Getting on the front foot with vaccination passport

New Zealand kicked off its Covid-19 vaccination program today, with vaccinators themselves receiving the first of the Pfizer-BioNTech shots and border and quarantine staff to follow from tomorrow. Australia is set to start on Monday, with frontline health workers, quarantine and border workers and aged care and disability residents all being prepared for the first phase.

The ball has started rolling on the largest vaccination programs our countries have ever seen, and the hope is the majority of our populations will be covered by October. We’ll wait and see on that as systems fall into place to support the wider roll-out to the community, and fingers crossed everything goes smoothly. Our technology companies are coming to the party, deploying IT solutions at pace, and we hope to hear more news on how general practice will be supported as it prepares.

In the meantime, attention is turning to preparations for how the world will function in the longer term, particularly as borders open up and international travel begins again. This has brought focus on the role of digital vaccine certificates and passports for use both internally and beyond national boundaries, and unlike what we think was poor forward planning by the Australian government in preparing the infrastructure for our vaccine roll-out, we’d like to see us get on the front foot.

Individual countries are moving to launch their own digital vaccine passports – Bahrain is the latest to do so – and there are a number of technologies being made available on a commercial basis that could help. IBM, for example has a blockchain-based Digital Health Pass product that is being offered for use to organisations to verify health credentials for employees, customers, and visitors entering their site.

Australia has a ready-made solution for a certificate through our Australian Immunisation Register (AIR), which can be accessed digitally through Medicare and the My Health Record and printed out, and New Zealand is getting a new National Immunisation Solution ready. Whether these certificates will become necessary for entry into premises or events within our borders is a discussion that will need to be had soon enough, although we doubt these will ever become mandatory here.

With international travel, however, they most certainly will, and this is where digital passports will come in. Airlines are already moving to begin building infrastructure through initiatives like the CommonPass, Qantas has spoken about making proof of vaccination mandatory, and Australia already has experience with requiring proof of vaccination before re-entry through the yellow fever certificate issued by the World Health Organisation (NZ doesn’t require this). The question is how to validate those certificates globally. One idea is the Vaccination Credential Initiative, which has been established for just this purpose and involves mammoth players including Cerner, Epic, Microsoft, Salesforce and the Mayo Clinic.

And as we mentioned last week, digital frontrunner Estonia is working on a global vaccine passport, partnering last year with the World Health Organisation for an International Certificate of Vaccination, a digital version of the yellow fever vaccine certificate better known as the yellow card. Estonian company Guardtime is also currently developing a system for cross-border recognition of electronic health records using blockchain.

All of these have potential, but for anyone working in health IT, a familiar problem arises. While they do sound promising, how are they all going to talk to each other? Are we going down the same old road of multiple applications built on different technologies that cannot interoperate?

We need a global standard, and this is what the Australasian Institute of Digital Health (AIDH) is encouraging. Next week, the institute is going to release a position paper calling for a global standards approach. The preference is for the WHO’s yellow card but the main thing is that there is global agreement. It would be good if Australia and New Zealand could get on the front foot about this.

The topic was the subject of our poll from last week, when we asked if you supported the idea of a digital Covid vaccination passport. The majority did – 78 per cent said yes, 22 per cent said no – and most believed an Australian vaccination certificate should be built using existing technology like the AIR and the MyHR, with a mobile app similar to those used for digital driver’s licences to display it. The yellow fever vaccination certificate was put forward by a number of respondents as a model for an international travel document.

That brings us to our poll question for this week:

Will the world agree on a global standard for an international vaccine passport?

Vote here and feel free to leave your comments below.

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