AIDH calls for international digital vaccine passport with agreed standards

The Australasian Institute of Digital Health (AIDH) has put its support behind the creation of an international digital vaccine passport or Yellow Card that can verify details of a person’s vaccination for COVID-19 and would assist overseas travellers returning home.

It has also called for agreement on a global standard to record vaccination status to avoid interoperability challenges as international borders open up.

A number of groups around the world are working on developing digital records of vaccination that can be recognised by other countries but there are fears they are not talking to each other.

The World Health Organisation (WHO) began a project in October 2020 to develop a digital COVID version of its Yellow Card or Carte Jaune, which documents vaccination against cholera and yellow fever as well as childhood illnesses such as rubella.

Evidence of vaccination is required for entry into some countries, with Australia requiring evidence of vaccination against yellow fever from people who have travelled in affected areas.

Other groups include the Vaccination Credential Initiative, which counts technology firms such as Cerner, Epic, Microsoft and Oracle as well as healthcare provider the Mayo Clinic on its books.

The International Air Transport Association (IATA) is also rolling out its Travel Pass, which it says is built on open standards and will be interoperable with the WHO’s passport. The World Economic Forum is working with the Commons Project Foundation on the Common Trust Network, which will consist of a global registry of trusted laboratory and vaccination data sources.

However, AIDH fellow and standards expert Grahame Grieve, who has been assisting the WHO on the Yellow Card project, warned that given the global need for a digital vaccination record that seamlessly travels with the individual, global agreement on the data standards will be essential.

“Many countries have a great need for a valid, secure digital record of vaccination which is recognised by other countries, given the travel patterns of people around the world and the challenges they’re facing in managing outbreaks,” Mr Grieve said.

“So, they’re moving at pace to define a standard to record vaccination status that can be digitally shared across systems and borders. The project has some way to go, but there is a lot of support and momentum for this work.

“Unfortunately, the greater the need for a standard, the greater the number of standards created.”

AIDH board chair Bettina McMahon said Australia was better prepared than any other country to accept internationally standard digital vaccine passports.

“The Australian government has recognised the need to include overseas administered vaccines in the Australian Immunisation Register (AIR) and is currently consulting on ways for healthcare providers to enter this information into the AIR,” Ms McMahon said.

“Given we only have a trickle of vaccinated international travellers entering Australia, this workaround is manageable, and it makes sense to focus first on Australians receiving the vaccine here.

“AIDH supports work on the international Yellow Card which will eliminate this manual step ahead of more Aussies coming home when global vaccination rates increase and international borders open again.”

She said Australia was in a position to readily adopt a digital Yellow Card for COVID because the essential technology was in place.

“We have the Australian Immunisation Register, which is a fully digital record of a person’s vaccines, and anyone who receives the COVID vaccine in Australia will get their COVID vaccine details put in the AIR.

“We have consumer portals for the AIR through the My Health Record and Medicare app. And clinical information systems in Australia that connect to the My Health Record enable authorised healthcare providers to view digital vaccination records in real time.”

“The missing link is people who received their vaccine overseas.”

AIDH fellow and board member Monica Trujillo said one of the success factors for Australia is the use of digital pathology systems, which have provided up to the minute data for clinicians and health system administrators on COVID cases.

“It is critical that we have comprehensive digital records for the next phase of managing the pandemic – vaccination,” Dr Trujillo said. “We’re in a great position for people receiving the vaccine in Australia, so let’s get on the front foot for travellers.”

AIDH's position statement can be found here.

Posted in Australian eHealth

Tags: COVID-19, digital vaccine passport


0 # Andrew Baird 2021-02-23 09:08
It's not yet known if the vaccines prevent transmission of SARS-CoV-2, so a vaccine passport holder could still potentially have SARS-CoV-2 (asymptomatic or symptomatic) and transmit this to others (eg in the country that the person is visiting, or interstate in Australia).
This could be a 'back door' to mandatory vaccination if people need a passport for access to shops, restaurants, cafes, workplaces, etc. People who are not vaccinated will be excluded.
And the under-18s will not get a passport as they will not be vaccinated under the current plan in Australia.
+1 # John Ryan 2021-02-23 09:24
And what if someone entering Australia has received a vaccine that is not yet approved for use in Australia?
+1 # Andrew Baird 2021-02-23 10:22
Good point.
And what about the authenticity of the 'passport'.
And so on ...
0 # Andrew Baird 2021-02-27 09:04
A COVID-19 vaccine certificate or passport will verify that the holder has completed a course of COVID-19 vaccination. It will not verify that the holder will not get COVID-19. It will not verify that the holder will not transmit the virus to others.

The World Health Organisation (WHO) states that the efficacy of vaccinations in preventing COVID-19, and in reducing transmission of SARS-CoV-2, are “critical unknowns”.

As recommended by WHO, national authorities “should not introduce requirements of proof of COVID-19 vaccination for international travel as a condition for departure or entry”. WHO also states that vaccination should not exempt travellers from risk-reduction measures, such as COVID-19 testing and quarantine.

Vaccination does not equal ‘no risk’.

Perhaps Australia should be very cautious about issuing and accepting COVID-19 certificates or passports as 'risk-free passes' and ‘exemption waivers’ for international travel and for other purposes, such as interstate travel, and access to workplaces, cafes, restaurants, shops, sporting venues, and entertainment venues.

There’s no point. The passport would not guarantee what it’s supposed to guarantee – that is, that the passport holder will not transmit the virus to others. The passport is a non-starter. We don’t even need to consider issues such as ‘human rights’ and ‘invasion of privacy’.
0 # Simon James 2021-02-27 19:22
Hi Andrew, if the various vaccinations do not greatly reduce the risk of transmission, but do prevent vaccinated people that catch the virus from serious illness and death, that sounds like a much better situation compared to where we were throughout 2020, and where we are now whilst we wait for everyone that wants a jab to get one. What is your view as to what needs to happen before jabbed Australians with a covid passport can travel internationally , and folks from other countries can enter Australia without hotel quarantine?
0 # Andrew Baird 2021-02-27 21:04
Hi Simon, thank you for your comments and questions. The vaccines may reduce transmission. There are not yet enough data to provide evidence for this. As the vaccines are rolled out (over 200 million doses worldwide so far) there will be data to provide evidence of whether or not the vaccines reduce transmission of SARS-CoV-2.
As you commented, the vaccines do protect against death and serious disease due to COVID-19. They also protect against hospitalisation . The effects of the vaccines on mild disease, on moderately severe disease, and on 'long' COVID are not known - yet.
Vaccinated Australians will be able to travel overseas once Australia has eliminated the virus - this is unlikely to happen so long as the hotel quarantine program continues. Returned travellers may develop COVID-19 and there is the risk that this will get into the community as has occurred with the recent Holiday Inn outbreak in Melbourne. If there is evidence that the vaccines are 100% effective in preventing transmission of SARS-CoV-2, then vaccinated Australians could travel overseas even if Australia does not have elimination.
Australia may allow vaccinated people to come to Australia from countries that have eliminated the virus, but not from countries that have any ongoing community transmission - unless there is evidence that the vaccines are 100% effective at preventing transmission of SARS-CoV-2.

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