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Joe Biden's new travel rules: What is a HIPAA-compliant Covid-19 card? Here's all about vaccine passport

A vaccine passport system could be a hard sell in the US, where the pandemic has exposed drastic political divides over coronavirus mitigation strategies

With Covid-19 vaccinations becoming widely accessible across the US, it is only a matter of time before companies fully throw themselves into getting back to "business as usual". This raises questions about how customers visiting stores, theaters, arenas, and the like can prove inoculation.

On Saturday, reports said that President Joe Biden's administration is working with the private sector on creating an unofficially dubbed "vaccine passport" program that would allow people to readily prove their vaccination or negative status via an app on their phones. After over a year since the WHO declared the coronavirus pandemic, and while average daily cases in the U.S. are still hovering at nearly 60,000 high per day, there are signs that some people are ready to travel again, despite pleadings from the CDCP to stay put.

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What are Covid-19 vaccine passports?

Vaccine passports are not a new idea. Vaccine cards have long been the go-to for frequent international travelers. The cards, also known as "international certificates of vaccination or prophylaxis," are typically a yellow paper showing a person's vaccinations. Some places require proof of vaccination against illnesses like yellow fever or tuberculosis. In January, President Joe Biden directed agencies to assess the feasibility of linking COVID-19 vaccinations to vaccine cards and digitizing them. 

A senior adviser to the White House coronavirus team, Andy Slavitt said on Monday, according to US News, that the government ought not to create such a passport or hold that kind of data on its citizens, but the Biden administration has decided to will provide guidance to the private sector on the topic. Slavitt, the Acting Administrator of the Centers for Medicare and Medicaid Services, described the ideal COVID-19 passport as "free, equitable, secure, accessible in multiple languages and available both digitally and on paper," but experts wonder whether a coronavirus vaccine passport needs to be different from the already existing vaccine card system.

Henry Raymond, an epidemiologist and associate professor at the Rutgers School of Public Health, says: "I honestly don't think there's a need for it to be a separate thing", adding that the vaccine is not a free pass to ditch the mask. Scientists are still trying to understand whether vaccinated people can become infected asymptomatically and transmit the virus to others. The scope of such a vaccination system; whether it will be used to resume a sporting event in the US or whether countries could implement it on international travelers; is also unclear.

What are the benefits?

Governments, citizens and travelers will be made more comfortable with opening up to tourism, due to these vaccine passports. The US Travel Association and other groups have asked the administration to set a May 1 deadline and come up with a plan to reopen the country to international visitors. In a letter to the Biden administration, the groups wrote: "If nothing is done to lift international travel bans and bring back demand, the U.S. Travel Association estimates that a total of 1.1 million American jobs will not be restored and $262 billion in export spending will be lost by the end of 2021." They added that vaccinated individuals should be exempt from international testing requirements, and are not in support of "vaccine requirements as a prerequisite for travel."

The new passports may lend a feeling of safety while traveling, but health officials say it is too soon to understand whether such a feeling is warranted. "We're still in a place where we don't know how much that vaccination prevents you from transmitting the virus," Raymond said. However, this hasn't stopped places from exploring similar ideas, like European Union's newly proposed Digital Green Certificate, the International Air Transport Association's Travel Pass, and IBM's 'digital health pass'.

'Preferential vaccination of travelers may result in inadequate supplies'

Apart from still ongoing research on vaccination and transmission, experts believe equity could be an additional concern. "It is hard to imagine how vaccine passports could be put into place in a way that would make travel safer around the world in an equitable manner," Mercedes Carnethon, vice chairwoman of preventive medicine at Northwestern University Feinberg School of Medicine, said in an email to US News.

According to the WHO, "national authorities and conveyance operators should not introduce requirements of proof of COVID-19 vaccination for international travel as a condition for departure or entry, given that there are still critical unknowns regarding the efficacy of vaccination in reducing transmission." There stance is that "preferential vaccination of travelers could result in inadequate supplies of vaccines for priority populations considered at high risk of severe COVID-19 disease."

Privacy concerns also loom overhead, as people may not be willing to share their health data with companies. "There's always going to be hesitancy, whether it's about getting the vaccine or giving information about their status," Raymond says. How much interest US citizens themselves would have in such a system, given that people are already travelling regardless of their vaccination status, is also a concern. A vaccine passport system could be a hard sell in the US, where the pandemic has exposed drastic political divides over coronavirus mitigation strategies.

"Our country has not shown a united front to date when it comes to [COVID-19] mitigation strategies, unlike countries in Europe, Asia and famously New Zealand who have gone through a series of rolling nationwide lockdowns as needed," Carnethon said. "It seems that requiring visitors to the U.S. to show vaccine passports would be challenging to receive bipartisan support to put into place."

What is a HIPAA-compliant digital vaccine card?

On Saturday, New York launched Excelsior Pass, the US’ first state-administered digital health app, whose vaccine passport program runs on an IBM blockchain and cross-references patient data with state health records. California startup Carbon Health on the West Coast, which is helping the cities of LA and San Mateo administer vaccines, recently became one of the first organizations to launch a HIPAA-compliant digital vaccine card. The Health Insurance Portability and Accountability Act (HIPAA) is a national law that protects sensitive patient information. “As vaccinations ramp up, we anticipate that more organizations will request proof of vaccination to allow people inside buildings or businesses, travel, or go to concerts and festivals,” Carbon Health CEO Eren Bali said to Morning Brew.

Experts on Yahoo Finance said it was unlikely for HIPAA to come into play under a government-mandated vaccine credentialing program. "The reason HIPAA's not relevant is because it applies to doctors, hospitals, health insurers, basically," data privacy lawyer and partner with WilmerHale Kirk J. Nahra, said. "And for an employer, the only way to be relevant is if they learned that somebody had tested positive because they submitted an insurance claim to the employee health benefits program."

People took to Twitter to share their views. "Setting aside the fact that this has absolutely nothing to do with HIPAA, a vaccine passport has nothing to do with disease status. It is about vaccination status," said a tweet. "LOLOLOLOL y’all get worked up over literally anything. Proof of vaccination to travel, or enroll in school for that matter, isn’t new. It’s not a HIPAA violation and if you don’t like it, no one is forcing you to take your stupid vacation," said another.

A netizen quipped: "communism is when private companies do hipaa". "No vaccine passport. It doesn’t get much more dystopian than being required to show your “health papers” wherever you go," said another. "It’s a close race between HIPAA and Sec 230 for the most misunderstood law out there," said a tweet.