Prevention, participating in the WHO’s effort to create “digital vaccination certificates,” is also preparing to help advise on the passport rollout. The health agency says it is expecting to play a role in determining which organizations will credential and issue the certificates, in addition to informing the public, according to CDC documents reviewed by The Post.

The Biden administration has promised to release more information about its efforts. Asked by Hawaii Gov. David Ige (D) on Tuesday about the state of the passport initiative, Zients told governors he would provide a more detailed briefing this week, according to two people on the call, speaking on the condition of anonymity to describe the private conversation.

Federal officials defended the pace of the project. Taking time to get the credentialing project right “is very, very important because this has a high likelihood of being either built wrong, used wrong, or a bureaucratic mess,” said one official, speaking on the condition of anonymity to discuss the effort.

The official said some considerations include adjusting for the spread of variants, how booster shots would be tracked, and even questions about how long immunity lasts after getting a shot. There’s “a lot to think through,” the official said.

“Many people see this as a key aspect to getting things closer to normal,” said Kristen McGovern, a partner at healthcare consultancy Sirona Strategies and former chief of staff at the Office of the National Coordinator for Health IT. But the technical challenges are significant, and given that so many individual efforts are underway, “it would be an almost herculean task to come up with a single standard” for all the vaccine credentials to follow, McGovern said.

There are evidence vaccine passports could motivate skeptical Americans to get shots. Several vaccine-hesitant participants at a recent focus group of Trump voters led by pollster Frank Luntz suggested their desire to see family, go on vacation and resume other aspects of daily life outpaced fear of the shots, particularly if travel companies and others moved to require proof of vaccination.

“We love to travel. We love to take cruises. I would get it to travel,” said Debbie of Georgia, who was identified only by her first name like others in the focus groups. Some attendees dissented and warned that requiring a credential would backfire. “I would change my travel plans,” said a man identified as Patrick of Tennessee.

after listening to politicians and pollsters, a focus group of vaccine-hesitant Trump voters spoke about their impressions of vaccine passports  (Courtesy of Frank Luntz and de Beaumont Foundation)

Public health and ethics experts agreed that the Biden administration needed to strike a careful balance: Encourage shots and support the private-sector initiatives but don’t put too much federal emphasis on the looming passports.

“If it became a government mandate, it would go down a dark road very quickly,” said Brian C. Castrucci, who leads the Bethesda, Md.-based de Beaumont Foundation, a public health group funding Luntz’s research into why some Americans are balking at the vaccine. “It becomes a credential. It becomes a ‘needing your papers,’ if you will. That could be dangerous — and it could turn off people.”

“It has to be that everyone can get it, and it’s their choice, as it were,” said Ezekiel Emanuel, a University of Pennsylvania bioethics expert. He co-authored a Journal of the American Medical Association article last year about the ethics of such certificates and advised Biden’s transition team on the coronavirus. “The one thing I am concerned about is that some people won’t be able to get vaccinated for a variety of reasons.”

Emanuel added that passports will be an element of global travel — not just domestic policy. Critical aviation and travel associations on March 22 called on the White House to finalize its vaccine credential plan by May, saying it was essential for the safe resumption of international travel.

Donald Rucker, who led the health IT office during the Trump administration, said myriad technical issues await the rollout of vaccine credentials, including how they are tracked, whether they are enforced, and who pulls together the initial records of which Americans have gotten shots.

Rucker said keeping vaccine credentials could help officials better understand coronavirus vaccination, including possible long-term side effects if the data is connected with the health information exchanges that states maintain. “The tracking of vaccinations is not just for vaccine passports,” Rucker said. “The tracking of vaccinations is a broader issue of ‘we’re giving a novel biologic agent to the entire country,’ more or less.”