Vaccine passports on the near horizon as DIY booking sites ramp up

Vaccine passports are shortly to become the next digital battleground in the fight against the COVID-19 pandemic, but unfortunately they are likely to be as divisive as contact tracing apps have been so far. Various Australian states and territories are expected to release details on exactly how these passports will work in a domestic sense in the next couple of weeks, with a national standard for vaccine passports for international travel still a bit up in the air.

Services Australia has done a pretty good job in getting vaccine certificates quickly available on the Medicare Express Plus app – they are also available on My Health Record, although few seem to be going there – and mandatory reporting to the Australian Immunisation Register is very much helping to make this process seamless. However, the PDF versions of the certificate on the Express Plus app have repeatedly been shown to be easily hacked, with fraudulent copies easily created, so the existing solution is obviously not one that can be used as a passport without a few fixes being made very quickly.

It has been obvious for some time that there will have to be a centrally organised verification process set up but as is our wont in Australia, the state and territory governments continue to pursue their own solutions, which does not bode well when talking about opening up the economy as a whole. We despair at Australia’s continued division into state, territory and federal jurisdictions, all with their different solutions and excuses, just like the QR code check-in apps that have been rolled out. NSW and Victoria do their own thing, the ACT through the Check-In CBR app comes up with a good system that several other states have adopted, but we are back to square one in squabbling about how to develop a national vaccine passport that will allow citizens of this country to cross internal borders. It is ludicrous.

How these jurisdictional “passports” will interact with actual vaccine passports developed for international travel – for which there are international standards that the major airlines are now signing on to – remains to be seen. It is also ridiculous that, just as was the case with the vaccine bookings systems, work on this is only now being kick started, 18 months after the pandemic began. It’s a criticism well levelled at the New Zealand government, for example, which has only recently launched its national vaccine booking solution and is also only now talking about developing its vaccine certificate and passport later this year.

Vaccine appointment booking solutions have been a bit of a bugbear for Pulse+IT over the last few months, as regular readers will be aware. This week, we had a chat to a savvy young bloke in Sydney called Ken Tsang who also noticed that what was being put up for vaccine bookings wasn’t really up to scratch, particularly for young people in hot spots who are happy to shop around and who generally don’t have a regular GP. So, rather than whinge about how it, Ken decided to build his own site streamline the booking process, built on top of an exposure notification site he had already developed as part of his day job as a geospatial engineer.

As a young NSW person being encouraged to get vaccinated as quickly as possible no matter the vaccine brand, Ken also quickly realised that there were accuracy issues with what is being displayed on HealthDirect’s eligibility checker and the actual appointment availability at an individual clinic level. In short, if you click on a practice on HealthDirect’s site that says a COVID-19 vaccine appointment is available in two days at this general practice or vaccination clinic, invariably when you do click on to that practice or clinic it says it has no Pfizer, or no vaccine appointments, or none until a few months away.

We think a lot of this is due to the different ways practices are loading information into their booking systems rather than any technical problem at the HealthDirect end, but it really doesn’t help with community faith in the value of such systems. And we can’t really blame the state v state system in Australia either – New Zealand’s tech community has got together to launch a site for younger people based on when a vaccine is available rather than where. This will continue to be a problem for appointment booking sites – practices preferring only to deal with their own patients and their own schedules versus younger people in particular willing to shop around.

This will also continue to be a problem as vaccine passports roll out and there is no standardisation between the various solutions. Surely, after all of the struggles digital health has faced over the years, we are at the stage where interoperability is front of mind rather than parochial needs? It really won’t end well otherwise.

That brings us to our poll question for the week. We’ve been reasonably impressed with the COVID check-in app approach, which has been adopted in NZ (although usage is patchy) and first rolled out in Australia by ACT Health as the Check-n CBR app, but not so much by the Bluetooth proximity tracing apps like COVIDSafe. After quite a few critical reports, last week we asked readers whether Australia’s COVIDSafe app should be written off.

There was pretty universal disdain for the app: 94 per cent said yes, write it off. Just six per cent said no. We also asked in our poll if there were any alternative technologies for contact tracing you’d recommend. The QR code check-in systems seem to be popular and – most importantly – well accepted by the public.

This week, we ask:

Does there need to be a standards-based, nationally agreed system for vaccine passports?

Vote and comment here or leave your comments below.

Comments  

-1 # Jan Stanek 2021-09-11 11:04
Some countries already reject the idea... [e.g. France].
+3 # Christopher Rushton 2021-09-11 12:48
There needs to be a passport and it needs to be standardised. it should be block-chain based and make sure of NFTs - it's a no-brainer as it will stop the hackers and fraudsters in their tracks
0 # Kate McDonald 2021-09-17 12:17
We also asked an optional question about what the vaccine passport should be based on.

Most currently widely used system
Needs to be internationally accepted and unable to be forged.
EU system
IATA
EU
EU
EU Digital covid certificate

It should be based on the HL7 FHIR smart card specification
The choice should be work in the most possible international constituencies. Obviously EU, UK, USA

IATA
SMART Health Cards

Pick one or all and enable technology options for people to present in format required for travel location

Wherever it needs be to so that it is universally accepted. Don’t want multiples

IATA
EU Digital COVID Certificate
EU Digital COVID Certificate
EU Digital Cert

If there is no single international standards-based system then there is no hope. It is exactly the same problem as within Australia but across all nations. If we pick one, then there is a good chance it will be the wrong one.
As an aside, the interoperabilit y problem with national vaccine systems is orders of magnitude simpler than that of clinical system interoperabilit y. Does anyone really think we anyone can solve the clinical problem?

US Canada Smart Card

Whatever base health related system is already in use in Australia- if there is one.

IATA
IATA

Block chain with NFTs - no brainer as it will stop the hackers and fraudsters in their tracks

Whatever Grahame Grieve says

The EU Digital COVID Certificate
Iata
Iata

What easily works and is not cheatable !
US/ Canada SmartCard System
A
s long as it is a recognised and verifiable digital certificate (like IT uses in the real world today for encryption and signing) it will work. Whoever decided to use dodgy PDFs should be shown the door.

Your article is a great case study of why we need an interoperable digital health system, but also the local challenges.

I align with the recent World Health Organisation guidance on Digital documentation of COVID-19 certificates: https://www.who.int/news/item/27-08-2021-moving-towards-digital-documentation-of-covid-19-status


People who have had all Covid vaccinations and have a valid proof vaccine Medicare document. Everyone should have a Covid Passport.
Doesn't matter as long as it's the same everywhere in Australia (unlike most other things....)

EU Digital COVID Certificate
The EU digital Covid certificate

As per World Health Organisation Digital Certificate report there is no evidence that passports reduce transmission and if used to reduce restrictions may in fact increase transmission. Worse there is a high risk they disadvantage groups and lead to discrimnatory behaviours, just take some time to look at social media as a leading indicator. How can we talk about health privacy and support non clinicians having being able to see our health data.

The EU Digital COVID Certificate

IATA

The same as the National Roll-out of Vaccine Passports in Serbia, recognizes all the above plus what any new ones come along, otherwise as normal, we will be in a mess - happy to share should there be any interest

The EU Digital COVID Certificate

IATA

Eu

Not sure what it should be based on, but it should be able to be used within Australia (between states), AND for overseas.

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